Page 1 Page 1 A B C D E F G H I J. School Business Services (217) ANNUAL STATEMENT OF AFFAIRS FOR THE FISCAL YEAR ENDING June 30, 2016

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1 Page Page A B C D E F G H I J This page must be sent to ISBE Note: For submitting to ISBE, the "Statement of Affairs" can and retained within the district/joint agreement ILLINOIS STATE BOARD OF EDUCATION be submitted as one file to avoid separating worksheets. administrative office for public inspection. School Business Services ()- SCHOOL DISTRICT/JOINT AGREEMENT NAME: South Fork CUSD DISTRICT TYPE RCDT NUMBER: Elementary ADDRESS: 0 Prairie Street - P.O. Box 0 / Kincaid, IL High School COUNTY: Christian Unit x NAME OF NEWSPAPER WHERE PUBLISHED: Breeze Courier / Taylorville, IL ASSURANCE The statement of affairs has been made available in the main administrative office of the school district/joint agreement and the required Annual Statement of Affairs Summary has been published in accordance with Section 0- of the School Code. YES CAPITAL ASSETS VALUE SIZE OF DISTRICT IN SQUARE MILES WORKS OF ART & HISTORICAL TREASURES NUMBER OF ATTENDANCE CENTERS LAND,00 MONTH AVERAGE DAILY ATTENDANCE 0 BUILDING & BUILDING IMPROVEMENTS,, NUMBER OF CERTIFICATED EMPLOYEES SITE IMPROVMENTS & INFRASTRUCTURE,0 FULL-TIME CAPITALIZED EQUIPMENT, PART-TIME CONSTRUCTION IN PROGRESS NUMBER OF NON-CERTIFICATED EMPLOYEES Total,0, FULL-TIME PART-TIME NUMBER OF PUPILS ENROLLED PER GRADE TAX RATE BY FUND (IN %) PRE-KINDERGARTEN EDUCATIONAL. KINDERGARTEN OPERATIONS & MAINTENANCE 0. FIRST BOND & INTEREST 0. SECOND TRANSPORTATION 0.00 THIRD MUNICIPAL RETIREMENT 0. FOURTH SOCIAL SECURITY 0.0 FIFTH WORKING CASH 0.0 SIXTH FIRE PREVENTION & SAFETY 0.0 SEVENTH TORT IMMUNITY 0. EIGHTH CAPITAL PROJECTS SPECIAL SPECIAL EDUCATION Total Elementary LEASING 0.0 NINTH OTHER TENTH OTHER ELEVENTH DISTRICT EQUALIZED ASSESSED VALUATION (EAV),,0 TWELFTH EQUALIZED ASSESSED VALUATION PER ADA PUPIL,0 SPECIAL TOTAL LONG TERM DEBT ALLOWED,, ##### Total Secondary 0 TOTAL LONG TERM DEBT OUTSTANDING AS OF June 0, 0,0,000 Total District 0 PERCENT OF LONG TERM DEBT OBLIGATED CURRENTLY.% ISBE 0- (0/0) ASAform.xls ANNUAL STATEMENT OF AFFAIRS FOR THE FISCAL YEAR ENDING June 0, 0 (Section 0- of the School Code)

2 Page Page A B C D E F G H I J K STATEMENT OF ASSETS AND LIABILITIES AS OF JUNE 0, 0 Description CURRENT ASSETS (00) Acct No (0) (0) (0) (0) (0) (0) (0) (0) (0) Educational Operations & Maintenance Debt Service Transportation Municipal Retirement & Social Security Capital Projects Working Cash Tort Fire Prevention & Safety Cash (Accounts thru ),,,,,0,0,0,0,0 Investments 0,0 Taxes Receivable 0 Interfund Receivables 0 Intergovernmental Accounts Receivable 0 Other Receivables 0 Inventory 0 Prepaid Items 0 Other Current Assets 0 Total Current Assets,,,,,0,0,0,0,0 CURRENT LIABILITIES (00) Interfund Payables 0 Intergovernmental Accounts Payable 0 Other Payable 0 Contracts Payable 0 Loans Payable 0 Salaries & Benefits Payable 0 Payroll Deductions & Withholdings 0 Deferred Revenues & Other Current Liabilities 0 Due to Activity Fund Organizations Total Current Liabilities LONG-TERM LIABILITIES (00) Long-Term Debt Payable Total Liabilities Reserved Fund Balance,0 Unreserved Fund Balance 0,,,,,0,0,0,0,0 Investments in General Fixed Assets Total Liabilities and Fund Balances,,,,,0,0,0,0,0

