FY2020

Instructions

This application must be completed by an officer or employee of the organization that is applying for discretionary funding. All requests for funding must be submitted and will only be accepted through the Blackbaud portal. Applications should be accurate and complete. Please keep a copy of the completed application for the organization’s records before it is submitted. All sections of the application are mandatory unless otherwise noted.

The person(s) who complete this application must be authorized by organization, and have a comprehensive understanding of the organization to be able to fully, truthfully and accurately complete the form.

All requests for funding that are submitted to the New York City Council are considered public documents.

Please review the following checklist to ensure you have all the required information to complete the application.

Please direct all questions to discretionary@council.nyc.gov

Upon completion of the application, there will be a prompt to print, complete and sign necessary documents that need to be uploaded. Please be advised that applications will not be considered finalized/complete without submission of required forms.

Below is a list of information needed in order to ably complete the application. Be sure to have this information handy to ensure a smooth application process.

Information required:

1. Federal Employer Identification Number (FEIN)

2. New York State Charities Bureau Registration Number

3. Annual Operating budget of Organization requesting funds

4. HHS Accelerator Prequalification Status and Approved Service Areas. Please note, beginning in FY2020 all applicants must register in the Mayor’s Office of Contract Services HHS Accelerator Portal.

5. Documentation concerning Independent Inquiries, Monitorships, Government Investigations, Inquiries or Audits (other than routine annual audit)

6. Staffing Information for the organization

7. Staffing Information for the programming/services

8. Certificate of Incorporation (for those incorporated on or after July 1, 2017)

9. Current list of Board Members and High/Executive Level Employees (as per IRS 990 Part VI §A and Part VII §A)

10. Please note Adobe Reader is required for viewing and printing the PDF (Portable Document Format) documents found at the end of the application. application.

Organization and Contact Info

	Legal Name of Organization Requesting Funding

	The Brooklyn Queens Land Trust

	Organization Acronym and Other Names Used

What is the Organization's Current Federal Employment Number (FEIN)

(FEIN,TIN,EIN) Use the following format: 123456789 (no dash)

611441052

Is the organization's FEIN now, or has it in the past, ever been used by any other organization(s)?

If YES please list the name of the organization(s) and time period?

Does the organization now use, or in the past, used an FEIN other than the one provided?

If yes, please enter the past FEIN Number

Is the organization tax exempt under the Internal Revenue Code?

Yes

If YES, is the organization's tax exempt status current with the Internal Revenue Service?

Yes

Has the organization ever had its tax exempt status revoked?

Please Provide the Organization's Web site

www.bqlt.org

Please provide the administrative Street Address

30 Third Avenue Suite 842

	City

	Brooklyn

	State

	NY

	Zip Code

	11217

Does the organization share office space, staff, equipment, or expenses with any other organization?

If YES, please name the organization(s) and the nature of the relationship

Has the organization ever applied for Council funding in the past?

Yes

	Was the organization incorporated before July 1, 2017

	Yes

	If no, please provide the date of incorporation

If No, you must fill out and attach this form:Supplementary Application Form

Any organization applying for New York City Council discretionary funding that was Created after July 1, 2017 must complete this form

	Is the organization registered with the Charities Bureau of the New York State Attorney General

	Yes

	If Yes, Please Provide ID Number

	212250

Is the organization exempt from registering with the Charities Bureau

If yes, you must fill out and attach this form: Charities Bureau Exemption Form

Please provide the mission/goal statement of the organization.

Ensure the conservation and preservation of open space in perpetuity, for the benefit of the general public, and act as steward of the open space properties that it owns, establish a community of gardeners in Brooklyn and Queens to: Educate and inspire people of all ages to become successful and environmentally responsible gardeners; Support community involvement in community gardening, and neighborhood beautification and open space enhancement through activities and programs, Promote the interests of community gardens. BQLT goal is to strengthen BQLT's 36 gardens and 1 affiliate gardens owned by government agencies.

What is the estimated operating budget for the organization's current fiscal year

140000

Does/will the organization apply for Prequalification Status from the Mayor’s Office of Contract Services (MOCS) via the HHS Accelerator portal?

