2014-02-10T09:19:18-06:00 2013-06-30 135381590 BDO USA LLP 7101 WISCONSIN AVE SUITE 800 BETHESDA MD 208144827 990 2012-07-01 522204473 THE GOLDEN LEAF INC GOLD 2524427474 301 N WINSTEAD AVE ROCKY MOUNT NC 27804 DANIEL J GERLACH 2524427474 2014-02-10 1 MICHAEL SORRELLS CPA P00001737 3016544900 2012 2015-11-30 17:44:51Z DANIEL J GERLACH 301 N WINSTEAD AVE ROCKY MOUNT NC 27804 315721228 0 X WWW.GOLDENLEAF.ORG X 1999 NC SEE PART III, LINE 1 15 15 15 0 74693 0 70489443 105581136 0 0 22755994 40875189 6569 5202 93252006 146461527 44742093 46018345 0 0 1600924 1702899 0 0 0 20780662 62444624 67123679 110165868 26128327 36295659 793382903 897044517 84625928 87667715 708756975 809376802 X GOLDEN LEAF'S MISSION IS TO PROMOTE THE SOCIAL WELFARE OF NORTH CAROLINA'S CITIZENS AND TO RECEIVE AND DISTRIBUTE FUNDS FOR ECONOMIC IMPACT ASSISTANCE TO ECONOMICALLY AFFECTED OR TOBACCO-DEPENDENT REGIONS OF NORTH CAROLINA. 0 0 47223132 46018345 THE PRIMARY PURPOSE FOR WHICH THIS CORPORATION WAS FORMED IS TO PROMOTE THE SOCIAL WELFARE AND LESSEN THE BURDENS OF GOVERNMENT BY RECEIVING AND DISTRIBUTING FUNDS TO BE USED TO PROVIDE ECONOMIC IMPACT ASSISTANCE TO ECONOMICALLY AFFECTED OR TOBACCO-DEPENDENT REGIONS OF NORTH CAROLINA IN ACCORDANCE WITH THE CONSENT DECREE AND FINAL JUDGMENT IN STATE OF NORTH CAROLINA V. PHILIP MORRIS INCORPORATED, ET AL., 98 CVS 14377.ACTIVITIES IN WHICH THE CORPORATION MAY ENGAGE IN THE STATE OF NORTH CAROLINA INCLUDE, BUT ARE NOT LIMITED TO, THE FOLLOWING:1. EDUCATION ASSISTANCE - PROVISION OF FUNDS FOR EDUCATIONAL PROGRAMS FOR TOBACCO FARMERS AND OTHER WORKERS IMPACTED OR PROJECTED TO BE IMPACTED BY A DECLINE IN DEMAND FOR AND/OR PRODUCTION OF TOBACCO OR TOBACCO PRODUCTS. (CONTINUED ON SCHEDULE O)2. JOB TRAINING AND EMPLOYMENT ASSISTANCE - PROVISION OF LOANS AND GRANTS, TO BE USED FOR JOB TRAINING AND OTHER EMPLOYMENT-RELATED PROGRAMS, TO ORGANIZATIONS ASSISTING TOBACCO FARMERS AND OTHER WORKERS DEPENDENT ON TOBACCO FARMING, PRODUCTION AND SALES TO TRANSITION TO OTHER SOURCES OF INCOME.3. SCIENTIFIC RESEARCH - PROVISION OF FUNDING FOR SCIENTIFIC RESEARCH TO DEVELOP NEW USES FOR TOBACCO OR FOR THE DEVELOPMENT OF ALTERNATIVE CASH CROPS.4. ECONOMIC HARDSHIP ASSISTANCE - PROVISION OF DIRECT GRANTS, LOANS AND OTHER ASSISTANCE PROGRAMS TO ALLEVIATE ECONOMIC HARDSHIP, POVERTY OR NEED EXPERIENCED BY TOBACCO FARMERS, QUOTA OWNERS, THEIR FAMILIES AND OTHERS AS A RESULT OF DECLINE IN QUOTA AND/OR PRODUCTION OF TOBACCO OR TOBACCO PRODUCTS.5. PUBLIC WORKS AND INDUSTRIAL RECRUITMENT - PROVISION OF GRANTS AND LOANS TO LOCAL GOVERNMENTS FOR UPGRADING UTILITIES, TRANSPORTATION, AND OTHER PUBLIC SERVICE INFRASTRUCTURE TO ATTRACT NEW BUSINESSES OR FOR MORE GENERAL ECONOMIC DEVELOPMENT PURPOSES.6. HEALTH AND HUMAN SERVICES - PROVISION OF FUNDING FOR IMPROVED HEALTH CARE AND OTHER SOCIAL SERVICES NEEDED TO MAINTAIN THE STABILITY OF TOBACCO-DEPENDENT COMMUNITIES.7. COMMUNITY ASSISTANCE - PROVISION OF DIRECT GRANTS AND LOANS TO ECONOMICALLY DEPRESSED AND DETERIORATING TOBACCO-DEPENDENT COMMUNITIES, TO BE USED EXCLUSIVELY FOR PUBLIC PURPOSES. 