3 Page Page RECEIPTS/REVENUES A B C D E F G H I J K STATEMENT OF REVENUES RECEIVED/REVENUES, EXPENDITURES DISBURSED/EXPENDITURES, OTHER SOURCES/USES AND CHANGES IN FUND BALANCE - FOR YEAR ENDING JUNE 0, 0 Description Acct No (0) (0) (0) (0) (0) (0) (0) (0) (0) Educational Operations & Maintenance Debt Service Transportation Municipal Retirement & Social Security Capital Projects Working Cash Tort Fire Prevention & Safety Local Sources 000,,,,0,,,, 0,0 Flow-Through Received/Revenue from One District to Another District 000 State Sources 000,0,0 0,00,000,,00,00 Federal Sources 000, Total Direct Receipts/Revenues,, 0,, 0, 0,0,,, 0,0 Rec./Rev. for "On Behalf" Payments 0, Total Receipts/Revenues,0,0 0,, 0, 0,0,,, 0,0 DISBURSEMENTS/EXPENDITURES Instruction 000,0,, Support Services 000,, 0,,0,,,0 Community Services 000 Payments to Other Districts & Govt Units 000, Debt Services 000,0 Total Direct Disbursements/Expenditures,,,,0 0, 0,0,,,0 Disb./Expend. for "On Behalf" Payments 0 0, Total Disbursements/Expenditures,0,0,,0 0, 0,0,,,0 Excess of Direct Receipts/Revenues Over (Under) Direct Disbursements/Expenditures (,0),,,0,,,0, Other Sources of Funds 000 Other Uses of Funds 000 Total Other Sources/Uses of Funds Excess of Receipts/Revenues & Other Sources of Funds (Over/Under) Expenditures/Disbursements & Other Uses of Funds (,0),,,0,,,0, Beginning Fund Balances - July, 0,0,,0,,,,0,, Other Changes in Fund Balances Increases (Decreases) Ending Fund Balances June 0, 0,,,,,0,0,0,0,0

4 Page Page 0 0 A B C D E F G H I J K L M The summary must be published in the local newspaper. South Fork CUSD School District/Joint Agreement Name Telephone SUMMARY: The following is the Annual Statement of Affairs Summary that is required to be published by the school district/joint agreement for the past fiscal year. Statement of Operations as of June 0, 0 ANNUAL STATEMENT OF AFFAIRS SUMMARY FOR FISCAL YEAR ENDING JUNE 0, 0 Copies of the detailed Annual Statement of Affairs for the Fiscal Year Ending June 0, 0 will be available for public inspection in the school district/joint agreement administrative office by December, 0. Individuals wanting to review this Annual Statement of Affairs should contact: 0 Prairie Street - P.O. Box 0 / Kincaid, IL Address Also by January, 0 the detailed Annual Statement of Affairs for the Fiscal Year Ending June 0, 0, will be posted on the Illinois State Board of Education's website@ Educational Municipal Operations & Fire Prevention & Debt Services Transportation Retirement/Social Capital Projects Working Cash Tort Maintenance Safety Security Local Sources 000,,,,0,,,, 0,0 Flow-Through Receipts/Revenues from One 000 District to Another District State Sources 000,0,0 0,00,000,,00 0 0,00 0 Federal Sources 000, Total Direct Receipts/Revenues,, 0,, 0, 0,0,,, 0,0 Total Direct Disbursements/Expenditures,,,,0 0, 0,0,,,0 Other Sources/Uses of Funds Beginning Fund Balances - July, 0,0,,0,,,,0,, Other Changes in Fund Balances Ending Fund Balances June 0, 0,,,,,0,0,0,0,0 Office Hours

