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Concessioner Annual Financial Report

ICR 202607-1024-005 · OMB 1024-0029 · Object 171334300.

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Concessioner Annual Financial Report
Thomas Drake
Acrobat PDFMaker 19 for Excel
2023-05-01
2019-11-04
complete

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INSTRUCTIONS FOR COMPLETING THE ANNUAL FINANCIAL REPORT
1 Enter your financial information in the dark grey cells on each of the following worksheets. Cells not highlighted in dark
grey are automatically calculated and should not be changed.
2 Since many Schedule A amounts are pulled from other schedules, it is suggested the information be input in the following
order: Schedule; G, H, J, I, P, Q, D, K, C, E, N (if needed), B then A. The input order of the remaining schedules is not
affected.
3 Use the tab key or arrow keys to move through the cells in each worksheet.
4 In the "Type of Entity" area on the Concessioner Information worksheet, make the appropriate selection using the
dropdown menu.
5 Manually enter the correct concessioner ID. Concessioner ID's take the form ABCD-###, where ABCD represents the
alphanumeric code for the park and the numbers are a contract number.
6 To move a comment box, place the cursor on the comment box, left click and hold, then drag the comment box to to
another place on the screen.
7 Generally, if there are not enough 'Other' lines, combine multiple amounts and input one number on the schedule;
provide a breakdown of the combined amounts on Schedule L unless otherwise directed.
8 The signature(s) on the Concessioner Info worksheet should be typed rather than written.
9 Do not enter zeroes, NA, dashes or anything else in cells which are not applicable to your operation. Leave these cells
blank.
10 For help, email [email protected]

OMB Control No. 1024-0029
Expiration Date: XX/XX/XXXX

NPS Form 10-356 (Rev. 12/2019)
National Park Service

CONCESSIONER: -

PERIOD ENDING: MM/DD/YYYY

For the Period from:

to:

Concessioner ID
Concessioner Name
Park Unit
Contract or Permit Number

Effective Date

Expiration Date

Type of Entity
Schedule A - Statement of Income
Schedule A-1 - Statement of Income & Comprehensive Income
Schedule B - Computation of Government Fees
Schedule C - Balance Sheet
Schedule D - Depreciable Fixed Assets (PI or LSI)
Schedule D-1 - Intangible Assets ASC Topic 853
Schedule E - Statement of Cash Flows - Direct Method
Schedule F - Notes to the Financial Statements
Schedule G - Detail of Gross Receipts

TABLE OF CONTENTS
Schedule H - Departmental Income and Expenses
Schedule I - General & Administrative Expenses
Schedule J - Info on Corporate Owners, Officers & Partners
Schedule K - Additions to & Disposals of Depreciable Fixed Assets
Schedule L - Supporting Schedule
Schedule M - Operational Statistics
Schedule P - Component Renewal/Replacement Reserve Annual Reconciliation
Schedule Q - Component Renewal/Replacement Reserve Expenditures

ANNUAL FINANCIAL STATEMENT CERTIFICATION (Either one or both of the certifications below may be completed)
COMPLETE THE CERTICATION BELOW IF YOU ARE THE CONCESSIONER AND COMPLETED THE ANNUAL FINANCIAL REPORT
By typing my name below, I certify that I am authorized to complete and submit this report. This report has been examined by me and to the best of my
knowledge and belief is a true, correct, and complete report.
Name of Person Responsible for Report Information
Title
Date
COMPLETE THE CERTIFICATION IF YOU ARE A CPA WHO HAS EITHER COMPILED, REVIEWED OR AUDITED THE CONCESSIONER'S FINANCIAL STATEMENTS
AND HAVE COMPLETED THE ANNUAL FINANCIAL REPORT.
By typing my name in the box below, I certify that I have been authorized to complete and submit this report on behalf of the concessioner. This report has
been completed and prepared under my supervision using data/information from the company's compiled/reviewed/audited financial statements and/or
other financial records and to the best of my knowledge and belief is a true, correct, and complete report.
Name of Person Responsible for Report Information
Title
Date
CONCESSIONER CONTACT INFORMATION

Mailing Address
City
State
Zip Code
Telephone
Email Address

RECORDS RETENTION. TEMPORARY. Destroy/Delete 3 years after closure. (NPS Records Schedule, Commercial Visitor Services, (Item 5D) (N1-79-08-4))

