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Home My WebLink About15-16 Annual Spec Dist-I I I I I I I I I I I I I I I I I I I I I I I I I I FLORIDA DEPARTMENT OF ECONOMIC OPPORTUNITY Invoice No.: 32939 Date Invoiced : 10/01/2015 FY 2015/2016 SPECIAL DISTRICT FEE INVOICE AND UPDATE FORM RECEIPT Postmarked Due Date: 12/03/2015 Cape Canaveral Community Redevelopment Agency ANNUAL FEE LATE FEE RECEIVED FEE DUE Vendor: Department of Economic Opportunity Vendor No. FDEO Vendor Account No: Invoice Number 32939 Date 10/1/2015 Description FY 201 5/201 6 CRA Annual Fee $175.00 $0.00 $0.00 Check Date: Check Amount: $175.00 1029 10/16/2015 175.00 Invoice Amount v. #32939 (10/1/2015) City of Cape Canaveral VENDOR: Department of Economic Opportunity Office of Financial Management 107 E. Madison Street, MSC 120 Tallahasee, FL 32399-4124 VENDOR NO. VENDOR PHONE UMBER SHIP TO: Comm & Economic 7510 N. Atlantic Avenue Cape Canaveral, FL 32920- TERMS DATE PURCHASE ORDER No. 0000012462 BILL TO: City of Cape Canaveral 105 Polk Avenue P.O. Box 326 Cape Canaveral, FL 32920 REQUIRED DELIVERY DATE FDEO (850) 921-3223 0 10/12/2015 SHIPPING INSTRUCTIONS (none) ITEM QTY U/M DESCRIPTIONffASK PRDCODE 1.00 FY 2015/2016 Annual Fee; Inv. ACCOUNT UNIT PRICE I 06-016-559-3 I 0001 175.00 SUBTOTAL: TAX: AMOUNT 175.00 175.00 0.00 TAXABLE: No SHIPPING: A _To_T_A_L_=~~~~~~--~ CONFIRMING: IMPORTANT: OUR ORDER NUMBER MUST APPEAR ON EVERY INVOICE AND PACKAGE If specified, the right is reserved to cancel this order if not filled within the contract time. The conditions of this order are not to be modified by any verbal understanding. Invoices and packages must bear this order number.This PURCHASE ORDER VOTO AFTER 9-30-2016. \ \?.\15 l () \ FLORIDA DEPARTMENT OF ECONOMIC OPPORTUNITY FY 20~t;;2~l16.SPECIAL DISTRICT FEE INVOICE AND UPDATE FORM Invoice No.: 32939 Date Invoiced: 10/0112015 Special District Accountability Program Instructions: In accorda~ce with Sec~ions 189.064 and 189.018, F.S., and Chapter 73C-24, F.A.C., please remit the fee due payable to the Department of Economic Opportunity OR complete the Zero Annual Fee Certification Section, as appropriate. In addition, review the information below about the distr!ct and update as ne~es~ary. Provide backup documentation if the district's name or status has changed. By the post~arked due date, mail the payment and this signed form to the Department of Economic Opportunity, Office of Financial Mgmt., 107 E. Madison Street, MSC 120, Tallahassee, Florida 32399-4124. Direct questions to (850) 717-8430. ANNUAL FEE: $175.00 I LATE FEE: $0.00 I RECEIVED: $0.00 I FEE DUE, POSTMARKED BY 12/03/2015: $175.00 District's Name, Registered Agent & Office*: Cape Canaveral Community Redevelopment Agency Mr. David L. Greene 105 Polk Avenue Cape Canaveral, FL 32920 Website: E-mail: County(ies): www.cityofcapecanaveral.org d.greene@cityofcapecanaveral.org Brevard Local Governing Authority*: City of Cape Canaveral Function(s)*: Community Redevelopment Date Established: 08/21/2012 Creation Documents*: Statutory Authority*: Board Selection*: Authority to Issue Bonds*: Revenue Source*: City Resolution 2012-16 Chapter 163, Part ill, Florida Statutes Same as Local Governing Authority Yes Tax Increment Financing *Explanations Telephone: (321) 868-1230 Fax: (321) 868-1248 Status*: Dependent Creation Document: On File Map: On File Last Update: 09/1412015 RECEIVED BY CITY OF CAPE CANAVERAL FINANCE DEPT. DATE: 1q!fa / j l)' Registered Agent: Status: The person designated by the special district to accept due process on behalf of the special district Independent or Dependent-see Section 189.012, F.S. Local Governing Authority: The governing body of a unit of local general-purpose government Functions: Creation Documents: Statutory Authority: Board Selection: Authority to Issue Bonds: The function/purpose