2012-05-15T08:23:09-05:00 2011-06-30 ERNST & YOUNG US LLP 75 BEATTIE PLACE SUITE 800 GREENVILLE SC 29601 990 2010-07-01 592451713 H LEE MOFFITT CANCER CENTER AND RESEARCH INSTITUTE INC HLEE 8137454673 12902 MAGNOLIA DRIVE TAMPA FL 33612 JANENE CULUMBER 8137451329 2012-05-15 0 EMILY STANCIL 8642425740 2010 2016-02-24 21:20:13Z WILLIAM S DALTON MD PHD 12902 MAGNOLIA DRIVE TAMPA FL 33612 148633947 0 X WWW.MOFFITT.ORG X 1984 FL TO PROMOTE AND SUPPORT THROUGH RESEARCH, MANAGEMENT AND OTHER MEANS OF SUPPORT. 20 19 1491 290 1970 0 94099419 111419521 3691373 1715798 64234 2376988 532987 1272356 98388013 116784663 20550 233784 0 0 75041589 115492094 0 0 0 49737222 20514455 124799361 136240333 -26411348 -19455670 286521048 520418415 253605994 289922597 32915054 230495818 X TO PROMOTE AND SUPPORT H. LEE MOFFITT CANCER CENTER AND RESEARCH INSTITUTE HOSPITAL, H. LEE MOFFITT CANCER CENTER AND RESEARCH INSTITUTE LIFETIME CANCER SCREENING CENTER, AND H. LEE MOFFITT CANCER CENTER AND RESEARCH INSTITUTE FOUNDATION THROUGH RESEARCH, MANAGEMENT AND OTHER MEANS OF SUPPORT. 0 0 89622862 233784 2402388 THE H. LEE MOFFITT CANCER CENTER AND RESEARCH INSTITUTE, INC. IS A RECOGNIZED LEADER IN FOCUSED, INNOVATIVE CANCER RESEARCH, A MAJOR REGIONAL ONCOLOGY REFERRAL CENTER, AND A NATIONAL CANCER INSTITUTE DESIGNATED COMPREHENSIVE CANCER CENTER.BASED ON ITS SINGULAR MISSION - TO CONTRIBUTE TO THE PREVENTION AND CURE OF CANCER - THE CANCER CENTER'S RESEARCH ACTIVITIES RELATE PRIMARILY TO THE AREAS OF BASIC SCIENCE, CANCER PREVENTION AND CONTROL, TRANSLATIONAL SCIENCE, PRE-CLINICAL AND CLINICAL INVESTIGATIONS, AND PROVIDING MANAGEMENT AND OTHER SUPPORT SERVICES AS THE SOLE CORPORATE MEMBER AND PARENT FOR THE FOLLOWING SUBSIDIARY CORPORATIONS: H. LEE MOFFITT CANCER CENTER AND RESEARCH INSTITUTE HOSPITAL, INC. (THE HOSPITAL) WHICH PROVIDES MEDICAL AND HOSPITAL CARE, MEDICAL EDUCATION AND TRAINING, AND CLINICAL (PATIENT-RELATED) RESEARCH IN MAINTAINING HEALTH, AND PREVENTING, DETECTING, AND TREATING CANCER;H. LEE MOFFITT CANCER CENTER AND RESEARCH INSTITUTE LIFETIME CANCER SCREENING CENTER, INC. (MOFFITT MEDICAL GROUP) WHICH EMPLOYS AND MANAGES PHYSICIANS AND OTHER MEDICAL PROFESSIONALS WHO STAFF THE HOSPITAL, AND PROVIDE CLINICAL RESEARCH SERVICES TO THE CANCER CENTER; ANDH. LEE MOFFITT CANCER CENTER AND RESEARCH INSTITUTE FOUNDATION, INC. (THE FOUNDATION) WHICH IS THE PRINCIPAL FUND-RAISING ORGANIZATION FOR THE CANCER CENTER AND ITS SUBSIDIARIES.THE CANCER CENTER'S MULTIDISCIPLINARY CLINICAL PROGRAM STRUCTURE AND OPEN LABORATORY ARCHITECTURE PROVIDE AN ENVIRONMENT CONDUCIVE FOR TRAINING FUTURE SCIENTIFIC AND CLINICAL LEADERS IN ONCOLOGY, AND REFLECT THE CANCER CENTER'S COMMITMENT TO COLLABORATION IN ALL ASPECTS OF CANCER RESEARCH. 89622862 1 1 0 1 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 1 0 1 1 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 1 1 1 0 0 1 210 0 1491 1 1 1 0 0 0 0 0 0 0 0 0 0 X 20 19 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 0 1 1 1 0 X JANENE CULUMBER 8137451329 12902 MAGNOLIA DR TAMPA FL 33612 X ROBERT ROTHMAN 1.00 X X 0 0 0 SENATOR CONNIE MACK 1.00 X X 0 0 0 TIMOTHY J ADAMS 1.00 X X 0 0 0 DONALD D BUCHANAN 1.00 X X 0 0 0 CARLOS ALFONSO 1.00 X 0 0 0 JORGE ARRIZURIETA 1.00 X 0 0 0 ANGELA BIEVER 1.00 X 0 0 0 THE HONORABLE CARL CARPENTER JR 1.00 X 0 0 0 THEODORE J COUCH SR 1.00 X 0 0 0 EDWARD C DROSTE 1.00 X 0 0 0 CECELIA D FERMAN 1.00 X 0 0 0 JUDY L GENSHAFT PHD 1.00 X 0 0 0 