NPS Form 10-356 (Rev. 08/2019)
National Park Service

OMB Control No. 1024-0029
Expiration Date xx/xx/xxxx

NOTICES
PRIVACY ACT STATEMENT
Authority: 16 U.S.C. 5966, Commercial Use Authorizations.
Purpose: The purposes of the system are (1) to assist NPS employees in managing the NPS Commercial
Services program allowing commercial uses within a unit of the National Park System to ensure that business
activities are conducted in a manner that complies with Federal laws and regulations; (2) to monitor resources that
are or may be affected by the authorized commercial uses within a unit of the National Park System; (3) to track
applicants and holders of commercial use authorizations who are planning to conduct or are conducting business
within units of the National Park System; and (4) to provide to the public the description and contact information for
businesses that provide services in national parks.
Routine Uses: In addition to those disclosures generally permitted under 5 U.S.C.552a(b) of the Privacy Act,
records or information contained in this system may be disclosed outside DOI as a routine use pursuant to 5
U.S.C. 552a(b)(3) to other Federal, state and local governments, tribal organizations, and members of the general
public upon request for names, addresses and phone numbers of Commercial Use Authorizations (CUA) holders
conducting business within units of the National Park System for the purpose of informing the public of the
availability of the services offered by the CUA holder. In addition, records or information contained in this system
may be disclosed outside DOI based on an authorized routine use when the disclosure is compatible with the
purpose for which the records were compiled as described under the system of records notice for this system.
Disclosure: Voluntary, however, failure to provide the requested information may impede our ability to 1) manage
the National Park Service (NPS) Commercial Services Program allowing commercial uses within a unit of the NPS,
2) monitor resources that are or may be affected by the authorized commercial uses, and 3) provide the public the
description and contact information for businesses that provide services in national parks.
PAPERWORK REDUCTION ACT STATEMENT
We collect this information under the authority of Title IV of the National Parks Omnibus Management Act of 1998
(Pub. L. 105–391). We use this information to determine the franchise fees of the concessioner. Your response is
required to obtain or retain a benefit. We may not collect or sponsor and you are not required to respond to a
collection of information unless it displays a currently valid OMB control number. OMB has approved this
collection of information and assigned Control No. 1024-0029.
ESTIMATED BURDEN STATEMENT
We estimate that it will take you 15 hours to complete this form, including time to review instructions, gather and
maintain data, and complete and review the form. You may send comments on the burden estimate or any aspect
of this form to the Information Collection Clearance Officer, National Park Service at [email protected] (email).
Please do not send your completed form to this address.

CONCESSIONER: -

SCHEDULE A - COMBINED STATEMENT OF INCOME AND RETAINED EARNINGS
PERIOD ENDING: MM/DD/YYYY

DEPARTMENTAL INCOME
1 GROSS RECEIPTS (Schedule H, Column A, Line 2)
2 SALES RETURNS AND ALLOWANCES (Schedule H, Column A, Line 3)
3 NET SALES (Schedule H, Column A, Line 4)
4 COST OF SALES (Schedule H, Column A, Line 8)
5 GROSS PROFIT (Schedule H, Column A, Line 9)
6 TOTAL DIRECT EXPENSES (Schedule H, Column A, Line 34)
7 DEPARTMENTAL INCOME (LOSS) (Schedule H, Column A, Line 35)

This Period: YYYY Last Period: YYYY

INDIRECT OPERATING EXPENSES
8 General and Administrative Expenses (Schedule I, Line 29)
9 Government Fees (Schedule B, Line 32)
10 Special Account Contributions (Schedule N, Line 10)
11 TOTAL INDIRECT OPERATING EXPENSES
12 TOTAL INCOME (LOSS) FROM OPERATIONS BEFORE FIXED EXPENSES
FIXED EXPENSES
13 Rent
14 Property Taxes
15 Business/Liability/Property Insurance
16 Interest Expense
17 Depreciation (Schedule D, Column G, Line 13)
18 Amortization (Schedule D-1, Line 8)
19 (Other Fixed Expenses)
20 (Other Fixed Expenses)
21 TOTAL FIXED EXPENSES
22 INCOME (LOSS) BEFORE INCOME TAXES AND OTHER INCOME (EXPENSES)
OTHER EXPENSES (INCOME)
23 Interest and Dividend (Income)
24 Loss (Gain) on Sale of Assets
25 Commissions/Fees/Compensation from Subconcessioners (Income)(Schedule B, Line 30)
26 (Additional Other Expenses (Income))
27 (Additional Other Expenses (Income))
28 TOTAL OTHER EXPENSES (INCOME)
29 INCOME (LOSS) BEFORE INCOME TAXES
INCOME TAXES
30 Federal
31 State and Local
32 TOTAL INCOME TAXES
33 NET INCOME (LOSS)
RETAINED EARNINGS
34 Retained Earnings - Beginning of Year
35 Prior Period Adjustments
36 (Other Retained Earnings)
37 Net Income (Loss) (Line 33)
38 Dividends Paid
39 Retained Earnings - End of Year
40 Total Shares
41 Earnings Per Share
*The accompanying notes are an integral part of these financial statements.

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CONCESSIONER: -

SCHEDULE A-1 - STATEMENT OF INCOME AND COMPREHENSIVE INCOME
PERIOD ENDING: MM/DD/YYYY
This Period: YYYY

Last Period: YYYY

1 Net Income (loss) (Schedule A, Line 33)

0

0

List Other Comprehensive Income:
2 Foreign Currency Items
3 Holding Losses or Gains on Available-For-Sale-Securities
4 Excess of Additional Pension Liability
5 Changes in Market Value of Futures Contract
6 Total Comprehensive Income

0

0

*The accompanying notes are an integral part of these financial statements.

Page 5

CONCESSIONER: -

SCHEDULE B - COMPUTATION OF GOVERNMENT FEES

PERIOD ENDING: MM/DD/YYYY

1 FLAT FEE
2 BUILDING USE FEE (USE OF GOVERNMENT-OWNED IMPROVEMENTS)
PERCENTAGE FEE
3 Gross Receipts (Schedule A, Line 1)

0

PLUS: Gross Receipts of Subconcessioners
4 (Name of Subconcessioner)
5 (Name of Subconcessioner)
6 (Name of Subconcessioner)
7 Total Gross Receipts of Subconcessioners