47223132 1 1 0 1 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 14 0 1 15 1 1 1 1 EI 0 0 0 0 0 0 0 0 X 15 15 0 0 0 0 0 1 1 1 1 0 0 1 1 1 1 1 1 1 0 0 X BETH EDMONDSON 2524427474 301 N WINSTEAD AVE ROCKY MOUNT NC 27804 WADE BARBER 3.00 X X 936 0 0 DALE C BONE 3.00 X 832 0 0 PAUL BROOKS 3.00 X 832 0 0 J THOMAS BUNN 3.00 X X 0 0 0 WILLIAM CLARKE 15.00 X X 1248 0 0 BRITT COBB 3.00 X 0 0 0 S LAWRENCE DAVENPORT 3.00 X X 832 0 0 DONALD E FLOW 3.00 X 0 0 0 CLAUDINE GIBSON 3.00 X 0 0 0 BILLY RAY HALL 3.00 X 1144 0 0 JAMES H JOHNSON JR 3.00 X 0 0 0 YVONNE J JOHNSON 3.00 X 624 0 0 LACY R JOYNER 3.00 X 624 0 0 J ARTHUR POPE 3.00 X 0 0 0 EDGAR M ROACH 3.00 X 1040 0 0 JOHNATHAN RHYNE 3.00 X 0 0 0 DAVID T STEPHENSON 3.00 X 0 0 0 THOMAS F TAFT SR 3.00 X X 0 0 0 EDWIN J VICK 3.00 X 0 0 0 DANIEL J GERLACH 40.00 X 186260 0 35964 MARK A SORRELLS 40.00 X 158026 0 33041 PETER J CERA 40.00 X 138934 0 30892 PATRICIA CABE-CANTRELL 40.00 X 106765 0 25019 EDWARD P LORD 40.00 X 104854 0 27300 BETH A EDMONDSON 30.00 X 90140 0 22750 793091 0 174966 5 0 1 0 ARTISAN PARTNERS 5 CONCOURSE PARKWAY SUITE 2120 ATLANTA GA 30328 INVESTMENT MANAGEMENT 369625 SILCHESTER INTERNATIONAL INVESTORS 780 THIRD AVE 42ND FLR NEW YORK NY 10017 INVESTMENT MANAGEMENT 357728 DRZ 250 PARK AVE SOUTH SUITE 250 WINTER PARK FL 32789 INVESTMENT MANAGEMENT 271160 PRIME BUCHHOLZ & ASSOCIATES INC 25 CHESTNUT STREET PORTSMOUTH NH 03801 INVESTMENT CONSULTING 245132 AXIOM INTERNATIONAL INVESTORS LLC 33 BENEDICT PLACE GREENWICH CT 06830 INVESTMENT MANAGEMENT 223537 11 105581136 105581136 11325255 74693 11250562 198809635 169259701 29549934 29549934 29549934 OTHER INCOME 900099 5202 5202 5202 146461527 5202 74693 40800496 46018345 46018345 996938 535647 461291 469288 375714 93574 46742 37367 9375 99431 69795 29636 90500 59315 31185 174510 174510 53279 53279 2228289 2228289 82549 82249 300 5111 5111 43290 43290 36213 36213 63563 63563 48898 41902 6996 2798 2798 22635 22635 PAYMENT TO STATE OF NC 59445436 59445436 MSA ENFORCEMENT 161221 161221 CAPITAL OUTLAYS 38857 38857 BOARD-DIRECTORS EXPENSE 32168 32168 5807 5807 110165868 47223132 62942736 0 445273 327381 1927 1695 167179 84348 89791 358916894 396264222 433934461 500194249 793382903 897044517 120371 144623 84505557 87523092 84625928 87667715 X 0 0 0 0 708756975 809376802 708756975 809376802 793382903 897044517 X 36295659 60510203 3813965 X X 0 1 X 1 0 X 87593455 73179244 69128105 70489443 105581136 405971383 87593455 73179244 69128105 70489443 105581136 405971383 405971383 6455370 5237547 8247547 8888370 11250562 40079396 -576622 -705680 87492 -1083463 74693 -2203580 50554 5040 8686 6569 5202 76051 443923250 0.91450 0.91640 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 0 0 0 0 1 4180 0 0 4180 0 EXPLANATION OF LOBBYING ACTIVITIES: PART II-B, LINE 1: THESE EXPENSES REPRESENT SALARY AND BENEFIT COSTS FOR OUR PRESIDENT'S TIME SPENT LOBBYING MEMBERS OF THE NC GENERAL ASSEMBLY RELATED TO STATE BUDGET BILLS AFFECTING GOLDEN LEAF FUNDING AND EDUCATING LEGISLATORS ABOUT THE FOUNDATION AND ITS WORK. 0 AG REALTY FUND VII (TE), L.P. 9900046 F ARCHSTONE OFFSHORE FUND, LTD. 22622828 F AURORA VENTURES IV & V 8404197 F AXIOM INTL EQUITY FUND II 21666873 F BEACON CAPITAL STRATEGIC PTRS V & VI 5369704 F SWIFTCURRENT OFFSHORE, LTD. 19138005 F CANTILLON GLOBAL VALUE FUND 31418783 F CARLYLE VENTURE PARTNERS II, LP 1932483 F CAROUSEL CAPITAL PARTNERS III, L.P. 3164501 F COLONY INVESTORS VIII, L.P. 2188200 F CREDIT SUISSE 2177650 F DENHAM COMMODITY PARTNERS FUND V LP 3679376 F ENCAP ENERGY CAPITAL FUND VII, L.P. 3441271 F