THE HONORABLE JOHN A GRANT 1.00 X 0 0 0 THE HONORABLE JAMES T HARGRETT 1.00 X 0 0 0 REVEREND MONSIGNOR LAURENCE HIGGINS 1.00 X 0 0 0 BENJAMIN H HILL III ESQ 1.00 X 0 0 0 BETH A HOUGHTON 1.00 X 0 0 0 RHEA F LAW ESQ 1.00 X 0 0 0 GARY W LITMAN PHD 1.00 X 0 0 0 THE HONORABLE H LEE MOFFITT 1.00 X 0 0 0 WILLIAM S DALTON 33.00 X 1314151 0 67154 LOUIS D DE LA PARTE 17.00 X 465035 0 39330 JOHN A KOLOSKY 17.00 X 725119 0 43330 ALAN F LIST 7.00 X 0 645585 43267 JAMES J MULAY 54.00 X 467715 0 36823 WARREN J PLEDGER 55.00 X 635507 0 41830 NICOLAS C PORTER 17.00 X 574354 0 39695 THOMAS A SELLERS 55.00 X 561879 0 47650 DANIEL M SULLIVAN 20.00 X 567706 0 44228 YVETTE LYONS TREMONTI 22.00 X 302801 0 37774 TIMOTHY J YEATMAN 5.00 X 0 816498 44960 MICHAEL K BENEDICT 55.00 X 296779 0 38250 JANENE CULUMBER 17.00 X 394396 0 34904 B LEE GREEN 55.00 X 258263 0 39675 DEAN R HEAD 55.00 X 206862 0 26423 DORTE HEIMBECK 31.00 X 62245 47734 8735 JOE HICE 55.00 X 0 0 0 MARK F HULSE 55.00 X 285574 0 33600 DANA E ROLLISON 55.00 X 115767 0 30527 W J WILSON 33.00 X 177270 108994 26240 LYNN C MOSCINSKI 5.00 X 0 473929 32282 ALEXANDER ANDERSON 55.00 X 282696 0 43818 SRIKUMAR CHELLAPPAN 55.00 X 315788 0 42570 ROBERT J GILLIES 55.00 X 405434 0 40635 ANNA R GIULIANO 55.00 X 261788 0 44364 SAID M SEBTI 55.00 X 441071 0 42507 BRAULIO VICENTE JR 0.00 X 0 358349 42361 W MICHAEL ALBERTS 0.00 X 0 423407 44229 ANNE L GOFF 0.00 X 136920 0 8718 9255120 2874496 1065879 143 1 1 0 SHUMAKER LOOP & KENDRICK LLP 101 E KENNEDY BLVD STE 2800 TAMPA FL 33602 LEGAL SERVICES 1579971 DELOITTE CONSULTING LLP 4022 SELLS DRIVE HERMITAGE TN 37076 CONSULTING SERVICES 1287104 THEO EXECUTIVE GROUP LLC 909 LAKE CAROLYN PKWY STE 775 IRVING TX 75039 ADVISORY SERVICES 318824 FORD & HARRISON LLP 101 E KENNEDY BLVD STE 900 TAMPA FL 33602 LEGAL SERVICES 231252 ROPES & GRAY LLP PO BOX 414265 BOSTON MA 02241 LEGAL SERVICES 223663 10 11975069 87908543 11535909 2101481 111419521 REIMBURSEMENTS 541900 1567147 1567147 CYCLOTRON 900099 120000 120000 CANCER REGISTRY 900099 28651 28651 1715798 1801892 1801892 581190 581190 31841994 1196 31710349 138935 131645 -137739 -6094 -6094 SERIES 2002B BONDS 523000 554437 554437 SERIES 2002A BONDS 523000 353252 353252 LICENSE FEES 541700 249256 249256 115411 105400 1970 8041 1272356 116784663 2402388 1970 2960784 233784 233784 9262087 4508831 4753256 53908 53908 84954188 46911997 38042191 2262891 1235616 1027275 15764284 8607837 7156447 3194736 1744435 1450301 2797892 2797892 266451 266451 207515 207515 105670 105670 8006025 4321367 3684658 2178026 2178026 22154562 8066228 14088334 3510685 3510685 15720468 5928088 9792380 1516764 1039482 477282 8790874 8790874 27878445 10512783 17365662 1848644 1848644 PURCHASED SERVICES 14037732 11065959 2971773 SUBCONTRACTS 8639568 8639568 LICENSES & FEES 2624685 205583 2419102 MINOR EQUIPMENT 2416223 84924 2331299 PURCHASED SERVICES - SP 975431 975431 -103161205 -36562587 -66598618 136240333 89622862 46617471 0 24075841 36644638 3998785 3941855 8300899 9186786 244062 88674 12953089 15679563 570879300 243133399 123142437 327745901 113805935 127130998 286521048 520418415 58629711 77634851 61706 208480 194914577 210026076 0 2053190 253605994 289922597 X -13483817 189844672 46398871 40651146 32915054 230495818 286521048 520418415 X -19455670 217036434 X 0 1 1 X 1 1 X 94377844 112810991 116278541 94099419 111419521 528986316 94377844 112810991 116278541 94099419 111419521 528986316 528986316 448766 605108 419553 104679 2383082 3961188 4830 42103 1970 48903 495315 598727 675538 490884 1270386 3530850 536527257 9316358 0.98590 0.98980 X Schedule A, Part IV, Supplemental Information: SCHEDULE A, PART II, LINE 10, EXPLANATION FOR OTHER INCOME: OTHER INCOME IS RELATED TO SERIES 2002A AND SERIES 2002B BONDS AS WELL AS LICENSE FEES. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1 1 0 1 16616 1 638 0 1 186450 0 1 3811 207515 0 Explanation of Other Lobbying Activities: Part II-B, Line 1i: THE H. LEE MOFFITT CANCER CENTER AND RESEARCH INSTITUTE, INC. AND ITS THREE NON-PROFIT SUBSIDIARY CORPORATIONS ("CORPORATION") WERE CREATED TO GOVERN AND OPERATE THE H. LEE MOFFITT CANCER CENTER AND RESEARCH INSTITUTE ("INSTITUTE") PURSUANT TO SECTION 1004.43, FLORIDA STATUTES. AMONG OTHER THINGS, SECTION 1004.43, FLORIDA STATUTES PROVIDES: (1) THAT THE CORPORATION SHALL ENTER INTO AN AGREEMENT WITH THE STATE BOARD OF EDUCATION FOR THE UTILIZATION OF FACILITIES ON THE CAMPUS OF THE UNIVERSITY OF SOUTH FLORIDA; (2) THAT THE CORPORATION SUBMIT ANNUAL POST AUDITS OF ITS FINANCIAL ACCOUNTS TO THE AUDITOR GENERAL OF THE STATE OF FLORIDA AND THE BOARD OF GOVERNORS FOR THEIR REVIEW; AND (3) THAT THE CORPORATION'S CEO REPORT TO THE BOARD OF GOVERNORS OR ITS DESIGNEE AND PROVIDE COPIES OF THE INSTITUTE'S ANNUAL REPORT TO THE GOVERNOR OF THE STATE OF FLORIDA, THE CABINET, THE PRESIDENT OF THE SENATE, THE SPEAKER OF THE HOUSE AND THE CHAIR OF THE BOARD OF GOVERNORS. ALTHOUGH THE CORPORATION IS A PRIVATE ENTITY, IT IS NONETHELESS SUBJECT TO THE STATE OF FLORIDA'S PUBLIC RECORDS AND THE PUBLIC MEETINGS LAWS. THE CORPORATION ALSO RELIES ON ANNUAL APPROPRIATIONS BY THE LEGISLATURE OF THE STATE OF FLORIDA AND GRANTS FROM VARIOUS LOCAL, STATE AND FEDERAL AGENCIES FOR OPERATION AND MAINTENANCE OF ITS FACILITIES AND FOR SPECIFIC RESEARCH AND CLINICAL PROGRAMS. FOR THESE REASONS, THE CORPORATION FROM TIME TO TIME ENGAGES LOBBYISTS AND OTHER CONSULTANTS; (1) TO ASSIST IT IN COMPLYING WITH ITS REPORTING REQUIREMENTS TO THE STATE OF FLORIDA UNDER SECTION 1004.43, FLORIDA STATUTES; (2) TO MONITOR LEGISLATIVE AND EXECUTIVE BRANCH ACTION AT LOCAL, STATE AND FEDERAL LEVELS OF GOVERNMENT WHICH IMPACT ITS OPERATION AND THE FULFILLMENT OF ITS MISSION; AND (3) TO INFLUENCE LEGISLATION IN FURTHERANCE OF ITS MISSION IN THE AREAS OF CANCER RESEARCH AND TREATMENT, THE TEACHING AND TRAINING OF HEALTH CARE PROFESSIONALS AND COMMUNITY EDUCATION AND OUTREACH ACTIVITIES. THE CORPORATION DOES NOT ENGAGE IN ANY ACTIVITIES TO SUPPORT OR OPPOSE ANY CANDIDATE FOR PUBLIC OFFICE. Part IV, Supplemental Information: OTHER ACTIVITIES, LINE 1i: THE OTHER ACTIVITIES AMOUNT LISTED ON LINE 1i IS COMPRISED OF EXPENSES RELATED TO ORGANIZING VOLUNTEERS TO VISIT LEGISLATORS. 9306184 9306184 338547224 101249455 237297769 3251445 2876878 374567 207758534 139007066 68751468 12015913 12015913 327745901 BOND ISSUE COSTS 1363110 INTEREST IN NET ASSETS OF FOUNDATION 20379518 ASSETS WHOSE USE IS LIMITED 104778896 OTHER ASSETS 109374 INVESTMENT IN MTC 500000 INVESTMENT IN M2GEN 100 127130998 LEASE OBLIGATIONS 2053190 2053190 Description of Uncertain Tax Positions Under FIN 48: Part X: THE CANCER CENTER RECOGNIZES UNCERTAIN TAX POSITIONS WHEN IT IS MORE LIKELY THAN NOT (I.E., GREATER THAN 50% LIKELIHOOD OF RECEIVING BENEFIT) AND RECORDS THESE BENEFITS AT THE AMOUNT MOST LIKELY TO BE REALIZED ASSUMING A REVIEW BY TAX AUTHORITIES HAVING ALL RELEVANT INFORMATION AND APPLYING CURRENT CONVENTIONS. THE CANCER CENTER HAS NO SIGNIFICANT UNRECOGNIZED TAX BENEFITS AND DOES NOT BELIEVE THAT THERE WILL BE ANY MATERIAL CHANGES IN THE CANCER CENTER'S UNRECOGNIZED TAX POSITION OVER THE NEXT 12 MONTHS. 