0

LESS: Authorized Deductions (ONLY If Included in Gross Receipts)
8 Genuine Authorized Native Handicrafts (Schedule G, Line 12)
9 Intracompany Earnings
10 Charges for Employees’ Meals, Lodgings and Transportation (Schedule G, Line 66)
11 Cash Discounts on Purchases (Purchases Discounts)
12 Cash Discounts on Sales (Sales Discounts)
13 Returned Sales and Allowances (Sales Returns and Allowances) (Schedule A, Line 2)
14 Excise Taxes Added to Sales Price
15 Gasoline Taxes
16 Cost of Fishing Licenses Fees Sold
17 Cost of Postage Stamps Sold
18 Outside of Park Sales (Included in Gross Receipts)
19 (Other)
20 Total Authorized Deductions
21 Total Gross Receipts Per Contract Subject to Percentage Fee
Fee Structure:
22 (Percentage fee)
23 (Percentage fee)
24 (Percentage fee)
25 (Percentage fee)
26 TOTAL PERCENTAGE FEE

% of
% of
% of
% of

(Gross Receipts)
(Gross Receipts)
(Gross Receipts)
(Gross Receipts)

=
=
=
=

COMMISSIONS/FEES/COMPENSATION FROM SUBCONCESSIONERS
27 (Name of Subconcessioner)
28 (Name of Subconcessioner)
29 (Name of Subconcessioner)
30 Total Commissions/Fees/Compensation From Subconcessioners
31 FIFTY PERCENT OF COMMISSIONS/FEES/COMPENSATION FROM SUBCONCESSIONERS
32 TOTAL GOVERNMENT FEES (Carry to Schedule A, Line 9)
*Schedule B is for computing Government Franchise Fees only. Computation of amounts due to the Component
Renewal/Replacement Reserve and Special Accounts should be done on Schedules P and N, respectively.

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CONCESSIONER: -

SCHEDULE C - BALANCE SHEET

ASSETS
CURRENT ASSETS
1 Cash and Cash Equivalents
2 Marketable Securities
3 Inventories - Merchandise
4 Accounts Receivable
5 Notes Receivable - Related Party
6 Notes Receivable - Other
7 Prepaid Expenses
8 Component Renewal/Replacement Reserve (Schedule P, Lines 8 and 11)
9 Special Account Fund
10 (Other Current Assets)
11 TOTAL CURRENT ASSETS
FIXED ASSETS
12 Depreciable Fixed Assets (Schedule D, Column G, Line 5)
13 Less: Accumulated Depreciation (Schedule D, Column G, Line 15)
14 Net Depreciable Fixed Assets (Schedule D, Column G, Line 16)
15 Construction in Progress
16 Land
17 TOTAL FIXED ASSETS
18 Net Intangible Assets (Schedule D-1, Line 11)
19 Gross PI/LSI Subject to ASC Topic 853
20 (Other Assets)
21 TOTAL OTHER ASSETS
22 TOTAL ASSETS
LIABILITIES
CURRENT LIABILITIES
23 Notes Payable - Related Party
24 Notes Payable - Other
25 Accounts Payable
26 Current Maturities on Long - Term Debt
27 Government Fees Payable
28 Special Account Payable
29 Accrued Liabilities
30 Advance Deposits
31 (Other Current Liabilities)
32 TOTAL CURRENT LIABILITIES
LONG-TERM LIABILITIES
33 Long -Term Debt, Excluding Current Maturities
34 (Other Long-Term Liabilities)
35 TOTAL LONG-TERM LIABILITIES
36 TOTAL LIABILITIES

PERIOD ENDING: MM/DD/YYYY
This Period: YYYY

Last Period: YYYY

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EQUITY
37 Partner’s or Proprietor’s Capital
38 Common and Preferred Stock
39 (Other Equity)
40 Additional Paid - In Capital
41 Less: Treasury Stock
42 Retained Earnings (Schedule A, Line 39)
0
43 Accumulated Other Comprehensive Income (Loss)
44 TOTAL EQUITY
0
45 TOTAL LIABILITIES AND EQUITY
0
*The accompanying notes are an integral part of these financial statements.

Page 7

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SCHEDULE D - DEPRECIABLE FIXED ASSETS

CONCESSIONER: -

PERIOD ENDING: MM/DD/YYYY
FIXED ASSETS IN
WHICH LEASEHOLD
SURRENDER
INTEREST IS
CLAIMED

FIXED ASSETS IN WHICH POSSESSORY
INTEREST IS CLAIMED

COST
1 Depreciable Fixed Assets / Gross
PI subject to ASC 853, Prior Year
Balance

NPS Approved
Concessioner
Improvements
A

NPS Approved
Government
Improvements
B

NPS Approved
Capital
Improvements
C

FIXED ASSETS EXCLUDING OR NOT ELIGIBLE FOR POSSESSORY INTEREST OR
LEASEHOLD SURRENDER INTEREST

Other
Improvements

Transportation
Equipment

Furniture, Fixtures
& Equipment

Other Personal
Property

D

E

F

G

TOTAL

H

0

2 Adjustment(s) to Prior Year
Balance(s)

0

3 Additions this Year (Must be
itemized on Schedule K)

0

4 Disposals this Year (Must be
itemized on Schedule K)

0

5 Depreciable Fixed Assets, Ending
Balance (Carry Column G to
Schedule C, Line 12)

0

0

0

0

0

0

0

0

ACCUMULATED DEPRECIATION
11 Accumulated Depreciation, Prior
Year Balance

0

12 Adjustment(s) to Prior Year
Balance(s)

0

13 Depreciation this Year (Carry
Column G to Schedule A, Line 17)

0

14 Accumulated Depreciation on
Assets Disposed this Year

0

15 Accumulated Depreciation,
Ending Balance (Carry Column G
to Schedule C, Line 13)

0

0

0

0

0

0

0

0

16 Net Depreciable Fixed Assets,
End of Year (Carry Column G to
Schedule C, Line 14)

0

0

0

0

0

0

0

0

Page 8

CONCESSIONER: -

COST
1 Gross PI or LSI subject to ASC 853, Prior Year
Balance
1A ASC 853 Implementation Adjustment
2 Adjustment(s) to Prior Year Balance(s)
3 Additions this Year
4 Disposals this Year
5 Gross PI or LSI subject to ASC 853, Ending
Balance