FARALLON CAPITAL INSTITUTIONAL PARTNERS, L.P. 17095453 F FPA HAWKEYE 16003171 F HATTERAS VENTURE PARTNERS II, L.P. 7453316 F HIGHLINE CAPITAL INTERNATIONAL, LTD. 20939071 F KING STREET CAPITAL, LTD. 20116534 F LEXINGTON CAPITAL PTRS V & LCPVI-A (OFFSHORE) 7992665 F LONE CASCADE, L.P. 20976850 F MATLIN PATTERSON GLOBAL OPPORTUNITIES PTRS III, L.P. 4730408 F OZ OVERSEAS FUND II, LTD. 20376690 F Q-BLK PRIVATE CAPITAL II, (PARALLEL), L.P. 9069615 F SHEPHERD INVESTMENTS INTERNATIONAL, LTD. 2979209 F SHERIDAN PRODUCTION PARTNERS 1-B & 11 11927000 F SILCHESTER INTL VALUE EQUITY TRUST 52663213 F SILVERPOINT CAPITAL OFFSHORE FUND, LTD. 816790 F SYNERGY LIFE SCIENCE PARTNERS, LP 2293864 F REALTY ASSOCIATES FUND VIII & IX 16019015 F TACONIC OPPORTUNITY OFFSHORE FUND, LTD 21329143 F THOMAS H LEE EQUITY FUND VI, L.P. 5702132 F VARDE FUND IX & X 14477050 F WARBURG PINCUS X 14302709 F WELLINGTON ARCHIPELAGO 32481390 F WELLINGTON BAY POND 27324802 F WELLINGTON CTF COMMODITIES II 18020242 F 500194249 204668748 60510203 60510203 144158545 2228289 74693 2302982 146461527 104048921 0 104048921 2228289 3888658 6116947 110165868 PART XI, LINE 4B - OTHER ADJUSTMENTS: PASS-THROUGH UBI INCOME FROM K-1S 74,693. PART XII, LINE 4B - OTHER ADJUSTMENTS: RESCISSIONS AND RETURNS OF GRANTS 3,888,658. NORTH AMERICA - CANADA AND MEXICO, BUT 0 0 INVESTMENTS 27324802 NORTH AMERICA - CANADA AND MEXICO, BUT 0 0 INVESTMENTS 32481390 CENTRAL AMERICA AND THE CARIBBEAN - 0 0 INVESTMENTS 816790 CENTRAL AMERICA AND THE CARIBBEAN - 0 0 INVESTMENTS 2177650 CENTRAL AMERICA AND THE CARIBBEAN - 0 0 INVESTMENTS 2979209 CENTRAL AMERICA AND THE CARIBBEAN - 0 0 INVESTMENTS 6136194 CENTRAL AMERICA AND THE CARIBBEAN - 0 0 INVESTMENTS 19138005 CENTRAL AMERICA AND THE CARIBBEAN - 0 0 INVESTMENTS 20116534 CENTRAL AMERICA AND THE CARIBBEAN - 0 0 INVESTMENTS 20376689 CENTRAL AMERICA AND THE CARIBBEAN - 0 0 INVESTMENTS 20939071 CENTRAL AMERICA AND THE CARIBBEAN - 0 0 INVESTMENTS 21329143 CENTRAL AMERICA AND THE CARIBBEAN - 0 0 INVESTMENTS 22622828 EUROPE (INCLUDING ICELAND & GREENLAND) - 0 0 INVESTMENTS 31418783 0 0 0 0 0 0 111170574 116686514 227857088 1 0 0 0 0 0 1 ALEXANDER CENTRAL HIGH SCHOOL 223 SCHOOL DRIVE TAYLORSVILLE NC 28681 566000984 GOV'T ENTITY 800000 1:1 WITH CHROME BOOKS ALLEGHANY COUNTY SCHOOLS 85 PEACHTREE STREET SPARTA NC 28675 566000985 EDUCATION/EXEMPT 1199726 HANDS ON MINDS ON STEM AND MODEL CLASSROOMS APPALACHIAN DISTRICT HEALTH PO BOX 309 SPARTA NC 28675 560001534 GOV'T ENTITY 500000 ENSURING PRIMARY CARE IN ALLEGHANY COUNTY APPALACHIAN STATE UNIVERSITY 287 RIVERS ST BOONE NC 28608 561176030 STATE-NC 65000 SUSTAINABLE PRODUCTION AND QUALITY ASSURANCE FOR THE NC GRAPE/WINE INDUSTRY BEAUFORT COUNTY COMM COLLEGE 5337 HWY 264 EAST WASHINGTON NC 27889 560894923 EDUCATION/EXEMPT 188000 STRENGTHENING THE BCCC TRUCK DRIVER TRAINING PROGRAM BHM REGIONAL LIBRARY INC 158 NORTH MARKET ST WASHINGTON NC 27889 566000093 501 (C )(3) 23257 LIBRARY TECHNOLOGY CENTER WITH COMPUTERS, EQUIPMENT, AND FURNISHINGS BLUE RIDGE COMMUNITY COLLEGE 180 WEST CAMPUS DRIVE FLAT ROCK NC 28731 560941830 EDUCATION/EXEMPT 200000 MECHATRONICS BLUE RIDGE COMMUNITY COLLEGE 180 WEST CAMPUS DRIVE FLAT ROCK NC 28731 560941830 EDUCATION/EXEMPT 485000 ADVANCED MANUFACTURING UPGRADE BOYS & GIRLS CLUB OF EDENTON 131 MORRISTOWN ROAD EDENTON NC 