1 AMERICAN CANCER SOCIETY 8095 NW 12TH STREET 200 DORAL FL 33126 590657320 501(C)(3) 28200 SPONSORSHIP THE V FOUNDATION FOR CANCER 106 TOWERVIEW COURT CARY NC 27513 133705951 501(C)(3) 25000 SPONSORSHIP MORE HEALTH INC 3821 HENDERSON BLVD TAMPA FL 33629 593397472 501(C)(3) 21000 SPONSORSHIP TAMPA GENERAL HOSPITAL FOUNDATION INC PO BOX 1289 RM H-149 TAMPA FL 33601 237354477 501(C)(3) 10000 SPONSORSHIP DEBARTOLO FAMILY FOUNDATION INC 15436 N FLORIDA AVE SUITE 200 TAMPA FL 33613 311739677 501(C)(3) 7735 SPONSORSHIP DREXEL UNIVERSITY COLLEGE OF MEDICINE 3141 CHESTNUT STREET PHILADELPHIA PA 19104 232979433 501(C)(3) 7500 SPONSORSHIP GREATER TAMPA CHAMBER OF COMMERCE INC 201 N FRANKLIN STREET SUITE 201 TAMPA FL 33602 590474960 501(C)(6) 5900 SPONSORSHIP 6 1 Procedure for Monitoring Grants in the U.S.: Part I, Line 2: Schedule I, Part I, Line 2: SPONSORSHIPS AND CHARITABLE CONTRIBUTIONS ARE APPROVED THROUGH THE CHECK REQUEST PROCESS. BECAUSE OF THE NATURE OF THE GRANTS, THE GRANT USE IS NOT MONITORED SINCE THEY ARE GIVEN TO THE ORGANIZATION FOR A SPECIFIC PURPOSE OR EVENT. X X 0 1 X X X X 1 1 0 0 0 0 0 0 0 WILLIAM S DALTON 863378 0 297504 0 153269 0 25603 0 49305 0 1389059 0 0 0 LOUIS D DE LA PARTE 369700 0 93553 0 1782 0 25603 0 17862 0 508500 0 0 0 JOHN A KOLOSKY 542940 0 128752 0 53427 0 25603 0 23633 0 774355 0 0 0 ALAN F LIST 0 474915 0 134109 0 36561 0 25602 0 25104 0 696291 0 0 JAMES J MULAY 357835 0 90802 0 19078 0 24096 0 22514 0 514325 0 0 0 WARREN J PLEDGER 421088 0 157687 0 56732 0 25603 0 26068 0 687178 0 0 0 NICOLAS C PORTER 410483 0 104026 0 59845 0 25603 0 21393 0 621350 0 0 0 THOMAS A SELLERS 436097 0 104972 0 20810 0 25602 0 29757 0 617238 0 0 0 DANIEL M SULLIVAN 392931 0 99195 0 75580 0 25602 0 25609 0 618917 0 0 0 YVETTE LYONS TREMONTI 240532 0 49238 0 13031 0 24353 0 23246 0 350400 0 0 0 TIMOTHY J YEATMAN 0 510817 0 273238 0 32443 0 26199 0 24306 0 867003 0 0 MICHAEL K BENEDICT 231209 0 51967 0 13603 0 19600 0 25887 0 342266 0 0 0 JANENE CULUMBER 320465 0 60000 0 13931 0 19600 0 21275 0 435271 0 0 0 B LEE GREEN 199990 0 41101 0 17172 0 19325 0 27140 0 304728 0 0 0 DEAN R HEAD 166491 0 32003 0 8368 0 16609 0 16267 0 239738 0 0 0 MARK F HULSE 228134 0 46001 0 11439 0 15750 0 24715 0 326039 0 0 0 W J WILSON 126581 104905 46534 0 4155 4089 11039 8449 6106 5374 194415 122817 0 0 LYNN C MOSCINSKI 0 384954 0 64643 0 24332 0 25603 0 12511 0 512043 0 0 ALEXANDER ANDERSON 181867 0 100000 0 829 0 25602 0 19176 0 327474 0 0 0 SRIKUMAR CHELLAPPAN 249749 0 64575 0 1464 0 23809 0 20097 0 359694 0 0 0 ROBERT J GILLIES 326035 0 63565 0 15834 0 25603 0 16461 0 447498 0 0 0 ANNA R GIULIANO 217937 0 41330 0 2521 0 25603 0 22059 0 309450 0 0 0 SAID M SEBTI 354738 0 70500 0 15833 0 25602 0 18488 0 485161 0 0 0 BRAULIO VICENTE JR 0 287224 0 56351 0 14774 0 19600 0 29884 0 407833 0 0 W MICHAEL ALBERTS 0 311593 0 62188 0 49626 0 25603 0 24617 0 473627 0 0 ANNE L GOFF -1426 0 0 0 138346 0 0 0 8718 0 145638 0 0 0 Part I, Line 1b PAYMENTS MADE FOR SOCIAL CLUB DUES AND PERSONAL SERVICES ARE APPROVED BY THE JOINT EXECUTIVE COMPENSATION AND BENEFITS COMMITTEE (JEC&BC). PAYMENTS ARE A FIXED AMOUNT BASED ON JOB CLASSIFICATION AND IS DOCUMENTED IN MINUTES OF THE COMMITTEE AND REPORTED BACK