5 Page Page A B C D E F G SALARY SCHEDULE OF GROSS PAYMENTS FOR CERTIFICATED PERSONNEL AND NON-CERTIFICATED PERSONNEL This listing must be published in the local newspaper, sent to ISBE, and retained within your district/joint agreement administrative office for public inspection GROSS PAYMENT FOR CERTIFICATED PERSONNEL Salary Range: Less Than $,000 Salary Range: $,000 - $, Salary Range: $0,000 - $, Salary Range: 0,000 - $, Salary Range: $0,000 and over Cearlock, Jamie Allen, Sharon Auvenshine, Patricia Clark, Chris Dawson, Bruce Cassista, Stephanie Chapman, Timothy Ess, Theresa Decourcy, Eunice Chase, Angela Graham, Ron Dees, Robert Craggs, Raimee Morehouse, Doris Foiles, Marie Creviston, Kayci Oller, Tabytha Ford, Dee Fassero, Catherine Rogers, Michelle Graham, Nate Hanlon, Zach Hart, Tammy Huddleston, Beth Johnson, Charles Martin, Philip Nussmeyer, Kim Spiker, Arnold Stalets, Cindy Wempen, Rachel Wilson, Karen Foli, Kelly Harrison, Gerald Haselhorst, Courtney Hawbaker, Britni Ippolito, Jennifer Leonard, Sue Maley, Sarah Noller, Jennifer Pembrook, Lindsey Richardson, Jennifer Sapetti, Jonna Shick, David Ryan Tavernor, Judy Warren, April GROSS PAYMENT FOR NON-CERTIFICATED PERSONNEL Salary Range: Less Than $,000 Salary Range: $,000 - $, Salary Range: $0,000 - $, Salary Range: $0,000 and over Brunk, Chaya Clayton, Cameron Demichael, Brent Goeschel, Jennifer Heflin, Sam Henley, Stephanie Jack, Tabytha Jack, Christopher Jarvis, Ruth Johnson, Terri McEntire, Melanie Merano, Madison Miller, Tracey Miloncius, Jeanette Mizera, Suzanne Moore, Bobbi Jo Moore, Libby Choate, Guy Foiles, Jesse Harris, Kathy Jarvis, Marshall Dulakis, Wendy

6 Page Page 0 0 A B C D E F G Moore, Sonya Morrison, Sara Nance, Jennifer Pop, Carrie Pop, Vincent Puccetti, Danny Reid, Kristi Selzer, Ashley Skinner, Abby Stanfield, Ted Steinkuehler, Michael Watson, Lissa Wilbur, Christina Willoughby, Dawn Wilson, Allison Withrow, Michael Workman, Jane

7 Page Page A B C D E Payments over $,00, excluding wages and salaries. Person, Firm, or Corporation Aggregate Amount Person, Firm, or Corporation Aggregate Amount AMCO,0 Global Gov. Ameren Illinois, Health Alliance. Aramark, Heartland Bank and Trust. Area Learning Technology,00 Henson and Robinson.0 Atlanta National Bank, Houghton Mifflin Co. AVG Technologies,00 IL Assoc. of School Boards 0 BMO Mastercard, Il School Dist. Agency BSN Sports, IMRF. CC FS, ISBE 0 CDW Government, Midstate. Center Point Energy, JH Petty and Associates Central Supply Co,0 Johnson Controls 0. The Center,00 Kincaid Water Dept. Christian Region of Midstate, Larry's Service Center.0 Chrismont Safe School, Lively, Mathias, Hooper Cleeton Sanitation, Midwest Bus sales.0 Common Goal,0 Taxes. Consolidated Communication,0 Miller, Hall, and Triggs. Cornerstone, Morrison Electric. Dell 0, New Air Heating and Cooling. D&K Bennett 0,0 Nextera Energy. Edmentum, Taylorville.0 EFE #0, Nolen Plumbing Heating. Evans Mason, OEHS 0. Gardner Glass,0 ROE. Renaissance Learning. Scholastic Book Fair. Service Master. Serv U 0 Sherwin Williams TRS Fund. Workers Comp Insurance Xerox 0.