27932 611546080 501 (C )(3) 162650 MAKING THE GRADES PROJECT BRUNSWICK COMMUNITY COLLEGE PO BOX 30 SUPPLY NC 28462 561255943 EDUCATION/EXEMPT 200000 BRUNSWICK COMMUNITY COLLEGE INCUBATOR CABARRUS HEALTH ALLIANCE 300 MOORESVILLE ROAD KANNAPOLIS NC 28081 562016594 GOV'T ENTITY 200000 CONNECTING CARE: THE NC TELEHEALTH NETWORK PROGRAM, NON-PROFIT HEALTHCARE PROVIDERS CALDWELL COMMUNITY COLLEGE 2855 HICKORY BOULEVARD HUDSON NC 28638 560817481 EDUCATION/EXEMPT 150000 PROJECT MILLWORK CATAWBA VALLEY COMM COLLEGE 2550 US HWY 70E HICKORY NC 286028302 560792028 EDUCATION/EXEMPT 900000 ENHANCED PROGRAMMING FOR CVCC SATELLITE COLLEGE CAMPUS IN ALEXANDER COUNTY - PHASE 1 CATAWBA VALLEY COMM COLLEGE 2550 US HWY 70E HICKORY NC 286028302 560792028 EDUCATION/EXEMPT 470000 CVCC PATHWAYS TO MID-SKILLS PHASE TWO ("CVCC PATHWAYS") CENTRAL PARK NC PO BOX 159 STAR NC 27356 561830629 501 (C )(3) 100000 PHASE III STARWORKS BUSINESS DEVELOPMENT EDA CHALLENGE CHOWAN COUNTY TDA 101 WEST WATER STREET EDENTON NC 27932 566000286 GOV'T ENTITY 150000 EDENTON/CHOWAN COUNTY TOURISM PROMOTION PROJECT CITY OF ASHEBORO 146 NORTH CHURCH STREET ASHEBORO NC 27204 566001167 GOV'T ENTITY 200000 WASTEWATER TO ENERGY PROJECT CITY OF BURLINGTON PO BOX 1358 BURLINGTON NC 27215 566001189 GOV'T ENTITY 695000 PROJECT SOUTHPARK CITY OF DUNN PO BOX 1065 DUNN NC 28335 566001214 GOV'T ENTITY 448000 PROJECT GLENWOOD CITY OF GRAHAM PO DRAWER 357 GRAHAM NC 27253 566001234 GOV'T ENTITY 900000 ALAMANCE COUNTY EDA/PROJECT SWORDFISH - INFRASTRUCTURE CLAY CO BOARD OF EDUCATION PO BOX 178 HAYESVILLE NC 28904 566001009 GOV'T ENTITY 98000 21ST CENTURY HEALTH CAREERS CLAY CO BOARD OF EDUCATION PO BOX 178 HAYESVILLE NC 28904 566001009 GOV'T ENTITY 750000 1:1 DEVICE INITIATIVE FOR CLAY COUNTY SCHOOLS CLAY COUNTY NORTH CAROLINA PO BOX 118 HAYESVILLE NC 28904 576000287 GOV'T ENTITY 1000000 HWY 69 SEWER LINE EXTENSION PROJECT CLEVELAND COMMUNITY COLLEGE 137 SOUTH POST ROAD SHELBY NC 28152 560848556 EDUCATION/EXEMPT 825000 CENTER FOR INTEGRATED MANUFACTURING COLLEGE OF THE ALBEMARLE 1208 NORTH ROAD STREET ELIZABETH CITY NC 279062327 566024012 EDUCATION/EXEMPT 350000 ALBEMARLE AREA WELDING WORKFORCE P.R.E.P. (PREPARING RESIDENTS FOR ECONOMIC PROSPERITY) CREST 241 TILLINGHAST STREET FAYETTEVILLE NC 28301 561258754 501 (C )(3) 13450 ADULT DAY VOCATIONAL PROGRAM, (ADVP) - INVENTORY MANAGEMENT PROJECT CTR FOR CREATIVE LEADERSHIP ONE LEADERSHIP PLACE GREENSBORO NC 274386300 237079591 GOV'T ENTITY 1550000 GOLDEN LEAF SCHOLARS LEADERSHIP PROGRAM DUPLIN COUNTY SCHOOLS 315 N MAIN STREET KENANSVILLE NC 283490128 566001020 GOV'T ENTITY 627692 DEVELOPING CAREER PATHWAYS THROUGH STEM EDENTON CHOWAN PARTNERSHIP 101 W WATER STREET EDENTON NC 27932 561978763 501 (C )(3) 130000 COMPLETING AIRPORT INDUSTRIAL PARK II (FIRING RANGE REMOVAL AND CLEAN-UP) EDENTON-CHOWAN BOARD OF EDUC PO BOX 206 EDENTON NC 27932 560889236 GOV'T ENTITY 285000 SECONDARY SCIENCE TECHNOLOGY ENGINEERING AND MATHEMATICS (STEM) CURRICULUM PROGRAMS EDENTON-CHOWAN BOARD OF EDUC PO BOX 206 EDENTON NC 27932 560889236 GOV'T ENTITY 827500 1:1 LEARNING INITIATIVE FARMER FOODSHARE INC 104 GRANITE RIDGE ROAD CHAPEL HILL NC 27516 273717889 501 (C )(3) 45000 POP FOOD MARKET FORSYTH TECH COMM COLLEGE 2100 SILAS CREEK PARKWAY WINSTONSALEM NC 27103 560792614 EDUCATION/EXEMPT 825000 BUILDING