If your organization receives more than $10,000 in City Council funding, it must be prequalified in HHS Accelerator and complete the Capacity Building Training Requirement. HHS Accelerator can be found here

Yes

	Prefix

	Miss

	First Name

	Domica

	Last Name

	Roberts

	Suffix

	<None>

Title

Program Associate

	Office Phone

	718-963-7020

	Extension

E-mail

info@bqlt.org

	Prefix

	Ms

	First Name

	Irene

	Last Name

	Van Slyke

	Suffix

	Board member

Title

Board Treasurer

	Office Phone

	7189637020

	Extension

E-mail

info@bqlt.org

Request Details

	Amount Requested
	Minimum Award is $5,000

	5000

	Contracting Agency


	DPR

Is the organization seeking funding related to Speaker Initiatives and/or City-Wide Initiatives

Speaker Initiatives and/or City-Wide Initiatives List

Please choose up to 10

No Selection / Not Applicable
Parks Equity Initiative
A Greener NYC

Council Member

Lander

Has any principal, authorized official and/or executive member of the organization ever applied for discretionary funding as a representative of another organization?

(If yes, please provide year and outcome.)

Former board member Meg Fellerath applied for small grants in 2016 through Brooklyn Greenway Initiative

	Within the last five (5) years, has the organization been subject of an independent inquiry, monitorship, government investigation or audit (by any local, state or federal government, including any current or past audit by the City Comptroller, request for information or other inquiry from the Department of Investigation, and/or any audit/inquiry by a licensing agency) other than a routing annual audit?

	No

	Has the organization’s current or former principal, senior employee(s) and/or officer been convicted of a felony, misdemeanor and/or been found in violation of any administrative, statutory and/or regulatory provision in the past ten (10) years?

	No

If yes, please describe status and outcome.

Does any current principal, employee and/or officer have any felony, misdemeanor and/or administrative charges currently pending?

If yes, please describe status and outcome.

Please provide the name of the program

BQLT gardens

Please describe the specific programming/services to be funded.

Include a description on how the requested funds will be used.

Funds will pay for the general upkeep of the Lincoln Berkeley Community Garden, that is one of BQLT's properties in the 39th district. General upkeep includes water services, repair and maintenance of garden infra-structure, tree management, fencing, pest elimination and insurance. In Lindoln Berkeley, trees need to be pruned and/or removed, and there is a need for garden tools and equipment and expert help with composting through workshops.
BQLT organizes two all garden events: a fall Celebration that offers workshops, and cultural programming and an Annual Business meeting to build community and strengthen BQLT's garden groups.

When will the program operate

Please list the times the program services operate

Gardens are open from April through November and the garden has specific open hours. Gardens are also open for events and meetings. During the fall/ winter BQLT organizes all garden events offering workshops and cultural programs. BQLT organizes monthly gardeners' meetings at its office

	Target population to be served


	Residents who live in the Park Slope area

 Geographic Area served
 e.g. Citywide; Brooklyn; Council District 39; Community Board 6; Flatbush, etc.
 District 39

Briefly describe the staffing for the program

BQLT has one part time staff member who coordinates events for garden groups as well as maintains a database through garden visits of conditions in BQLT's 35 community gardens that it owns in Brooklyn and Queens and manages DEP water systems turning water on in the spring and off in the fall. She helps and works with board member to maintain a presence in social media.

Please describe the community benefit of the program / services that is being considered for funding

The benefit to the community is: the availability of open space for use by the residents, the ability to grow crops for local consumption, to learn about climate change and community driven sustainability while building community, and to partake in arts and cultural programming.

Please provide a description of what the organization does and plans to do that invite the community

BQLT performs outreach with brochures and flyers at BQLT’s Bike and Walk tours, the Brooklyn Botanic Garden "Making Brooklyn Bloom" conference, the yearly Green Thumb conference, as well as block parties. During the growing season, BQLT organizes monthly meetings in various gardens with neighbors and garden members. BQLT also performs outreach through social media such as Facebook, Instagram, Flickr

Please Provide the address of the location/site where the programming/services are offered.

During the growing season (April through November), BQLT gardens are open during daylight hours for gardening, meetings, and events. During the winter, BQLT offers monthly garden meetings at its office space and two annual events: a Fall Celebration and an Annual Business meeting.

