2012-07-31T14:06:43-05:00 2011-12-31 391173131 SCHENCK SC 200 E WASHINGTON ST PO BOX 1739 APPLETON WI 549121739 990 2011-01-01 390906273 COMMUNITY BLOOD CENTER INC COMM 9207383131 4406 W SPENCER STREET APPLETON WI 54914 RICK HART 9207383131 2012-07-30 1 MIKE VANDEN HOGEN P00499282 9207318111 2011 2016-02-24 21:20:13Z RICK HART 4406 W SPENCER STREET APPLETON WI 54914 15905275 0 X WWW.SAVE3LIVES.ORG X 1955 WI THE PURPOSE OF THIS ORGANIZATION SHALL BE TO SUPERVISE AND PERFORM THE COLLECTION, PROCESSING AND DISTRIBUTION OF BLOOD, BLOOD COMPONENTS AND OTHER RELATED PRODUCTS, TO HOSPITALS OR TO OTHER BLOOD CENTERS. TO ENGAGE IN OTHER EXCLUSIVE CHARITABLE, SCIENTIFIC AND EDUCATIONAL ACTIVITIES AND ENDEAVORS INCLUDING PARTICIPATION IN ANY BUSINESS OR ENTERPRISE TO PROCURE FUNDS FOR THE FOREGOING, INCLUDING ALSO THE SOLICITATION OF FUNDS FOR THE FINANCIAL SUPPORT OF ITS PURPOSE AND OBJECTIVES. 16 15 180 250 0 0 63568 72516 15878330 15649916 178861 182826 70 17 16120829 15905275 0 0 0 0 5963547 6881263 0 0 0 8617116 7646986 14580663 14528249 1540166 1377026 16652312 18007259 2532927 2275784 14119385 15731475 THE COMMUNITY BLOOD CENTER PROVIDES RELIABLE, HIGH QUALITY BLOOD PRODUCTS AND SERVICES THAT SAVE LIVES IN THE COMMUNITIES WE SERVE. 0 0 12111942 15190453 COMMUNITY BLOOD CENTER PROVIDES 100% OF THE BLOOD TO 18 HOSPITALS THROUGHOUT NORTHEASTERN WISCONSIN AND THE UPPER PENINSULA OF MICHIGAN. IN 2011 WE COLLECTED MORE THAN 47,000 UNITS OF RED BLOOD CELLS THAT WE THEN TESTED, PROCESSED AND DISTRIBUTED TO HOSPITALS FOR BLOOD TRANSFUSION TO PATIENTS IN NEED. WE ARE ALSO ONE OF THE LOWEST COST PROVIDERS OF BLOOD IN THE NATION THROUGH OUR DEDICATION TO COST CONTAINMENT AND EFFICIENCY. 123650 465558 BONE MARROW DONOR MATCHING PROGRAM 12235592 1 1 0 0 0 0 0 0 0 1 1 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 7 0 180 1 0 0 0 0 0 0 0 0 0 0 X 16 15 0 0 0 1 0 0 0 1 1 0 0 1 1 1 1 0 1 1 1 0 WI X LORI GLYNN 9207383131 4406 W SPENCER STREET APPLETON WI 54914 CULLEN H HENSHAW MD TERM 2012 1.00 X 0 0 0 BEN VOGEL TERM END 2014 1.00 X 0 0 0 JOHN M WOLLNER TERM END 2012 1.00 X X 0 0 0 MARGI MANN TERM END 2014 1.00 X 0 0 0 CURT DETJEN TERM END 2013 1.00 X 0 0 0 DAN FLANNERY TERM END 2013 1.00 X 0 0 0 MARY HAYES TERM END 2012 1.00 X 0 0 0 THERESA MOORE TERM END 2013 1.00 X 0 0 0 STEVE SEIFERT TERM END 2012 1.00 X 0 0 0 MICHAEL WISE TERM END 2013 1.00 X 0 0 0 NANCY JOHNSHOY TERM END 2012 1.00 X 0 0 0 MARK KEHRBERG MD TERM END 2012 1.00 X 0 0 0 JO ANN LANG TERM END 2012 1.00 X X 0 0 0 RICK SCHINLER TERM END 2013 1.00 X X 0 0 0 JIM VANDERMISSEN TERM END 2012 1.00 X 0 0 0 RICK