MID-SKILLS IN ADVANCED MANUFACTURING FOR THE PIEDMONT TRIAD GASTON COLLEGE 201 HIGHWAY 321 SOUTH DALLAS NC 28034 560792292 EDUCATION/EXEMPT 500000 GASTON COLLEGE CENTER FOR ADVANCED MANUFACTURING HIGH COUNTRY COMMUNITY HEALTH PO BOX 1490 BOONE NC 28607 273033445 501 (C )(3) 200000 PROVIDING PRIMARY CARE IN THE HIGH COUNTRY HOKE COUNTY 227 NORTH MAIN STREET RAEFORD NC 28376 566001525 GOV'T ENTITY 1000000 HOKE COUNTY - PHASE 1B SEWER & WATER SYSTEM IMPROVEMENTS JAMES SPRUNT COMM COLLEGE PO BOX 398 KENANSVILLE NC 28349 560892755 GOV'T ENTITY 1000000 JSCC DIESEL MECHANIC PROGRAM JOHNSTON COMMUNITY COLLEGE 245 COLLEGE ROAD SMITHFIELD NC 27577 560937578 501 (C )(3) 275000 PARTNERSHIP REALIZING IMPACT ON MANUFACTURING ECONOMY (PRIME) LAURINBURG-MAXTON AIRPORT 16701 AIRPORT ROAD MAXTON NC 28364 566018132 GOV'T ENTITY 200000 LMAC WATER SYSTEM IMPROVEMENTS FOR FCC NORTH CAROLINA LEE COUNTY INDUSTRIES INC 2711 TRAMWAY ROAD SANFORD NC 27332 560898262 501 (C )(3) 35000 DOCUMENT MANAGEMENT BUSINESS MAYLAND COMM COLLEGE FDN P O BOX 547 SPRUCE PINE NC 28777 581486405 501 (C )(3) 71000 READINESS NOW: BUILDING WORKFORCE SKILLS AND PREPAREDNESS IN AVERY COUNTY MCDOWELL COUNTY SCHOOLS 334 SOUTH MAIN STREET MARION NC 28752 566001073 GOV'T ENTITY 200000 IMPLEMENTING 9-12 ONE-TO-ONE COMPUTING IN MCDOWELL COUNTY SCHOOLS MCDOWELL EDA 25 SOUTH GARDNER STREET MARION NC 285721289 561346748 501 (C )(3) 60258 FOOTHILLS PILOT PLANT, FINAL SUSTAINABILITY PHASE MDC INC PO BOX 17268 CHAPEL HILL NC 275167268 560894222 501 (C )(3) 37500 BUILDING AN EDUCATION-TO-CAREER SYSTEM IN DURHAM METROPOLITAN COMM HEALTH PO BOX 1886 WASHINGTON NC 278891886 562143419 501 (C )(3) 200000 AGAPE CLINIC #2 SATELLITE CLINIC BELHAVEN, NORTH CAROLINA MILES JOB FUND INC PO BOX 727 SPARTA NC 28675 261802548 501 (C )(3) 75000 JOB CREATION MITCHELL COMMUNITY COLLEGE 500 WEST BROAD STREET STATESVILLE NC 28677 561048429 EDUCATION/EXEMPT 418742 GOLDEN LEAF: BUILDING TECHNICAL TALENTS MONTGOMERY COUNTY 102 EAST SPRING STREET TROY NC 273710425 566000321 GOV'T ENTITY 3500000 PROJECT SKYFALL MOSS MEMORIAL LIBRARY PO BOX 900 HAYESVILLE NC 28904 566000703 GOV'T ENTITY 60000 WORK TRAINING CENTER MOUNTAIN AREA HEALTH ED CTR 121 HENDERSONVILLE ROAD ASHEVILLE NC 288032868 561071426 501 (C )(3) 175000 PRIMARY HEALTHCARE ACCESS IN WESTERN NORTH CAROLINA NASH COMMUNITY COLLEGE 522 NORTH OLD CARRIAGE ROAD ROCKY MOUNT NC 27804 560895794 EDUCATION/EXEMPT 845000 PROJECT NC301 NASH HOSPITALS INC 2460 CURTIS ELLIS DRIVE ROCKY MOUNT NC 27804 237027004 501 (C )(3) 200000 DIGITAL RADIOGRAPHY EQUIPMENT FOR PEDIATRIC EMERGENCY DEPARTMENT NASH-ROCKY MOUNT PUBLIC SCH 930 EASTERN AVENUE NASHVILLE NC 27856 561766036 EDUCATION/EXEMPT 150000 DIGITAL CONVERSION: 21ST CENTURY PROFESSIONAL LEARNING FOR EDUCATORS NC COMMUNITY COLLEGE SYSTEM 5016 MAIL SERVICE CENTER RALEIGH NC 276995016 561288079 EDUCATION/EXEMPT 750000 GOLDEN LEAF SCHOLARS PROGRAM - TWO-YEAR COLLEGES (2013-14) NC INDEPENDENT COLLEGES 530 N BLOUNT STREET RALEIGH NC 27604 560775353 501 (C )(3) 210000 NCICU GOLDEN LEAF FOUNDATION SCHOLARSHIP PROGRAM, 2013-14 NC NEW SCHOOLS PROJECT INC 4600 MARRIOTT DRIVE SUITE 510 RALEIGH NC 276123307 204031703 501 (C )(3) 100000 1:1 NC LEARNING TECHNOLOGY INITIATIVE NC SEAA 10 TW ALEXANDER DRIVE RESEARCH TRIANGLE PARK NC 277094103 900145439 GOV'T ENTITY 1894000 