TO THE BOARD. Part I, Lines 4a-b SEVERENCE PAYMENTS WERE MADE TO ANNE GOFF IN THE AMOUNT OF $134,596.00. THE FOLLOWING INDIVIDUALS PARTICIPATE IN A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN AND AMOUNTS LISTED ARE INCLUDED IN THEIR TOTAL COMPENSATION, RESPECTIVELY: MICHAEL K. BENEDICT - $2,848.74 YVETTE M. LYONS TREMONTI - $4,737.49 NICOLAS C. PORTER - $25,999.79 WARREN J. PLEDGER - $27,729.51 JOHN A. KOLOSKY - $41,138.42 WILLIAM S. DALTON - $87,104.55 HILLSBOROUGH COUNTY INDUSTRIAL DEVELOPMENT AUTHORITY 591293512 43233ADJ2 2007-11-08 118550173 SEE SUPPLEMENTAL SCH K PART IA(f) 0 0 0 HILLSBOROUGH COUNTY INDUSTRIAL DEVELOPMENT AUTHORITY 591293512 2010-09-08 22000000 SEE SUPPLEMENTAL SCH K PART IB(f) 0 0 0 123576564 26666689 1028820 90147292 2010 0 0 0 0 22034124 13192499 345805 8501471 2011 0 0 0 0 0 0 0 0 1 0.00000 0.00000 0.00000 1 0 0 0 0 1 0.00000 0.00000 0.00000 1 0 0 0 1 SUNTRUST 9.100000000000 1 0 0 0 0 0 0 0 0 Schedule K, Part IA(f) 1. FINANCING THE COST OF CONSTRUCTING AND EQUIPPING A FOUR STORY ADDITION TO THE MAIN CAMPUS OF THE HOSPITAL, TO INCLUDE 36 ADDITIONAL INPATIENT BEDS, RADIATION ONCOLOGY CLINIC PROGRAM EXPANSION WITH THE ADDITION OF TWO NEW VAULTS USED FOR STATE OF THE ART LINEAR ACCELERATORS, CLINICAL LAB AND PATHOLOGY PROGRAM EXPANSION, APPROXIMATELY 40,000 GROSS SQUARE FEET OF FACULTY OFFICE SPACE, AND 1,000 SPACE PARKING GARAGE. 2. FINANCING THE COST OF VARIOUS BACKFILL AND REFURBISHMENT PROJECTS, INCLUDING THE ADDITION OF EIGHT INPATIENT BEDS IN EXISTING SPACE LOCATED AT THE INSTITUTE AND HOSPITAL. Schedule K, Part IB(f) 1. PAYING ALL OR A PORTION OF THE COST OF IMPROVEMENT, BUILD-OUT AND EQUIPPING OF CERTAIN CAPITAL IMPROVEMENTS LOCATED ON THE PROJECT SITE AND THE ACQUISITION OF EQUIPMENT, INCLUDING, WITHOUT LIMITATION, THE IMPROVEMENT, BUILD-OUT, DESIGN, RENOVATION AND EQUIPPING OF A CANCER TREATMENT AND IMAGING CENTER TO BE LOCATED ON THE PROJECT SITE; 2. FINANCING AND REFINANCING CERTAIN OTHER CAPITAL COSTS PREVIOUSLY INCURRED BY THE HOSPITAL WITH RESPECT TO SUCH PROJECTS. LAURIE SULLIVAN SEE PART V 103226 SEE PART V 0 KYLE DALTON SEE PART V 18547 SEE PART V 0 FOWLER WHITE BOGGS SEE PART V 195853 SEE PART V 0 Form 990, Schedule L, Part IV INTERESTED PERSON: LAURIE SULLIVANRELATIONSHIP: FAMILY MEMBER OF DANIEL SULLIVANTRANSACTION DESCRIPTION: COMPENSATIONINTERESTED PERSON: KYLE DALTONRELATIONSHIP: FAMILY MEMBER OF WILLIAM S. DALTONTRANSACTION DESCRIPTION: COMPENSATIONINTERESTED PERSON: FOWLER WHITE BOGGSRELATIONSHIP: RHEA LAW IS A KEY EMPLOYEE OF FOWLER WHITE BOGGSTRANSACTION DESCRIPTION: COMPENSATION FOR SERVICES X EQUIPMENT 73 2101481 PURCHASE PRICE 0 0 0 0 Method for Determining Number of Contributors: Part I, Column (b): THE NUMBER OF CONTRIBUTORS REPORTED REFLECTS THE NUMBER OF ITEMS CONTRIBUTED. Form 990, Part VI, Section A, line 2 THE FOLLOWING DIRECTORS AND OFFICERS, THAT JOINTLY SERVE ON THE INSTITUTE AND A FOR-PROFIT RELATED ENTITY, QUALIFY AS HAVING A BUSINESS RELATIONSHIP. INSTITUTE & MOFFITT GENETICS CORPORATION: H. LEE MOFFITT - DIRECTOR WILLIAM S. DALTON - OFFICER LOUIS D. DE LA PARTE - OFFICER JANENE J. CULUMBER - OFFICER INSTITUTE & MOFFITT TECHNOLOGIES CORPORATION: WILLIAM S. DALTON - OFFICER JOHN A. KOLOSKY - OFFICER LOUIS D. DE LA PARTE - OFFICER JANENE J. CULUMBER - OFFICER Form 990, Part VI, Section B, line 11 PRIOR TO PROVIDING FORM 990, RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX, TO THE PARENT-RESEARCH BOARD OF