The Freeport-Mcmoran Copper & Gold Foundation Partners with Organizations to Work to Create

LOCAL CONTRIBUTIONS APPLICATION (Miami Operations)

I M P O R T AN T N O T ES: - This Application should only be completed if the requested amount is less than $10,000 - Requested amount may not be for more than 50% of the project budget or to support annual operating funds - Please be sure to also submit the organization’s Form W-9 - Application should not exceed the 4 pages allotted (excluding signature page) - Please be sure to complete each question. Incomplete questions may cause an application to be ineligible

ORGANIZATIONAL OVERVIEW

Date of request: Name of organization requesting funds: Name / title of main contact person: Phone number: Email address: Mailing address: Total (annual) organization budget: [ ] 501c3 [ ] 501c6 [ ] government Organizational status: [ ] other (please specify):

Name of project or activity: Grant amount requested:

Date donation is required: (if applicable) Total project budget / cost:

Project or activity START date: (if applicable) Project or activity END date: (if applicable)

Check the Focus Area / Category Does your project address a special population? For which You Are Applying:

Education Women’s Development Community Safety Senior Citizens Health & Wellness Youth Environment Other (please list): Cultural Heritage & Preservation Community/Economic Development Community Services Other (please describe)

M i a m i O p e r a t i o n s Page 1 Please describe the project for which you are requesting funds.

Please describe the geographic area you currently serve and the geographic area that the project will serve.

How many people will directly benefit from this project? Please provide a numeric value.

Please describe how the requested funds will be used. If funds will be used to purchase items/materials, please describe. (Please also include a simple budget detailing how funds will be used)

Is this a one-time project or event?

☐ Yes ☐ No

If ongoing, how long has the event occurred?

M i a m i O p e r a t i o n s Page 2 Please describe the need addressed by your project or activity

Please describe the goals of the project or activity (what you hope to accomplish)

How will you know if you’ve achieved the goals of the project?

Have you received funding from Miami Operations or Freeport-McMoRan in the past?

☐Yes ☐No

Will funding from Miami Operations help you to secure additional funding for the project? If so, how?

M i a m i O p e r a t i o n s Page 3 Please list any other partners in this project who are providing funds or other resources. (Please list any known amounts that have been or will be provided):

How might a donation support a sustainable benefit to the community, the program or your organization? What do you believe the sustainable benefit might be?

Please list any Miami Operations/Freeport-McMoRan employees that you know are involved in your organization (such as volunteers, board members or donors)

M i a m i O p e r a t i o n s Page 4 Please be sure to include support documentation and sign the Statement of Understanding on the LAST PAGE of this document. Support Documentation Required (please check the boxes to ensure these items are attached)

Copy of 501c-3 status letter from the IRS or Related Certification Copy of Form W-9 Detailed Project Budget (including other sources of funding/income) Current Board of Directors list (if applicable)

SUBMITTING APPLICATION:

Please return this application and required documents via e-mail to the following contact. If you have questions, please feel free to call or email.

Robin Horta, Community Development 928-473-7507 r ob i n_ho r t a @ f m i . c o m

STATEMENT OF UNDERSTANDING

If awarded, contributed funds must be used for developing and implementing the project as described in this application. Miami Operations has the right to disseminate information and materials developed as a result of the project.

Signature:

M i a m i O p e r a t i o n s Page 5