GOLDEN LEAF SCHOLARS PROGRAM 2013-2014 NC STATE UNIVERSITY 2701 SULLIVAN DR SUITE 240 RALEIGH NC 276957514 566000756 STATE-NC 297244 GOLDEN LEAF MID-SKILLS EVALUATION NC STATE UNIVERSITY 2701 SULLIVAN DR SUITE 240 RALEIGH NC 276957514 566000756 STATE-NC 185326 ALTERNATIVES TO PEAT MOSS AND PERLITE IN HORTICULTURAL CROP PRODUCTION NC STATE UNIVERSITY 2701 SULLIVAN DR SUITE 240 RALEIGH NC 276957514 566000756 STATE-NC 125000 EXPANDING THE IMPACT AND SUCCESS OF THE NC 10% CAMPAIGN NC STATE UNIVERSITY 2701 SULLIVAN DR SUITE 240 RALEIGH NC 276957514 566000756 STATE-NC 199925 OPERATION: FLY GULL ROCK NC STATE UNIVERSITY CAMPUS BOX 7514 RALEIGH NC 276957626 566000756 STATE-NC 99890 ECONOMIC GROWTH FOR RURAL WOOD PRODUCTS SHOPS VIA SALES TO RETAIL STORES PHARMACY FOUNDATION OF NC 194 FINLEY GOLF COURSE RD STE 106 CHAPEL HILL NC 27517 566037918 501 (C )(3) 100000 UNC ESHELMAN SCHOOL OF PHARMACY ASHEVILLE SATELLITE PROGRAM PIEDMONT COMMUNITY COLLEGE PO BOX 1197 ROXBORO NC 27573 560990351 EDUCATION/EXEMPT 165032 PIEDMONT COMMUNITY COLLEGE'S WORKFORCE CERTIFICATION ACADEMY PIEDMONT TRIAD AIRPORT AUTH 1000 A TED JOHNSON PARKWAY GREENSBORO NC 27409 560668378 501 (C )(3) 1000000 PROJECT RADAR PITT COMMUNITY COLLEGE PO DRAWER 7007 GREENVILLE NC 278357007 560793335 GOV'T ENTITY 900000 REGIONAL PARTNERSHIP FOR INCREASING MID-LEVEL SKILLS IN ADVANCED MANUFACTURING REGENERATION DEV GROUP INC P O BOX 485 SCOTLAND NECK NC 27874 521867108 501 (C )(3) 52280 ALLIED HEALTH WORKFORCE TRAINING AND JOB CREATION PROJECT RICHMOND COUNTY SCHOOLS 118 VANCE STREET HAMLET NC 28345 566002508 EDUCATION/EXEMPT 110000 INTERACTIVE PROJECT BASED LEARNING USING 3D ROCKINGHAM COMMUNITY COLLEGE PO BOX 38 WENTWORTH NC 27289 560812577 GOV'T ENTITY 496000 WELDING FOR SUCCESS ROWAN-CABARRUS COMM COLLEGE PO BOX 1595 SALISBURY NC 28145 560792333 EDUCATION/EXEMPT 491451 ADVANCED MACHINING PROJECT SAMPSON COUNTY 406 COUNTY COMPLEX RD BLDG C CLINTON NC 28328 566000338 GOV'T ENTITY 450000 PROJECT TRIO SAMPSON COUNTY 406 COUNTY COMPLEX RD BLDG C CLINTON NC 28328 566000338 GOV'T ENTITY 450000 PROJECT TRIUMPH SAMPSON REGIONAL MEDICAL CTR 607 BEAMAN STREET 28328 CLINTON NC 283290260 560562304 501 (C )(3) 200000 EASTERN NORTH CAROLINA RURAL HOSPITAL LEAN IMPROVEMENT SCOTLAND COUNTY PO BOX 489 LAURINBURG NC 28352 566000339 GOV'T ENTITY 1000000 FCC (NORTH CAROLINA), LLC EXPANSION SOUTH PIEDMONT COMM COLLEGE PO BOX 126 POLKTON NC 28135 560893801 EDUCATION/EXEMPT 345000 MACHINING CREDENTIAL TO COLLEGE CREDIT & APPRENTICESHIP PROJECT SOUTHEASTERN COMM COLLEGE PO BOX 151 WHITEVILLE NC 284720151 560815200 EDUCATION/EXEMPT 275000 PROJECT PRIME (PLASTICS RESOURCES IN MANUFACTURING EXCELLENCE) STOKES COUNTY PO BOX 20 DANBURY NC 27016 566000340 GOV'T ENTITY 2000000 MEADOWS & FORSYTH TECHNICAL COMMUNITY COLLEGE WATER & SEWER IMPROVEMENTS TEACH FOR AMERICA NC 324 BLACKWELL ST SUITE 1160 DURHAM NC 27701 133541913 501 (C )(3) 100000 CLOSING THE ACHIEVEMENT GAP IN EASTERN NORTH CAROLINA THE SOUTHERN DOCUMENTARY FUND 762 NINTH ST 574 DURHAM NC 27705 752993148 501 (C )(3) 75000 A CHEF'S LIFE (WORKING TITLE FOR TV SERIES AND WEBSITE) TOWN OF BLOWING ROCK PO BOX 47 BLOWING ROCK NC 28605 566001184 GOV'T ENTITY 100000 HOSPITAL SERVICES EXPANSION PROJECT TOWN OF NORTH WILKESBORO 832 MAIN STREET NORTH WILKESBORO NC 28659 566001302 GOV'T