DIRECTORS FOR REVIEW, THE CHIEF FINANCIAL OFFICER REVIEWS THE RETURN. SUGGESTED COMMENTS OR CHANGES ARE DISCUSSED AND ANY NECESSARY CORRECTIONS ARE MADE. PRIOR TO ELECTRONICALLY FILING FORM 990, MOFFITT PARENT-RESEARCH PROVIDES A COPY OF THE RETURN TO THE GOVERNING BODY, GIVING EACH BOARD MEMBER TIME TO REVIEW THE RETURN. BOARD MEMBERS HAVE THE OPPORTUNITY TO ASK QUESTIONS RELATED TO THE INFORMATION PROVIDED ON THE RETURN. Form 990, Part VI, Section B, line 12c ON AN ANNUAL BASIS A PRESENTATION IS MADE TO RESEARCH BOARD MEMBERS TO REVIEW THE CONFLICT OF INTEREST POLICY AND PROCEDURES FOR DISCLOSING ANY POTENTIAL CONFLICTS. EACH DIRECTOR, OFFICER, COMMITTEE MEMBER, AND KEY EMPLOYEE SHALL COMPLETE A CONFLICT OF INTEREST DISCLOSURE FORM ATTACHED TO THE POLICY. ANY DIRECTOR, OFFICER, COMMITTEE MEMBER, OR KEY EMPLOYEE WHO REASONABLY BELIEVES THAT HE OR SHE MAY HAVE AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST MUST DISCLOSE THE EXISTENCE OF AND THE MATERIAL FACTS OF THE NATURE OF HIS/HER INTEREST ON THE FORM. THE FORM IS SUBMITTED TO THE CORPORATE COMPLIANCE OFFICE, WHICH REVIEWS THE FORMS, GATHERS ADDITIONAL RELEVANT INFORMATION WHERE NECESSARY, AND PREPARES A SUMMARY OF THE DISCLOSURES TO BE REVIEWED BY THE CONFLICT OF INTEREST WORK GROUP. IF A DIRECTOR OR COMMITTEE MEMBER DISCLOSES THAT HE/SHE HAS A POTENTIAL CONFLICT OF INTEREST AT A BOARD OR COMMITTEE MEETING, SUCH DIRECTOR OR COMMITTEE MEMBER MUST DISCLOSE THE NATURE OF THE INTEREST AND ANY RELATED INFORMATION AND RESPOND TO QUESTIONS AS MAY BE REQUIRED BY THE REMAINING MEMBERS. BASED ON THE INFORMATION DISCLOSED, THE REMAINING BOARD MEMBERS WILL DETERMINE WHETHER A CONFLICT OF INTEREST EXISTS. IF A CONFLICT EXISTS THE BOARD OR COMMITTEE SHALL DETERMINE WHETHER AN ALTERNATIVE TRANSACTION OR ARRANGEMENT THAT WOULD NOT GIVE RISE TO A CONFLICT IS EQUALLY ADVANTAGEOUS. IF AN ALTERNATIVE TRANSACTION IS NOT EQUALLY ADVANTAGEOUS THE DIRECTOR OR COMMITTEE MEMBER WHO IS THE SUBJECT OF THE CONFLICT SHALL NOT VOTE ON, NOR USE HIS/HER PERSONAL INFLUENCE ON, NOR PARTICIPATE IN DISCUSSIONS OR DELIBERATIONS WITH RESPECT TO THE TRANSACTION. Form 990, Part VI, Section B, line 15 MOFFITT'S BOARD OF DIRECTORS HAS AN ESTABLISHED SUB-COMMITTEE, THE JOINT EXECUTIVE COMPENSATION & BENEFITS COMMITTEE (JEC&BC) THAT IS MADE UP ENTIRELY OF INDEPENDENT, OUTSIDE DIRECTORS. THIS COMMITTEE IS CHARGED WITH THE OVERSIGHT OF THE PERFORMANCE AND COMPENSATION OF MOFFITT EXECUTIVES AND DISQUALIFIED PERSONS. THESE POSITIONS INCLUDE THE CEO, EXECUTIVE VICE PRESIDENTS, SENIOR VICE PRESIDENTS, VICE PRESIDENTS AND DEPARTMENT CHAIRPERSONS. TO ACCOMPLISH ITS MISSION, THE COMMITTEE CAN AS NEEDED AND DOES AT ITS DISCRETION, ENGAGE OUTSIDE INDEPENDENT, OUTSIDE ADVISORS INCLUDING, BUT NOT LIMITED TO ATTORNEYS AND COMPENSATION CONSULTANTS. ON AN ANNUAL BASIS THE JEC&BC ENGAGES A NATIONALLY KNOWN, THIRD PARTY CONSULTING FIRM TO PROVIDE A DETAILED STUDY OF THE CASH COMPENSATION FOR EACH EXECUTIVE, DISQUALIFIED PERSON AND INDIVIDUAL IN KEY POSITIONS. THE CONSULTANT USES A VARIETY OF PUBLISHED SURVEYS COMPILED BY INDEPENDENT FIRMS TO PROVIDE THE SOURCE DATA FOR THE STUDY. USING FUNCTIONALLY COMPARABLE POSITIONS IN OTHER SIMILARLY SIZED, NOT-FOR-PROFIT AND FOR-PROFIT HEALTHCARE, ACADEMIC AND RESEARCH ORGANIZATIONS, THE CONSULTING FIRM PRODUCES A STUDY THAT COMPARES EACH DESIGNATED MOFFITT POSITION TO ITS APPROPRIATE MARKET EQUIVALENT. THE RESULTING DATA IS PROVIDED TO THE DIRECTOR