SCHEDULE D - FINANCIAL ASSETS

PERIOD ENDING: MM/DD/YYYY

NON-FIXED ASSETS IN
WHICH LEASEHOLD
NON-FIXED ASSETS IN WHICH POSSESSORY INTEREST
SURRENDER INTEREST IS
IS CLAIMED - SUBJECT TO ASC TOPIC 853
CLAIMED - SUBJECT TO
ASC TOPIC 853
NPS Approved
NPS Approved Capital
NPS Approved Capital
Government
Improvements
Improvements
Improvements

0

0

0

0

0

0

0

0

0

VALUATION ADJUSTMENTS
6 PI or LSI valuation adjustment, Prior Year
Balance
7 Current Year PI or LSI valuation adjustment
(Carry Column H to Schedule A, Line 26)
8 PI or LSI valuation adjustment, Ending
Balance
9 PI or LSI subject to ASC 853 (Carry Column H
to Schedule C, Line 19)

Page 9

CONCESSIONER: -

SCHEDULE D - INTANGIBLE ASSETS

PERIOD ENDING: MM/DD/YYYY

COST
1 Gross intangible, Prior Year Balance
1A ASC 853 Implementation Adjustment
2 Adjustment(s) to Prior Year Balance(s)
3 Additions this Year
4 Disposals this Year
5 Gross intangible, Ending Balance

0

ACCUMULATED AMORTIZATION
6 Accumulated Amortization, Prior Year Balance
7 Adjustment(s) to Prior Year Balance(s)
8 Amortization this Year (Carry to Schedule A, Line 18)
9 Accumulated Amortization on Assets Disposed this Year
10 Accumulated Amortization, Ending Balance
11 Net intangible (Carry to Schedule C, Line 18)

0
0

Page 10

CONCESSIONER: -

SCHEDULE E - STATEMENT OF CASH FLOWS - DIRECT METHOD
PERIOD ENDING: MM/DD/YYYY
This Period: YYYY

Last Period: YYYY

0

0

CASH FLOWS FROM INVESTING ACTIVITIES
10 Purchase of assets
11 Proceeds from sale of assets
12 (Other Cash from Investing Acitivities)
13 (Other Cash from Investing Acitivities)
14 (Other Cash from Investing Acitivities)
15 (Other Cash from Investing Acitivities)
16 Net Cash Flows Provided (Used) by Investing Activities

0

0

CASH FLOWS FROM FINANCING ACTIVITIES
17 Net increase/decrease in intracompany receivable account
18 Cash received from issuing stock
19 Cash paid to retire bonds
20 Cash paid for dividends
21 (Other Cash from Financing Acitivities)
22 (Other Cash from Financing Acitivities)
23 Net Cash Flows Provided (Used) by Financing Activities
24 NET INCREASE (DECREASE) IN CASH

0
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0
0

25 CASH AT BEGINNING OF YEAR
26 CASH AT END OF YEAR (Schedule C, Line 1)

0
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0

0

0

0
0
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0
0
0

CASH FLOWS FROM OPERATING ACTIVITIES
1 Cash received from customers
2 Cash paid for merchandise
3 Cash paid for wages and other operating expenses
4a Cash received for interest
4b Cash paid for interest
5 Cash paid for taxes
6 Cash paid to National Park Service for franchise fees
7 (Other Cash from Operating Acitivities)
8 (Other Cash from Operating Acitivities)
9 Net Cash Flows Provided (Used) by Operating Activities

RECONCILIATION OF NET INCOME TO NET CASH PROVIDED BY OPERATIONS
27 Net Income (Loss) (Schedule A, line 33)
Adjustments to reconcile net income to net cash provided by operating activities
28
Depreciation expense (Schedule A, Line 17)
29
Amortization expense (Schedule A, Line 18)
30
Gain or loss on sale of assets (Schedule A, Line 24)
31
(Other non-cash expenses (income))
Changes in Assets and Liabilities:
32
Inventories
33
Accounts receivable
34
Prepaid expenses
35
Other current assets
36
Accounts payable
37
Government fees and contributions payable
38
Accrued liabilities
39
Advance deposits
40
Other current liabilities
41
(Other)
42
(Other)
43 Net Cash provided by operating activities
*The accompanying notes are an integral part of these financial statements.

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CONCESSIONER: -

SCHEDULE F - NOTES TO FINANCIAL STATEMENTS

PERIOD ENDING: MM/DD/YYYY

1
2
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*If the financial notes do not fit on this page, save them as a separate Word, Excel or PDF file and upload with the AFR. See
User's Guide for instructions.