ENTITY 150000 115 SEWER INFRASTRUCTURE PROJECT TOWN OF PEMBROKE PO BOX 866 PEMBROKE NC 28372 560809922 GOV'T ENTITY 1158000 ONSITE PRE-TREATMENT WASTE WATER PROCESSING PLANT TOWN OF TAYLORSVILLE 67 MAIN AVENUE DRIVE TAYLORSVILLE NC 28681 156001351 GOV'T ENTITY 300000 MILLERSVILLE COMMUNITY SANITARY SEWER PROJECT TRANSYLVANIA COUNTY SCHOOLS 225 ROSENWALD LN BREVARD NC 28712 566001121 GOV'T ENTITY 200000 MASTERING THE GLOBAL WORLD TRI-COUNTY COMMUNITY COLLEGE 21 CAMPUS CIRCLE MURPHY NC 28906 560896010 GOV'T ENTITY 55000 MACHINING TRAINING FOR INDUSTRY EXPANSION UNC - GA 910 RALEIGH ROAD CHAPEL HILL NC 275152688 566172047 EDUCATION/EXEMPT 315000 GOLDEN LEAF SCHOLARS PROGRAM, 2013-14 UNC-G 1713 HHRA BLDG GREENSBORO NC 274026170 566001468 EDUCATION/EXEMPT 200000 21ST CENTURY LEADERSHIP WITH INSTRUCTIONAL TECHNOLOGY FACILITATOR CERTIFICATION VANCE COUNTY 122 YOUNG STREET STE B HENDERSON NC 275365574 566000346 GOV'T ENTITY 7806 SATTERWHITE POINTE ROAD WATER PROJECT VIDANT DUPLIN HOSPITAL PO BOX 274 KENANSVILLE NC 28349 566011594 501 (C )(3) 389266 DUPLIN TELEHEALTH CHRONIC DISEASE MANAGEMENT PROGRAM WAYNE COMMUNITY COLLEGE PO BOX 8002 GOLDSBORO NC 275338002 560792849 EDUCATION/EXEMPT 1250000 WAYNE COMMUNITY COLLEGE'S TRAINING AND CREDENTIALING (TAC) PROJECT WAYNE COUNTY PUBLIC SCHOOLS PO DRAWER 1797 GOLDSBORO NC 27533 566001131 GOV'T ENTITY 526095 GOLDEN LEAF STEM LEARNING CENTERS WAYNE HEALTH FOUNDATION PO BOX 8001 GOLDSBORO NC 27533 581881912 501 (C )(3) 225000 WATCH HEALTHCARE PROGRAM EXPANSION WHITAKER PARK DEV AUTH 635 NORTH TRADE STREET WINSTONSALEM NC 27101 453814914 501 (C )(3) 1700000 WHITAKER PARK WILKES ADULT DEVELOPMENT PO BOX 968 NORTH WILKESBORO NC 28659 561158621 501 (C )(3) 50000 A MIND IS A TERRIBLE THING TO WASTE WILKES COMMUNITY COLLEGE PO BOX 120 WILKESBORO NC 286970120 560846669 EDUCATION/EXEMPT 1250000 WILKES COMMUNITY COLLEGE HEALTH SCIENCES CENTER WILKES DENTAL CONSORTIUM 1915 WEST PARK DRIVE STE 104 NORTH WILKESBORO NC 286593777 911943799 501 (C )(3) 305255 MOBILE DENTAL CLINIC WILSON EDC PO BOX 728 WILSON NC 278940728 560654413 GOV'T ENTITY 1000000 WOODARD PARKWAY INFRASTRUCTURE IMPROVEMENTS (WPII) YADKIN COUNTY SCHOOLS 121 WASHINGTON STREET YADKINVILLE NC 27055 566001137 EDUCATION/EXEMPT 200000 LEARNERS ENGAGED AND FUTURE-READY 98 0 PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: APPLICANTS THAT RECEIVE AWARDS FROM THE BOARD ARE REQUIRED TO SIGN A GRANTEE ACKNOWLEDGEMENT & AGREEMENT, WHICH STATES GUIDELINES AND CONDITIONS FOR A GRANT. GRANTEES MUST ALSO ATTEND A GRANTS MANAGEMENT SESSION. THE GRANTEE ACKNOWLEDGEMENT & AGREEMENT MAY CONTAIN CONDITIONS THAT MUST BE SATISFIED BEFORE FUNDS WILL BE RELEASED. THESE CONDITIONS, ALONG WITH REQUIREMENTS FOR INTERIM AND FINAL REPORTS, ARE ENTERED IN A DATABASE. ONCE THE FOUNDATION RECEIVES THE SIGNED GRANTEE ACKNOWLEDGEMENT & AGREEMENT, EVIDENCE THAT PRECONDITIONS HAVE BEEN MET, AND A WRITTEN REQUEST FOR PAYMENT, THE APPLICANT IS ELIGIBLE TO RECIEVE AN INITIAL DISBURSEMENT OF UP TO 80% OF THE GRANT AWARD. A SUM EQUAL TO 20% OF THE TOTAL AMOUNT OF THE GRANT IS RETAINED BY THE FOUNDATION UNTIL COMPLETION OF THE GRANTEE'S OBLIGATIONS UNDER THE GRANT, INCLUDING THE SUBMISSION TO THE FOUNDATION OF A FINAL REPORT ON THE FUNDED PROJECT AND SATISFACTION OF ANY REMAINING CONDITIONS TO RELEASE OF FUNDS. GRANTEES