OF COMPENSATION, WHO IS NOT INCLUDED IN THE EXECUTIVE OR DISQUALIFIED PERSON CATEGORIES, FOR USE IN THE FORMULATION OF RECOMMENDATIONS FOR COMPENSATION CHANGES TO MAINTAIN MARKET COMPETITIVENESS OR TO REWARD PERFORMANCE. THESE RECOMMENDATIONS ALONG WITH THE CONSULTANT'S COMPARABILITY DATA ARE PRESENTED TO THE JEC&BC FOR IT TO CONFIRM ITS REASONABLENESS, MAKE MODIFICATIONS AS IT DEEMS NECESSARY AND PROVIDE FINAL APPROVAL. EVERY THIRD YEAR THE INDEPENDENT CONSULTANT ANALYZES THE TOTAL EXECUTIVE COMPENSATION PROGRAM, USING THE SAME METHODOLOGY AS DESCRIBED ABOVE, THAT INCLUDEDS THE VALUE OF ALL BENEFITS AND PREREQUISITES (CASH AND NON-CASH) PROVIDED AS COMPENSATION TO THE EXECUTIVES AND DISQUALIFIED PERSONS. THE PURPOSE OF THE ANALYSIS IS TO PROVIDE AN OPINION ON THE REASONABLENESS OF EACH OF THE INDIVIDUAL COMPENSATION COMPONENTS AND THE AGGREGATE COMPENSATION TOTAL. THIS MORE COMPREHENSIVE ANALYSIS IS PROVIDED TO THE JEC&BC FOR THEIR USE IN THE ANNUAL REVIEW PROCESS. MINUTES ARE KEPT AT EACH OF THESE ANNUAL MEETINGS DETAILING THE RECOMMENDATIONS PRESENTED AND THE DECISIONS MADE BY THE COMMITTEE. THESE MINUTES ARE PUBLISHED TO THE COMMITTEE AT THE NEXT MEETING AND REPORTED BACK TO THE FULL BOARD. Form 990, Part VI, Section C, line 19 MOFFITT RESEARCH MAKES AVAILABLE TO THE PUBLIC THROUGH THIRD PARTY VENDORS' WEBSITES, ITS FORM 990 AND AUDITED FINANCIAL STATEMENTS. FORM 990 IS MADE AVAILABLE ON GUIDESTAR WHILE THE AUDITED FINANCIAL STATEMENTS ARE MADE AVAILABLE ON DACBOND. ALL ORGANIZING AND GOVERNING DOCUMENTS SUCH AS FORM 1023, CONFLICTS OF INTEREST POLICY, AND BYLAWS AS WELL AS FORM 990 AND AUDITED FINANCIAL STATEMENTS ARE MADE AVAILABLE UPON REQUEST. Form 990, Part VI, Section B, Line 14: THE ORGANIZATION HAS A WRITTEN DOCUMENT RETENTION AND DESTRUCTION POLICY WITH WHICH IT COMPLIES; HOWEVER, THE POLICY WAS NOT APPROVED BY THE BOARD OR A COMMITTEE BY THE FISCAL YEAR END. Form 990, Part VI, Section B, Line 16b: THE ORGANIZATION HAS ADOPTED A WRITTEN JOINT VENTURE PROCEDURE WITH WHICH IT COMPLIES; HOWEVER, IT WAS NOT APPROVED BY THE BOARD OR A COMMITTEE BY THE FISCAL YEAR END. Form 990, Part VII, Section A, Line 1b: DIRECTORS ESTIMATE OF AVERAGE HOURS PER WEEK DEVOTED TO RELATED ORGANIZATIONS TIMOTHY J. ADAMS: H. LEE MOFFITT CANCER CENTER AND RESEARCH INSTITUTE LIFETIME CANCER SCREENING, INC. 1HR DONALD D. BUCHANAN: H. LEE MOFFITT CANCER CENTER AND RESEARCH INSTITUTE LIFETIME CANCER SCREENING, INC. 1HR MOFFITT GENETICS CORPORATION 1HR THEODORE J. COUCH: MOFFITT GENETICS CORPORATION 1HR EDWARD C DROSTE: H. LEE MOFFITT CANCER CENTER AND RESEARCH INSTITUTE, FOUNDATION, INC. 1HR BENJAMIN H. HILL: H. LEE MOFFITT CANCER CENTER AND RESEARCH INSTITUTE, FOUNDATION, INC. 1HR BETH A. HOUGHTON: H. LEE MOFFITT CANCER CENTER AND RESEARCH INSTITUTE HOSPITAL, INC. 1HR THE HONORABLE H. LEE MOFFITT: H. LEE MOFFITT CANCER CENTER AND RESEARCH INSTITUTE HOSPITAL, INC. 1HR H. LEE MOFFITT CANCER CENTER AND RESEARCH INSTITUTE, FOUNDATION, INC. 1HR H. LEE MOFFITT CANCER CENTER AND RESEARCH INSTITUTE LIFETIME CANCER SCREENING, INC. 1HR MOFFITT GENETICS CORPORATION 1HR ROBERT ROTHMAN: MOFFITT GENETICS CORPORATION 1HR FORM 990, PART VII, SECTION A, LINE 1B: CURRENT & FORMER OFFICERS ESTIMATE OF AVERAGE HOURS PER WEEK DEVOTED TO RELATED ORGANIZATIONS JANENE CULUMBER H. LEE MOFFITT CANCER CENTER AND RESEARCH INSTITUTE HOSPITAL, INC. 22HRS H. LEE MOFFITT CANCER CENTER AND RESEARCH INSTITUTE FOUNDATION, INC. 5HRS H. LEE