Page 12

CONCESSIONER: -

SCHEDULE G - DETAIL OF GROSS RECEIPTS

PERIOD ENDING: MM/DD/YYYY
Reference to Table Column
on Schedule H

Amount

LODGING
1 Hotel and Motel
2 Cabins and Cottages
3 Hostels
4 Tent Cabins
5 LODGING DEPARTMENT TOTAL

0

FOOD AND BEVERAGE
6 Restaurant
7 Cafeteria
8 Snack Bar and Fast Food
9 FOOD DEPARTMENT TOTAL
10 Alcoholic Beverages

0

SOUVENIRS
11 Gifts, Curios
12 Genuine Authorized Native Handicrafts
13 SOUVENIR DEPARTMENT TOTAL

0

GENERAL MERCHANDISE
14 Grocery
15 Package Liquor
16 Camera and Photographic Supplies
17 (Other General Merchandise)
18 MERCHANDISE DEPARTMENT TOTAL

0

RECREATION VEHICLE PARKS AND CAMPSITES
19 Tents
20 RV Camping (without hook-ups)
21 RV Camping (with hook-ups)
22 RV Park
23 RV AND CAMPSITES DEPARTMENT TOTAL

0

AUTO SERVICE
24 Fuel and Oil
25 Parts, Service and Other
26 AUTO SERVICE DEPARTMENT TOTAL

0

MARINA
27 Covered Slips
28 Uncovered Slips and Mooring
29 Houseboat Rental
30 Boat and Motor Rental
31 Fuel and Oil
32 Boat and Motor Sales
33 Boat Repair
34 Dry Storage
35 (Other Marina)
36 (Other Marina)
37 MARINA DEPARTMENT TOTAL

0

TRANSPORTATION OF VISITORS
38 Water
39 Air

Page 13

CONCESSIONER: -

SCHEDULE G - DETAIL OF GROSS RECEIPTS

PERIOD ENDING: MM/DD/YYYY
Reference to Table Column
on Schedule H

Amount

40 Ground
41 (Other Transportation)
42 (Other Transportation)
43 TRANSPORTATION OF VISITORS DEPARTMENT TOTAL

0

HORSE AND MULE
44 Horse and Mule Pack Services
GUIDED TOURS
45 Float Trips and River Runners
46 Water
47 Ground (Vehicle/Tram/Bus)
48 Ground (Snowmobiles)
49 Air
50 Backcountry Horse Trail Rides
51 Backcountry Hiking
52 (Other Guided Tours)
53 (Other Guided Tours)
54 GUIDED DEPARTMENT TOTAL

0

CRUISE SHIPS
55 Cruise Ships
OTHER
56 Parking Lot
57 Vending Machine
58 Bathhouse/Health Spa Services
59 Rentals (Equipment, Video, Bicycles & Other)
60 Hunting Guides
61 Instructional Service (mountain climbing school; environmental
school, etc.)
62 Medical Care
63 Golf Course and Driving Range
64 Sports Facilities
65 (Other Departments)
66 (Other Departments)
EMPLOYEE CHARGES
67 Charges for Employee's meals, lodgings and transportation
68 TOTAL GROSS RECEIPTS

0

Page 14

SCHEDULE H - DEPARTMENTAL INCOME AND EXPENSES
CONCESSIONER: 1 DEPARTMENT
2 GROSS RECEIPTS
3 SALES RETURNS AND ALLOWANCES
4 NET SALES
COST OF SALES
5 Inventory, Beginning
6 Plus: Purchases
7 Less: Ending Inventory
8 TOTAL COST OF SALES
9 GROSS PROFIT
DIRECT EXPENSES
DIRECT LABOR
10 Direct Salaries, Wages, Payroll Taxes,
and Benefits
11 Maintenance Salaries, Payroll Taxes,
and Benefits
12 TOTAL DIRECT LABOR
OTHER DIRECT
13 Laundry
14 Uniforms
15 China, Silver, Linen and Glass
16 Commissions
17 Music and Entertainment
18 Operating Supplies
19 Equipment Rental
20 Contract Services
21 Utilities Expense
22 Licenses and Fees
23 Repair and Maintenance Expense
24 Repair and Maintenance Expensed
from Component Renewal/
Replacement Reserve
25 Vehicle Expense
26 Spoilage
27 Travel and Trip Expense
28 Equipment Purchased
29 Hay, Pasture and Feed
30 (Other Direct Expenses)
31 (Other Direct Expenses)
32 (Other Direct Expenses)
33 TOTAL OTHER DIRECT
34 TOTAL DIRECT EXPENSES
35 DEPARTMENTAL INCOME (LOSS)

PERIOD ENDING: MM/DD/YYYY
A
Total All Columns

PERIOD ENDING: MM/DD/YYYY

PERIOD ENDING: MM/DD/YYYY

B
(Department)

C
(Department)

D
(Department)

E
(Department)

F
(Department)

G
(Department)

H
(Department)

I
(Department)

J
(Department)

K
(Department)

L
(Department)

M
(Department)

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Page 15

CONCESSIONER: -

SCHEDULE I - GENERAL AND ADMINISTRATIVE EXPENSES

PERIOD ENDING: MM/DD/YYYY

This Period: YYYY
1 Owners, Officers and Partners Salaries, Payroll Taxes and Benefits (Schedule J,
Column I, Line 21)
Other Salaries, Payroll Taxes and Benefits:
2a
Office / Manager's Office
2b
Accounting / Finance
2c
Human Resources / Personnel
2d
Information System / Data Processing
2e
Marketing / Promotion
2f
(Other Salaries, Payroll Taxes and Benefits)
2g
(Other Salaries, Payroll Taxes and Benefits)
2 Total Other (Administrative) Salaries, Payroll Taxes and Benefits
3 Employee Recruitment
4 Over and Short
5 Credit Card Fees
6 Bank Charges
7 Bad Debts
8 Office Expense
9 Data Processing
10 Postage and Freight
11 Dues and Subscriptions
12 Travel Expense
13 Telecommunications Expense
14 Donations
15 Complimentary
16 Management Fees
17 Corporate Overhead
18 Legal Fees
19 Accounting and Audit Fees
20 Advertising and Promotional Expense
21 Security Expense
22 Consulting Agreements
23 Training Cost
24 Other Personnel Expenses
25 (Other G&A Expenses)
26 (Other G&A Expenses)
27 (Other G&A Expenses)
28 (Other G&A Expenses)
29 TOTAL GENERAL AND ADMINISTRATIVE EXPENSES (Carry to Schedule A, Line
8)