MAY USE FUNDS ONLY FOR ITEMS IDENTIFIED IN THE PROJECT'S APPROVED BUDGET. SHOULD THE GRANTEE SEEK TO SPEND FUNDS ON AN ITEM NOT INCLUDED IN THE BUDGET OR IN AN AMOUNT IN EXCESS OF THE APPROVED BUDGET AMOUNT, THE GRANTEE MUST RECEIVE APPROVAL OF A BUDGET MODIFICATION. IN NO EVENT MAY A GRANTEE SPEND GOLDEN LEAF FUNDS IN EXCESS OF THE AMOUNT AWARDED BY THE GOLDEN LEAF BOARD. GRANTEES MUST SUBMIT INTERIM REPORTS IN SIX MONTH INCREMENTS BEGINNING SIX MONTHS AFTER THE AWARD DATE AND A FINAL REPORT WITHIN 60 DAYS AFTER COMPLETION OF THE PROJECT. THE REPORTS INCLUDE INFORMATION REGARDING THE WORK ACCOMPLISHED, COMPARED TO AN APPROVED SCOPE OF WORK, REPORTED OUTCOMES OF THE PROJECT, AND EXPENDITURE REPORTS WITH SUPPORTING DOCUMENTATION. X 1 1 X X X X 0 0 0 0 0 0 0 0 0 DANIEL J GERLACH 185990 0 0 0 270 0 18973 0 16991 0 222224 0 0 0 MARK A SORRELLS 157612 0 0 0 414 0 16425 0 16616 0 191067 0 0 0 PETER J CERA 138664 0 0 0 270 0 14264 0 16628 0 169826 0 0 0 PART I, LINE 1A ROTARY CLUB DUES. PART I, LINE 1B PAYMENT OF DUES APPROVED BY BOARD. FORM 990, PART VI, SECTION A, LINE 7A THE FOUNDATION IS GOVERNED BY A BOARD OF DIRECTORS COMPRISED OF FIFTEEN DIRECTORS. FIVE DIRECTORS ARE APPOINTED BY THE GOVERNOR OF THE STATE OF NORTH CAROLINA. FIVE DIRECTORS ARE APPOINTED BY THE PRESIDENT PRO TEMPORE OF THE NORTH CAROLINA SENATE. FIVE DIRECTORS ARE APPOINTED BY THE SPEAKER OF THE NORTH CAROLINA HOUSE OF REPRESENTATIVES. FORM 990, PART VI, SECTION A, LINE 7B THE FOUNDATION MAY NOT DISPOSE OF ASSETS PURSUANT TO THE PROVISIONS OF SECTION 55A-12-02 OF THE NORTH CAROLINA GENERAL STATUTES WITHOUT THE APPROVAL OF THE NORTH CAROLINA GENERAL ASSEMBLY. THE FOUNDATION MAY NOT AMEND ITS ARTICLES OF INCORPORATION WITHOUT THE APPROVAL OF THE NORTH CAROLINA GENERAL ASSEMBLY. FORM 990, PART VI, SECTION B, LINE 11 A COPY OF FORM 990 WAS PROVIDED TO EACH MEMBER OF THE FOUNDATION'S BOARD OF DIRECTORS. THE AUDIT COMMITTEE OF THE BOARD REVIEWED THE FORM 990 AND RECOMMENDED APPROVAL TO THE FULL BOARD. THE BOARD OF DIRECTORS APPROVED THE FORM 990 PRIOR TO ITS FILING. FORM 990, PART VI, SECTION B, LINE 12C THE FOUNDATION'S BOARD OF DIRECTORS AND COMMITTEES MEET APPROXIMATELY SIX TIMES PER YEAR. AT EACH SUCH MEETING, OR GROUP OF MEETINGS, DIRECTORS ARE ASKED TO CONFIRM THEIR DISCLOSURES OR MAKE ANY NEW DISCLOSURES. WHEN A DIRECTOR DISCLOSES AN INTEREST IN A PROPOSED TRANSACTION, THE DIRECTOR DOES NOT PARTICIPATE IN THE DISCUSSION CONCERNING, OR THE VOTE UPON, THE PROPOSED TRANSACTION. FORM 990, PART VI, SECTION B, LINE 15A THE PERSONNEL COMMITTEE OF THE BOARD OF DIRECTORS REVIEWED SALARY AND BENEFIT INFORMATION FOR POSITIONS COMPARABLE TO THE PRESIDENT AT OTHER NORTH CAROLINA FOUNDATIONS AND ENDOWMENTS AND NORTH CAROLINA STATE AGENCIES PRIOR TO MAKING A RECOMMENDATION TO THE BOARD REGARDING THE PRESIDENT'S SALARY AND BENEFITS. THE BOARD APPROVED THE SALARY AND BENEFITS OF THE PRESIDENT. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY AVAILABLE UPON REQUEST. THE FINANCIAL STATEMENTS ARE MADE AVAILABLE ON THE ORGANIZATION'S WEBSITE AND UPON REQUEST. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 9: PASS-THROUGH UBI INCOME FROM K-1S -74,693. RESCISSIONS AND RETURNS OF GRANTS 3,888,658. OVERSIGHT OF AUDIT: FORM 990, PART XII, LINE 2C THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.