8 Page Page A B C D E F PAYMENTS TO PERSON, FIRM, OR CORPORATION OF $,000 TO $,00 This listing must be sent to ISBE, and retained within your district/jointagreement administrative office for public inspection. South Fork CUSD Payments of $,000 to $,00, excluding wages and salaries Person, Firm, or Corporation Aggregate Amount Person, Firm, or Corporation Aggregate Amount Ace Hardware,0 AEC Fire/Safety, American Fidelity Assurance,0 American Water Treatment,0 Barb Behrends,00 Bates Automotive,0 Blakley Heating and Cooling, Blick Art Materials, Caroliina Biological, Cavallo,00 Chalkable,0 GTM Sportswear, Life Insurance, Lowes paving and Sealcoating,0 McMillan Landscaping,00 Mediacom, Morrisonville Community,00 Pearson Education,00 Quill, Rare Pest Control, Riddell,000 RP Lumber,0 SOCS,000

9 Page Page A B C D E PAYMENTS TO PERSON, FIRM, OR CORPORATION OF $00 TO $ This listing must be retained within your district/joint agreement administrative office for public inspection. South Fork CUSD Payments of $00 to $, excluding wages and salaries. Person, Firm, or Corporation Aggregate Amount Person, Firm, or Corporation Aggregate Amount Butch's Lawnmower. SS Worldwide. Campus Agendas. TALX Ucexpress 0 Caseys General Store. Casner Industrial Lighting. Central States Bus Sales. Coy's Fire Equipment Edinburg Comm # 0. Firm Systems Forsyth Ins Co 0 Horace Mann Insurance. Human Relations Media 0. IASB Publications IESA. Il Plumbing and Heating. IPA 0 James Novar 0 Jostens. Macon/Piatt 0 McGraw Hill 00.0 MSM Conference 0 Nancy Larson Publishers 0.0 Reliance Communiciations. Reliable Environment 00 ROE # 0. Simplex Grinnell LP 0.

10 Page 0 Page 0 A REPORT ON CONTRACTS EXCEEDING $,000 AWARDED DURING FY0 In conformity with sub-section (c) of Section 0-0. of the School Code [0 ILCS /0-0.], the following information is required to be submitted in conjunction with submission of the Annual Statement of Affairs [0 ILCS /0-]. INSTRUCTIONS: (See the attached document (pdf) for additional guidance and definitions.) B 0 0 M:\ASA0\ Guidance Regardin ITEM. Count only contracts where the consideration exceeds $,000 over the life of the contract and that were awarded during FY0 and record the number below in the space provided. Do not include: () multi-year contracts awarded prior to FY0; () collective bargaining agreements with district employee groups; and () personal services contracts with individual district employees. ITEM. Aggregate the value of consideration of all contracts included in item and record the dollar amount below in the space provided. ITEM. - Count only contracts where the consideration exceeds $,000 over the life of the contract that were awarded during FY0 to minority, female, disabled or local contractors and record the number below in the space provided. Do not include: () multi-year contracts awarded prior to FY0; () collective bargaining agreements with district employee groups; and () personal services contracts with individual district employees. ITEM. Aggregate the value of consideration of all contracts included in item and record the dollar amount below in the space provided.. Total number of all contracts awarded by the school district: (Enter Number Here). Total value of all contracts awarded:, (Enter $ Amount Here). Total number of contracts awarded to minority owned businesses, female owned businesses, businesses owned by persons with disabilities, and locally owned businesses: 0 (Enter Number Here). Total value of contracts awarded to minority owned businesses, female owned businesses, businesses owned by person with disabilities, and locally owned businesses: 0 (Enter $ Amount Here)