Page 16

Last Period: YYYY

0

0

0

0

0

CONCESSIONER: A

SCHEDULE J - INFORMATION ON CORPORATE OWNERS, OFFICERS AND PARTNERS
PERIOD ENDING: MM/DD/YYYY
B

C

D

E
% of Ownership

F

% of Time
Devoted to Partnership Common Preferred
Business
Interest
Stock
Stock

Name
Title
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20 Individual Total of Columns G and H
21 Total Amount of Owners, Officers and Partners Compensation (Carry to Schedule I, Line 1)

Page 17

G

H

Total
Wages

Total
Benefits

0

I

0

Total Amount
of
Compensation
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

SCHEDULE K - ADDITIONS TO AND DISPOSALS OF DEPRECIABLE FIXED ASSETS AND PI/LSI ASSETS
CONCESSIONER: PERIOD ENDING: MM/DD/YYYY

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40

Asset
Description

NPS
Asset #

Date of
Acquisition
Type* or Disposal

Depreciation
Method

Years of
Useful
Life

Cost

Current Year
Depreciation

Accumulated
Depreciation
for Disposal

*Use the following letters in "Type" Column to describe the assets types for all appropriate additions and disposals:
C = Concessioner improvements with or eligible for Possessory Interest.
G = Government assigned improvements with or eligible for Possessory Interest.
L = Capital improvements with or eligible for Leasehold Surrender Interest.
I = Other improvements excluding or not eligible for Leasehold Surrender Interest or Possessory Interest.
M = Concessioner's contractually required Component Renewal/Replacement Reserve.
P = Personal Property.

Page 18

CONCESSIONER: -

SCHEDULE L - SUPPLEMENTAL INFORMATION

PERIOD ENDING: MM/DD/YYYY

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
*If the financial notes do not fit on this page, save them as a separate Word, Excel or PDF file and upload with the AFR. See
User's Guide for instructions.

Page 19

CONCESSIONER: -

SCHEDULE M1 - OPERATIONAL STATISTICS

PERIOD ENDING: MM/DD/YYYY

Site:
Period Covered:
LODGING
1 Number of Rooms in Facility
2 Total Number of Room Nights Available
3 Total Number of Room Nights Occupied
4 Occupancy Percentage
5 Average Daily Room Rate (ADR)
6 Revenue Per Available Room (RevPAR)
7 Total Number of Guests
8 Number of Lodging Employees

0%
0

FOOD AND BEVERAGE
9 Number of Seats
10 Total Square Feet of Seating Area
11 Total Customers
12 Average Check per Customer
13 Number of Food and Beverage Employees
GIFTS AND MERCHANDISE
14 Total Retail Square Feet (including storage)
15 Average Transaction / square foot
16 Total Number of Retail Employees
MARINAS
17 Covered Slips
18 Uncovered Slips
19 Rental Boats and Houseboats
20 Dry Storage Units
21 Linear Feet of Wet Moorage
22 Number of Marina Employees
TRANSPORTATION / TOUR / GUIDE SERVICE
23 (Type of Trip/Tour)
24 (Type of Trip/Tour)
25 (Type of Trip/Tour)
26 (Type of Trip/Tour)
27 (Type of Trip/Tour)
28 Number of Transportation Employees
CAMPGROUNDS
29 Campground Sites
30 Number of Campground Employees
CONCESSION EMPLOYEES
31 Permanent year around employees
32 Filled seasonal positions
33 Estimated total full-time equivalents (One FTE =
2,080 hours)
CONCESSION EMPLOYEE HOUSING
34 Employee Beds
35 Direct Housing Expense

Number Available

Average Occupied

Occupancy Rate

Annual Trips

Annual Riders

Riders per Trip

Number Available

Average Occupied

Occupancy Rate

Number Available

Average Occupied

Occupancy Rate

Total

Per Occupied Bed
0.00

0%
0%
0%
0%

0
0
0
0
0

0%

Annual

Page 20

0%

CONCESSIONER: -

SCHEDULE M2 - OPERATIONAL STATISTICS

PERIOD ENDING: MM/DD/YYYY

Site:
Period Covered:
LODGING
1 Number of Rooms in Facility
2 Total Number of Room Nights Available
3 Total Number of Room Nights Occupied
4 Occupancy Percentage
5 Average Daily Room Rate (ADR)
6 Revenue Per Available Room (RevPAR)
7 Total Number of Guests
8 Number of Lodging Employees