HART 40.00 X X 170095 0 21906 LORI GLYNN 40.00 X 91832 0 23759 ANDREA MICHAUD 40.00 X 107088 0 24617 MATT MCCARTER 40.00 X 122494 0 8654 491509 0 78936 3 0 1 0 LIFESOURCE DONOR TESTING FIVE PARKWAY CENTER 875 GREENTREE PITTSBURG PA 15220 BLOOD TESTING SERVICES 213451 PROPHIT MARKETING INC 154 N BROADWAY GREEN BAY WI 54303 MARKETING 149232 FEDEX PO BOX 94515 PALATINE IL 600944515 COURIER SERVICES 120806 E-FREIGHT COURIER PO BOX 13885 WAUWATOSA WI 532130885 COURIER SERVICES 120507 GLOBAL MED TECHNOLOGIES 4925 ROBERT J MATHEWS PARKWAY STE EL DORADO CA 95672 COMPUTER MAINTENANCE 103390 5 72516 72516 RED BLOOD CELLS 621500 8780205 8780205 APHERESIS PROCEDURES 621500 4431748 4431748 RECOVERED PLASMA 621500 1251839 1251839 COMPONENTS 621500 677246 677246 OTHER TESTING AND FEES 621500 465558 465558 43320 43320 15649916 176748 176748 6078 0 6078 6078 6078 MISC. REVENUE-RELATED- 900099 17 17 17 15905275 15656011 0 176748 307592 307592 5115207 4120578 994629 209300 168850 40450 786333 614540 171793 462831 287701 175130 5004 5004 48190 48190 114149 13675 100474 146611 146611 105564 88405 17159 263062 260954 2108 203218 144907 58311 177088 134545 42543 38506 25794 12712 15580 15580 375149 227341 147808 183722 161377 22345 SUPPLIES AND PURCHASED 2773861 2768225 5636 TESTING 2279059 2279059 REPAIRS AND MAINTENANCE 319597 214070 105527 SHIPPING AND HANDLING 271070 271070 327556 307890 19666 14528249 12235592 2292657 0 205 207 1506034 1574904 1719356 1971437 428457 420058 134557 174892 9741675 3505137 6304544 6236538 6305498 7374491 167626 170475 86035 84257 16652312 18007259 974801 892678 1558126 1383106 2532927 2275784 X 14113601 15724621 5784 6854 14119385 15731475 16652312 18007259 X 1377026 235064 X 0 1 1 X 0 X 53393 95379 45748 63568 72516 330604 13933567 16067597 17366362 15878330 15649916 78895772 13986960 16162976 17412110 15941898 15722432 79226376 0 10966712 10966712 10966712 10966712 68259664 225935 -210162 106800 178861 176478 477912 225935 -210162 106800 178861 176478 477912 1695 1098 10 70 17 2890 14214590 15953912 17518920 16120829 15898927 79707178 0.85640 0.98260 0.00600 0.00590 X SCHEDULE A, PART II, LINE 12, EXPLANATION OF OTHER INCOME: MISCELLANEOUS RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 86035 -52 1726 84257 76685 10435 1085 86035 1.00000 1 0 681582 681582 5967843 1089976 4877867 64509 21251 43258 2304675 1826459 478216 723066 567451 155615 6236538 15905275 14528249 1377026 -94936 330000 235064 1612090 16140339 -94936 330000 235064 15905275 0 15905275 14528249 0 14528249 0 14528249 DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: TO SUPPORT THE MISSION OF THE ORGANIZATION. PART XI, LINE 8 - OTHER ADJUSTMENTS: INSURANCE RECOVERY OF MISAPPROPRIATED FUNDS 330,000. X 0 0 0 0 0 0 0 0 0 RICK HART 164440 0 0 0 5655 0 9048 0 12858 0 192001 0 0 0 PART I, LINE 3 ANNUALLY THE DIRECTOR OF HUMAN RESOURCES PROVIDES THE BOARD WITH INDEPENDENT, COMPARABLE DATA TO USE TO MAKE ANY CHANGES TO THE CEO'S COMPENSATION. THE BOARD APPROVES ANY CHANGES TO THE CEO'S COMPENSATION. VILLAGE OF LITTLE CHUTE WISCONSIN 396006304 2009-01-06 3500000 THE RAZING OF BUILDING, IMPROVEMENTS TO BUILDING, AND PURCHASE OF EQUIPMENT 0 0 0 510475 1893581 1893581 2009 0 0 1 1 0 0 0 0 0.00000 0.00000 0.00000 0 SCHEDULE K BOND PROCEEDS BOND PROCEEDS ARE LESS THAN TOTAL BOND ISSUE BECAUSE CAPITAL EXPENDITURE NEEDS WAS LESS THAN $3.5 MILLION. FORM 990, PART VI, SECTION A, LINE 5 IN APRIL 2011 AN EMBEZZLEMENT OF $485,000 BY THE ACCOUNTING SPECIALIST WAS DISCOVERED. SUBSEQUENTLY, SHE PLEADED NO CONTEST AND WAS SENTENCED TO PRISON FOR 5 YEARS. THE BLOOD CENTER RECOVERED $330,000 FROM INSURANCE PROCEEDS. WHEN THE EMBEZZLEMENT WAS DISCOVERED, THE BLOOD CENTER HIRED A FORENSIC AUDITOR TO REVIEW THE INTERNAL CONTROLS IN PLACE AND MAKE SUGGESTIONS TO SHORE UP AREAS THAT WERE VULNERABLE. THESE CHANGES HAVE BEEN MADE AND WE CONTINUE TO MONITOR OUR INTERNAL CONTROLS ON A REGULAR BASIS. IN ADDITION, WE PLAN TO HAVE AN INTERNAL CONTROL AUDIT ON A REGULAR BASIS GOING FORWARD. FORM 990, PART VI, SECTION B, LINE 11 THE BOARD MEMBERS REVIEW AND APPROVE THE FORM 990 BEFORE IT IS FILED. FORM 990, PART VI, SECTION B, LINE 12C ANNUALLY EACH MEMBER OF THE BOARD OF DIRECTORS IS PROVIDED A CONFLICT OF INTEREST QUESTIONAIRE AND ARE REQUIRED TO COMPLETE AND SUBMIT. FORM 990, PART VI, SECTION B, LINE 15 ANNUALLY THE DIRECTOR OF HUMAN RESOURCES PROVIDES THE BOARD WITH INDEPENDENT, COMPARABLE DATA TO USE TO MAKE ANY CHANGES TO THE CEO'S COMPENSATION. ANNUALLY THE DIRECTOR OF HUMAN RESOURCES DOES A REVIEW OF OUR WAGE RANGES COMPARING THEM TO EXTERNAL SURVEYS AND OTHER DATA TO MAKE SURE WE ARE COMPETITIVE. THIS INFORMATION IS USED TO DETERMINE CHANGES IN KEY EMPLOYEE'S COMPENSATION. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENTS, INCLUDING GOVERNING, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS, ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART VI, LINE 13 THE ORGANIZATION IS CURRENTLY IN THE PROCESS OF APPROVING A WRITTEN WHISTLEBLOWER POLICY. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED LOSSES ON INVESTMENTS: -94,936. INSURANCE RECOVERY OF MISAPPROPRIATED FUNDS 330,000. TOTAL TO FORM 990, PART XI, LINE 5: 235,064.