MOFFITT CANCER CENTER AND RESEARCH INSTITUTE LIFETIME CANCER SCREENING, INC. 5HRS MOFFITT TECHNOLOGIES CORPORATION 1HR MOFFITT GENETICS CORPORATION 5HRS WILLIAM S. DALTON H. LEE MOFFITT CANCER CENTER AND RESEARCH INSTITUTE HOSPITAL, INC. 1HR H. LEE MOFFITT CANCER CENTER AND RESEARCH INSTITUTE FOUNDATION, INC. 10HRS MOFFITT TECHNOLOGIES CORPORATION 1HR MOFFITT GENETICS CORPORATION 11HRS LOUIS D. DE LA PARTE H. LEE MOFFITT CANCER CENTER AND RESEARCH INSTITUTE HOSPITAL, INC. 22HRS H. LEE MOFFITT CANCER CENTER AND RESEARCH INSTITUTE FOUNDATION, INC. 5HRS H. LEE MOFFITT CANCER CENTER AND RESEARCH INSTITUTE LIFETIME CANCER SCREENING, INC. 5HRS MOFFITT TECHNOLOGIES CORPORATION 1HR MOFFITT GENETICS CORPORATION 5HRS DORTE HEIMBECK H. LEE MOFFITT CANCER CENTER AND RESEARCH INSTITUTE HOSPITAL, INC. 24HRS JOHN A. KOLOSKY H. LEE MOFFITT CANCER CENTER AND RESEARCH INSTITUTE HOSPITAL, INC. 33HRS H. LEE MOFFITT CANCER CENTER AND RESEARCH INSTITUTE FOUNDATION, INC. 4HRS MOFFITT TECHNOLOGIES CORPORATION 1HR ALAN F. LIST H. LEE MOFFITT CANCER CENTER AND RESEARCH INSTITUTE HOSPITAL, INC. 33HRS H. LEE MOFFITT CANCER CENTER AND RESEARCH INSTITUTE LIFETIME CANCER SCREENING, INC. 15HRS YVETTE M. LYONS TREMONTI H. LEE MOFFITT CANCER CENTER AND RESEARCH INSTITUTE HOSPITAL, INC. 33HRS LYNN C MOSCINSKI H. LEE MOFFITT CANCER CENTER AND RESEARCH INSTITUTE LIFETIME CANCER SCREENING, INC. 50HRS JAMES J. MULAY MOFFITT TECHNOLOGIES CORPORATION 1HR NICOLAS C. PORTER H. LEE MOFFITT CANCER CENTER AND RESEARCH INSTITUTE HOSPITAL, INC. 33HRS H. LEE MOFFITT CANCER CENTER AND RESEARCH INSTITUTE FOUNDATION, INC. 5HRS DANIEL M. SULLIVAN H. LEE MOFFITT CANCER CENTER AND RESEARCH INSTITUTE LIFETIME CANCER SCREENING, INC. 35HRS W. J. WILSON H. LEE MOFFITT CANCER CENTER AND RESEARCH INSTITUTE HOSPITAL, INC. 22HRS TIMOTHY J. YEATMAN MOFFITT GENETICS CORPORATION 50HRS W. MICHAEL ALBERTS H. LEE MOFFITT CANCER CENTER AND RESEARCH INSTITUTE HOSPITAL, INC. 55HRS BRAULIO VICENTE JR. H. LEE MOFFITT CANCER CENTER AND RESEARCH INSTITUTE HOSPITAL, INC. 40HRS H. LEE MOFFITT CANCER CENTER AND RESEARCH INSTITUTE LIFETIME CANCER SCREENING, INC. 15HRS Changes in Net Assets or Fund Balances: Form 990, Part XI, line 5: Net unrealized losses on investments: -18350. PREMIER PARTNERSHIP INCOME -1970. INTEREST IN NET ASSETS OF FOUNDATION -467482. TRANSFER FROM FOUNDATION PHILANTHROPIC -751493. TRANSFER TO/FROM TAX EXEMPT AFFILIATES XXX-XX-XXXX. GRANT REFUNDS -218255. LOSS ON TEMPORARY INVESTMENTS -497922. Total to Form 990, Part XI, Line 5: XXX-XX-XXXX. H LEE MOFFITT CANCER CTR & RESEARCH INSTITUTE HOSPITAL INC 12902 MAGN0LIA DRIVE TAMPA FL 33612 593238634 PATIENT CARE FL 501(c)(3) Line 3 N/A 1 H LEE MOFFITT CANCER CTR & RESEARCH INSTITUTE FOUNDATION INC 12902 MAGN0LIA DRIVE TAMPA FL 33612 593238636 FUNDRAISING FL 501(c)(3) Line 7 N/A 1 H LEE MOFFITT CC&RI LIFETIME CANCER SCREENING CENTER INC 12902 MAGN0LIA DRIVE TAMPA FL 33612 593238640 PRACTICE MANAGEMENT FL 501(c)(3) Line 9 N/A 1 MOFFITT TECHNOLOGIES CORPORATION 12902 MAGNOLIA DRIVE TAMPA FL 33612 300332914 TECHNOLOGY MANAGEMENT FL H LEE MOFFITT CC&RI INC C 263976 1.00000 MOFFITT GENETICS CORPORATION 12902 MAGNOLIA DRIVE TAMPA FL 33612 208486180 DATABASE MANAGEMENT FL H LEE MOFFITT CC&RI INC C -928739 2414809 1.00000 0 0 1 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 MOFFITT GENETICS CORPORATION C 1016038 FMV MOFFITT GENETICS CORPORATION D 2148457 FMV MOFFITT GENETICS CORPORATION O 178805 FMV