of the special district Ordinance, Resolution, Statute, Special Act, Court Decree, lnterlocal Agreement, etc. The Florida Statute governing the function of the special district Appointed, Appointed/Elected, Elected, Governor Appoints, Local Governing Authority Appoints, Same as Local Governing Authority, Similar to Local Governing Authority, Other Yes or No Revenue Sources: Ad Valorem, Agreement, Assessments, Bond Issuer Fees, Co., Donations, Fed, Fees, Other, Investments, Grants, Municipality, Non-Ad Valorem, Priv. Enterprise, Sales Surtax, Sales/Leases, State, TIF, Tolls, None CERTIFICATION: I, the undersigned registered agent, do hereby certify that the information above is accurate and complete as of this date. It does __ or d~ ~need to be changed. . Registered Agent's Signature: ~ ""::[. }-t,~ Date: ID //, /J .$ ' r 7 ZERO ANNUAL FEE CERTIFICATION SECTION-If eligible, the special district may request a zero annual fee instead of making a payment by having the registered agent certify to the following: 1. This special district is not a component unit of a general purpose local government as defined in the Governmental Accounting Standards Board's Statement No. 14, issued in June 1991 effective after December 15, 1992, as amended. 2. This special district is in compliance with the reporting requirements of the Department of Financial Services. 3. This special district reported $3,000.00 or less in annual revenues to the Department of Financial Services on its Annual Financial Report for Fiscal Year 2013/2014 (special districts created after that fiscal year must attach a current income statement verifying $3,000.00 or less in revenues for the current fiscal year). 4. This certification will be returned to the Department at the address above postmarked by 12/03/2015 and, 5. This special district understands that if the Department determines any of these items to be inaccurate, this special district must pay the appropriate fee when invoiced. The Department will verify these statements within 30 days of receiving this form. I, the undersigned registered agent, do hereby certify that to the best of my knowledge and belief, ALL of the above statements contained herein and on any attachments hereto are true, correct, complete, and made in good faith as of this date. I understand that any information I give may be investigated and verified with the Department of Financial Services and the Auditor General. SIGN ONLY IF ELIGIBLE FOR AND REQUESTING A ZERO ANNUAL FEE: FLORIDA DEPARTMENT OF ECONOMIC OPPORTUNITY Invoice No.: 32939 Date Invoiced: 10/01/2015 FY 2015/2016 SPECIAL DISTRICT FEE INVOICE AND UPDATE FORM Special District Accountability Program Instructions: In accordance with SecUons 169.064 and 169.016, F.S., and Chapter 73C-24, F.A.C., please remil the fee due payable to the Department of Economic Opportunity OR complete the Zero Annual Fee Certification Section, as appropriate. In addition, review the information below about the district and update as necessary. Provide backup documentation if the district's name or status has changed. By the postmarked due date, mail the payment and this signed form to the Department of Economic Opportunity. Office of Financial Mgmt.. 107 E. Madison Street, MSC 120, Tallahassee, Florida 32399-4124. Direct questions to (850) 717-8430. ANNUAL FEE: $175.00 I LATE FEE: $0.00 I RECEIVED: $0.00 I FEE DUE, POSTMARKED BY 12/03/2015: $175.00 District's Name, Registered Agent & Office•: Cape Canaveral Community Redevelopment Agency Mr. David L. Greene 105 Polk Avenue Cape Canaveral, FL 32920 Website: E-mail: County(les): www.cltyofcapecanaveral.org d.greene@cityofcapecanaveral.org Brevard Local Governing Authority•: City of Cape Canaveral Functlon(s)•: Community Redevelopment Date Established: 08121/2012 Creation Documents•: Statutory Authority•: Board