0%
0

FOOD AND BEVERAGE
9 Number of Seats
10 Total Square Feet of Seating Area
11 Total Customers
12 Average Check per Customer
13 Number of Food and Beverage Employees
GIFTS AND MERCHANDISE
14 Total Retail Square Feet (including storage)
15 Average Transaction / square foot
16 Total Number of Retail Employees
MARINAS
17 Covered Slips
18 Uncovered Slips
19 Rental Boats and Houseboats
20 Dry Storage Units
21 Linear Feet of Wet Moorage
22 Number of Marina Employees
TRANSPORTATION / TOUR / GUIDE SERVICE
23 (Type of Trip/Tour)
24 (Type of Trip/Tour)
25 (Type of Trip/Tour)
26 (Type of Trip/Tour)
27 (Type of Trip/Tour)
28 Number of Transportation Employees
CAMPGROUNDS
29 Campground Sites
30 Number of Campground Employees

Number Available

Average Occupied

Occupancy Rate

Annual Trips

Annual Riders

Riders per Trip

Number Available

Average Occupied

Occupancy Rate

Page 21

0%
0%
0%
0%

0
0
0
0
0

0%

CONCESSIONER: -

SCHEDULE M3 - OPERATIONAL STATISTICS

PERIOD ENDING: MM/DD/YYYY

Site:
Period Covered:
LODGING
1 Number of Rooms in Facility
2 Total Number of Room Nights Available
3 Total Number of Room Nights Occupied
4 Occupancy Percentage
5 Average Daily Room Rate (ADR)
6 Revenue Per Available Room (RevPAR)
7 Total Number of Guests
8 Number of Lodging Employees

0%
0

FOOD AND BEVERAGE
9 Number of Seats
10 Total Square Feet of Seating Area
11 Total Customers
12 Average Check per Customer
13 Number of Food and Beverage Employees
GIFTS AND MERCHANDISE
14 Total Retail Square Feet (including storage)
15 Average Transaction / square foot
16 Total Number of Retail Employees
MARINAS
17 Covered Slips
18 Uncovered Slips
19 Rental Boats and Houseboats
20 Dry Storage Units
21 Linear Feet of Wet Moorage
22 Number of Marina Employees
TRANSPORTATION / TOUR / GUIDE SERVICE
23 (Type of Trip/Tour)
24 (Type of Trip/Tour)
25 (Type of Trip/Tour)
26 (Type of Trip/Tour)
27 (Type of Trip/Tour)
28 Number of Transportation Employees
CAMPGROUNDS
29 Campground Sites
30 Number of Campground Employees

Number Available

Average Occupied

Occupancy Rate

Annual Trips

Annual Riders

Riders per Trip

Number Available

Average Occupied

Occupancy Rate

Page 22

0%
0%
0%
0%

0
0
0
0
0

0%

CONCESSIONER: -

SCHEDULE M4 - OPERATIONAL STATISTICS

PERIOD ENDING: MM/DD/YYYY

Site:
Period Covered:
LODGING
1 Number of Rooms in Facility
2 Total Number of Room Nights Available
3 Total Number of Room Nights Occupied
4 Occupancy Percentage
5 Average Daily Room Rate (ADR)
6 Revenue Per Available Room (RevPAR)
7 Total Number of Guests
8 Number of Lodging Employees

0%
0

FOOD AND BEVERAGE
9 Number of Seats
10 Total Square Feet of Seating Area
11 Total Customers
12 Average Check per Customer
13 Number of Food and Beverage Employees
GIFTS AND MERCHANDISE
14 Total Retail Square Feet (including storage)
15 Average Transaction / square foot
16 Total Number of Retail Employees
MARINAS
17 Covered Slips
18 Uncovered Slips
19 Rental Boats and Houseboats
20 Dry Storage Units
21 Linear Feet of Wet Moorage
22 Number of Marina Employees
TRANSPORTATION / TOUR / GUIDE SERVICE
23 (Type of Trip/Tour)
24 (Type of Trip/Tour)
25 (Type of Trip/Tour)
26 (Type of Trip/Tour)
27 (Type of Trip/Tour)
28 Number of Transportation Employees
CAMPGROUNDS
29 Campground Sites
30 Number of Campground Employees

Number Available

Average Occupied

Occupancy Rate

Annual Trips

Annual Riders

Riders per Trip

Number Available

Average Occupied

Occupancy Rate

Page 23

0%
0%
0%
0%

0
0
0
0
0

0%

CONCESSIONER: -

SCHEDULE M5 - OPERATIONAL STATISTICS

PERIOD ENDING: MM/DD/YYYY

Site:
Period Covered:
LODGING
1 Number of Rooms in Facility
2 Total Number of Room Nights Available
3 Total Number of Room Nights Occupied
4 Occupancy Percentage
5 Average Daily Room Rate (ADR)
6 Revenue Per Available Room (RevPAR)
7 Total Number of Guests
8 Number of Lodging Employees

0%
0

FOOD AND BEVERAGE
9 Number of Seats
10 Total Square Feet of Seating Area
11 Total Customers
12 Average Check per Customer
13 Number of Food and Beverage Employees
GIFTS AND MERCHANDISE
14 Total Retail Square Feet (including storage)
15 Average Transaction / square foot
16 Total Number of Retail Employees
MARINAS
17 Covered Slips
18 Uncovered Slips
19 Rental Boats and Houseboats
20 Dry Storage Units
21 Linear Feet of Wet Moorage
22 Number of Marina Employees
TRANSPORTATION / TOUR / GUIDE SERVICE
23 (Type of Trip/Tour)
24 (Type of Trip/Tour)
25 (Type of Trip/Tour)
26 (Type of Trip/Tour)
27 (Type of Trip/Tour)
28 Number of Transportation Employees
CAMPGROUNDS
29 Campground Sites
30 Number of Campground Employees