Has the organization proposed or similar services in the past?

Yes

If yes, briefly describe how long service(s) have been offered.

Founded in 2004, BQLT is a 501 C (3) non profit organization comprised of a 14 member board of directors, one part time staff person, and 35 gardens. Our gardens cannot be sold or developed and are permanently saved as open spaces. BQLT also manages one affiliate garden owned by the MTA. To promote and strengthen a community of gardeners, BQLT educates residents on environmentally responsible practices while supporting neighborhood beautification and community involvement.

If no, briefly explain why proposed service/program had not been previously offered; and what qualifications the organization has to start providing these services.

Did the organization receive funding for Fiscal Year 2018

Yes

If yes, please describe how the Fiscal Year 2018 funds were utilized.

(Please respond to each separate allocation your organization received.)

BQLT did not receive funding for the Lincoln Berkeley Garden located in district 39, but BQLT does take care of all its gardens and the organization bought a shed for Lincoln Berkeley. BQLT serviced all its garden properties through its office and staff, events, insurance. Lincoln Berkeley has an active garden group attends that attends BQLT's monthly meetings and annual events and partakes of all other BQLT offerings.

Please list all performance evaluations from federal, state, and city agencies for the last three years

Include agency, rating and date

BQLT has not had any performance evaluations

An organization requesting discretionary funding must itself deliver the programming/services of the funded program. Subcontractors or consultants must only be an ancillary part of the delivery of the programming/services. Does your organization have the capacity to provide the proposed programming/services?

Yes

Affiliations

Is/will the program/service be located in, operated by and/or affiliated with a religious/parochial and/or private school?

What estimated percentage of program/service participants also attend the religious/parochial and/or private school?

	Is/will the program/service be located in, operated by and/or affiliated with a religious organization and/or place of worship?

	No

	What estimated percentage of program/service participants also participate or are members of the religious organization or place of worship?

Please describe what types of outreach and/or advertising is done to invite the community/general public to invite and participate in the programming/services being offered.

Outreach with brochures and flyers at gardening events at the Brooklyn Botanic Garden Making Brooklyn Bloom, and the annual Green Thumb conference as well as block parties. During the growing season BQLT organizes monthly meetings in various gardens during the summer and in the BQLT office during the winter months.

Is/was the organization connected in any manner, officially or unofficially, to any elected official? (Please error on the side of disclosure if unsure.)

Was the organization created, founded, expanded and/or directed by any past or current elected official, or any person associated with an elected official; in either an official or an unofficial capacity?

Does the organization have any relationships, partnerships, affiliations and/or associations with any elected officials, and/or political organizations, not including discretionary funding, standard community engagement and/or participartory budgeting?

Please describe any past and/or current roles, duties, responsibilities held by any elected official; including but not limited to Board Member, Consulting, Executive Staff, Managerial Staff, or Advisor (either official or unofficial).

Does the organization share office space (physical locale/address), staff, equipment (including telephones, cell phones, internet/network, and fax services) or expenses with any other community-based organization, business or political organization/entity?

If yes, please describe and list the affiliation of any elelcted officals to the above-mentioned entities

If so, please list the name of the organization, business, elected official, political organization or political campaign, time-period, and amount/value of office space.

Has the office space ever been or currently been provided to the organization, by either donation or payment, by another not-for-profit, business, elected official, political organization and/or political campaign?

Acknowledgement

Before you resume, please review the discretionary funding policies and procedures .

Have you viewed the discretionary polices?

Yes

Do you certify that all statements, answers, information and representations given in the foregoing application and in all the supporting forms and documentation, are true, correct and accurate?

Yes

Required Attachments

Please download the forms from the link below, print them out and sign them.

After signing, please scan them and upload the forms here.

Certification of Authorization form

Conflicts of Interest Disclosure Form

Conflict o fInterest Disclosure.pdf

Organization Elected Official Affiliation Disclosure Form

Organizational Affiliation Disclosure.pdf

Please note that all applicants are required to submit a notarized Certification of Authorization form, and a signed Conflicts of Interest form. The Charities Exemption form and the Supplemental Questionnaire (found in the application) should only be completed as needed.