Salactlon•: Au1horlty to Issue Bonds*: Revenue Source*: City Resolution 2012-16 Chapter 163, Part Ill, Florida Statutes Same as Local Governing Authority Yes Tax Increment Financing •Explanations Telephone: (321) 868-1230 Fax: (321) 866-1248 Status•: Dependent Creation Document: On Fiie Map: On File Last Update: 09/14/2015 RECEIVED BY CITY OF CAPE CANAVERAL FINANCE DEPT. DATE: 1qlt, / I tz"' Registered Agent: Status: The person designated by the special district to accept due process on behalf of the special district Independent or Dependent -see Section 189.012, F.S. Local Governing Authority: Functions: Creation Documents: Statu1ory Authority: Board Selection: Authority to Issue Bonds: The governing body of a unit of local general-purpose government The function/purpose of the special district Ordinance, Resolution, Statute, Special Act, Court Decree. lnterlocal Agreement, etc. The Florida Statute governing the function of the special district Appointed, Appointed/Elected, Elected, Governor Appoints, Local Governing Authority Appoints, Same as Local Governing Authority, Similar to Local Governing Authority. Other Yes or No Revenue Sources: Ad Valorem, Agreement, Assessments, Bond Issuer Fees, Co., Donations, Fed, Fees, Other, Investments, Grants, Municipality, Non-Ad Valorem, Priv. Enterprise, Sales Surtax, Sales/Leases, State, TIF, Tolls, None CERTIFICATION: I, the undersigned reg istered agent, do hereby certify that the Information above Is accurate and complete as of this date. It does __ or does not __ need to be changed. Registered Agenfs Signature:-------------------------Date: --------- ZERO ANNUAL FEE CERTIFICATION SECTION-If eligible. the special district may request a zero annual fee instead of making a payment by having the registered agent certify to the following: 1. This special district Is not a component unit of a general purpose local government as defined in the Governmental Accounting Standards Board's Statement No. 14, Issued In June 1991 effective after December 15, 1992, as amended. 2. This special district is in compliance with the reporting requirements of the Department of Financial Services. 3. This special district reported $3,000.00 or less In annual revenues to the Department of Financial Services on its Annual Financial Report for Fiscal Year 2013/2014 (special districts created after that fiscal year must attach a current income statement verifying $3,000.00 or less In revenues for the current fiscal year). 4. This certlflcallon will be returned to the Department at the address above postmarked by 12/03/2015 and, 5. This special district understands that if the Department determines any of these Items to be inaccurate, this special district must pay \he appropriate fee when Invoiced. The Department will verify these statements within 30 days of receiving this form. I, lhe undersigned registered agent, do hereby certify that to the best of my knowledge and belief, ALL of the above statements contained herein and on any attachments hereto are true, correct, complete, and made In good faith as of this date. I understand that any Information I give may be investigated and verified with the Department of Financial Services and the Auditor General. SIGN ONLY IF ELIGIBLE FOR AND REQUESTING A ZERO ANNUAL FEE: Registered Agent's Signature: Date:--------- Department Use Only: __ Verified and Approved __ Denied -Reason(s): ------------------ ' DETACH AND RETURN THIS PORTION WITH YOUR PAYMENT. DEO-SDAP-001 EffectiveOS/15/2014 DETACH AND KEEP THIS PORTION FOR YOUR RECORDS. FLORIDA DEPARTMENT OF ECONOMIC OPPORTUNITY Invoice No.: 32939 Date Invoiced: 10/01/2015 Postmarked Due Data: 12103/2015 FY 2015/2016 SPECIAL DISTRICT FEE INVOICE AND UPDATE FORM RECEIPT Cape Canaveral Community Redevelopment Agency ANNUAL FEE $175.00 LATE FEE $0.00 RECEIVED $0.00 FEE DUE $175.00