Number Available

Average Occupied

Occupancy Rate

Annual Trips

Annual Riders

Riders per Trip

Number Available

Average Occupied

Occupancy Rate

Page 24

0%
0%
0%
0%

0
0
0
0
0

0%

CONCESSIONER: -

SCHEDULE M6 - OPERATIONAL STATISTICS

PERIOD ENDING: MM/DD/YYYY

Site:
Period Covered:
LODGING
1 Number of Rooms in Facility
2 Total Number of Room Nights Available
3 Total Number of Room Nights Occupied
4 Occupancy Percentage
5 Average Daily Room Rate (ADR)
6 Revenue Per Available Room (RevPAR)
7 Total Number of Guests
8 Number of Lodging Employees

0%
0

FOOD AND BEVERAGE
9 Number of Seats
10 Total Square Feet of Seating Area
11 Total Customers
12 Average Check per Customer
13 Number of Food and Beverage Employees
GIFTS AND MERCHANDISE
14 Total Retail Square Feet (including storage)
15 Average Transaction / square foot
16 Total Number of Retail Employees
MARINAS
17 Covered Slips
18 Uncovered Slips
19 Rental Boats and Houseboats
20 Dry Storage Units
21 Linear Feet of Wet Moorage
22 Number of Marina Employees
TRANSPORTATION / TOUR / GUIDE SERVICE
23 (Type of Trip/Tour)
24 (Type of Trip/Tour)
25 (Type of Trip/Tour)
26 (Type of Trip/Tour)
27 (Type of Trip/Tour)
28 Number of Transportation Employees
CAMPGROUNDS
29 Campground Sites
30 Number of Campground Employees

Number Available

Average Occupied

Occupancy Rate

Annual Trips

Annual Riders

Riders per Trip

Number Available

Average Occupied

Occupancy Rate

Page 25

0%
0%
0%
0%

0
0
0
0
0

0%

CONCESSIONER: -

SCHEDULE M7 - OPERATIONAL STATISTICS

PERIOD ENDING: MM/DD/YYYY

Site:
Period Covered:
LODGING
1 Number of Rooms in Facility
2 Total Number of Room Nights Available
3 Total Number of Room Nights Occupied
4 Occupancy Percentage
5 Average Daily Room Rate (ADR)
6 Revenue Per Available Room (RevPAR)
7 Total Number of Guests
8 Number of Lodging Employees

0%
0

FOOD AND BEVERAGE
9 Number of Seats
10 Total Square Feet of Seating Area
11 Total Customers
12 Average Check per Customer
13 Number of Food and Beverage Employees
GIFTS AND MERCHANDISE
14 Total Retail Square Feet (including storage)
15 Average Transaction / square foot
16 Total Number of Retail Employees
MARINAS
17 Covered Slips
18 Uncovered Slips
19 Rental Boats and Houseboats
20 Dry Storage Units
21 Linear Feet of Wet Moorage
22 Number of Marina Employees
TRANSPORTATION / TOUR / GUIDE SERVICE
23 (Type of Trip/Tour)
24 (Type of Trip/Tour)
25 (Type of Trip/Tour)
26 (Type of Trip/Tour)
27 (Type of Trip/Tour)
28 Number of Transportation Employees
CAMPGROUNDS
29 Campground Sites
30 Number of Campground Employees

Number Available

Average Occupied

Occupancy Rate

Annual Trips

Annual Riders

Riders per Trip

Number Available

Average Occupied

Occupancy Rate

Page 26

0%
0%
0%
0%

0
0
0
0
0

0%

SCHEDULE P - COMPONENT RENEWAL/REPLACEMENT RESERVE ANNUAL RECONCILIATION
CONCESSIONER: PERIOD ENDING: MM/DD/YYYY
CALCULATION OF COMPONENT RENEWAL/REPLACEMENT RESERVE
1 Gross Receipts (Schedule A, Line 1)
2 Less - Adjustments to Gross Receipts (Schedule B, Line 20)
3 Gross Receipts Subject to Reserve Calculation (Schedule B, Line 21)
4 Component Renewal/Replacement Reserve Percentage
5 Amount Due to Component Renewal/Replacement Reserve
6 (Other Method - Per Authorization (Specify Calculations))
7 Total Amount Due to Component Renewal/Replacement Reserve for the Current Year
COMPONENT RENEWAL/REPLACEMENT RESERVE RECONCILIATION
8 Balance in Component Renewal/Replacement Reserve from Prior Year
9 Total Amount Due to Component Renewal/Replacement Reserve for Current Year
10 Less: Total Expenditures Made in Current Year (Schedule Q, Line 40)
11 Balance in Component Renewal/Replacement Reserve at Year End

Page 27

0
0
0
0
0

0
0
0

CONCESSIONER: -

SCHEDULE Q - COMPONENT RENEWAL/REPLACEMENT RESERVE EXPENDITURES
PERIOD ENDING: MM/DD/YYYY

Expenditure Description

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40 TOTAL EXPENDITURES MADE IN CURRENT YEAR

Expenditures Made in
Current Year

AFR Reference*

0

*Identify which Schedule(s) and Line(s) each Expenditure is Reported on in the AFR

Page 28

NPS Approval
Date

Schedule K, Type
C
G
L
I
M
P

Concessioner Info, Type of Entity
C Corporation
S Corporation
B Corporation
Limited Liability Company
Partnership
Sole Proprietorship
Other