FURP.ORG / PUBLIC DATA EXPLORER

GREAT LAKES MOBILE PET: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
GREAT LAKES MOBILE PET (EIN 36-4508671)
Tax period
2011-01-01 to 2011-12-31
Filed
2012-11-15
IRS object ID
201233209349302658
Schema version
2011v1.2
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2012-11-15T08:48:55-06:00Timestamp
Tax Period End Date2011-12-31TaxPeriodEndDate
Return Type990ReturnType
Tax Period Begin Date2011-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN364508671EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1GREAT LAKES MOBILE PETBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlGREANameControl
Phone2319355000Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 1188AddressLine1
CityTRAVERSE CITYCity
StateMIState
ZIP Code496851188ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameLINDA WARDName
TitleTREASURERTitle
Phone2319355000Phone
Date Signed2012-11-12DateSigned
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonCHRIS PODGESNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line11105 SIXTH STAddressLine1
CityTRAVERSE CITYCity
StateMIState
ZIP Code49684ZIPCode
FieldValueIRS element (for citing)
Gross Receipts1129900GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteN/AWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation2002YearFormation
State Legal DomicileMIStateLegalDomicile
Activity Or Mission DescriptionTO ESTABLISH, ACQUIRE AND MAINTAIN A MOBILE POSITRON EMISSION TOMOGRAPHY NETWORK TO IMPROVE AND PROMOTE THE HEALTH OF THE CITIZENS OF NORTHERN MICHIGAN.ActivityOrMissionDescription
Nbr Voting Members Governing Body8NbrVotingMembersGoverningBody
Nbr Independent Voting Members8NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Gross UBI0TotalGrossUBI
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year1105600ProgramServiceRevenuePriorYear
Program Service Revenue CY1129900ProgramServiceRevenueCY
Investment Income Prior Year613InvestmentIncomePriorYear
Investment Income Current Year0InvestmentIncomeCurrentYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year1106213TotalRevenuePriorYear
Total Revenue Current Year1129900TotalRevenueCurrentYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Current Year0SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year1088834OtherExpensePriorYear
Other Expenses Current Year1088393OtherExpensesCurrentYear
Total Expenses Prior Year1088834TotalExpensesPriorYear
Total Expenses Current Year1088393TotalExpensesCurrentYear
Revenues Less Expenses Prior Year17379RevenuesLessExpensesPriorYear
Revenues Less Expenses CY41507RevenuesLessExpensesCY
Total Assets BOY1758355TotalAssetsBOY
Total Assets EOY1247002TotalAssetsEOY
Total Liabilities BOY1470372TotalLiabilitiesBOY
Total Liabilities EOY917512TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY287983NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY329490NetAssetsOrFundBalancesEOY
Mission DescriptionTO ESTABLISH, ACQUIRE AND MAINTAIN A MOBILE POSITRON EMISSION TOMOGRAPHY NETWORK TO IMPROVE AND PROMOTE THE HEALTH OF THE CITIZENS OF NORTHERN MICHIGAN.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense1036864Expense
DescriptionPROVISION OF POSITRON EMISSION TOMOGRAPHY TO PATIENTS OF THREE MEMBER HOSPITALS: MUNSON MEDICAL CENTER, ALPENA GENERAL HOSPITAL AND NORTHERN MICHIGAN HOSPITAL. IN 2011, GREAT LAKES MOBILE PET PERFORMED 1,956 SCANS IN NORTHERN MICHIGAN.Description
Total Program Service Expense1036864TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredfalseScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiesfalseReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmtfalseConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredfalseScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntityfalseRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With10961NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees0NumberOfEmployees
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members8NbrVotingGoverningBodyMembers
Number Independent Voting Members8NumberIndependentVotingMembers
Family Or Business RelationshiptrueFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovaltrueDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementfalseRegularMonitoringEnforcement
Whistleblower PolicyfalseWhistleblowerPolicy
Document Retention PolicyfalseDocumentRetentionPolicy
Compensation Process CEOfalseCompensationProcessCEO
Compensation Process OtherfalseCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonMUNSON HEALTHCARE CORPORATE ACCOUNTNamePerson
Telephone Number2319357777TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line13668 N US 31 SAddressLine1
CityTRAVERSE CITYCity
StateMIState
ZIP Code49684ZIPCode
FieldValueIRS element (for citing)
No Listed Persons CompensatedXNoListedPersonsCompensated

Form990 Part VII Section A Form990PartVIISectionA (8 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensation
MARK ANTHONY
PRESIDENT1.00XX000
CHUCK SHERWIN
SECRETARY1.00XX000
LINDA WARD
TREASURER1.00XX000
KATHLEEN A MCMANUS
DIRECTOR1.00X000
DOUG KREIS
DIRECTOR1.00X000
STEVE CROSS
DIRECTOR1.00X000
SHERRY HANECKOW
DIRECTOR1.00X000
CHRIS PODGES
PRESIDENT1.00XX000
FieldValueIRS element (for citing)
Formers ListedfalseFormersListed
Total Comp GT150 KfalseTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (2 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
MUNSON MOBILE IMAGING
1105 SIXTH STTRAVERSE CITYMI49684MEDICAL & TECH112331
MUNSON MEDICAL CENTER
1105 SIXTH STTRAVERSE CITYMI49684MEDICAL & TECH109294
FieldValueIRS element (for citing)
Number Of Contractors GT100 K2NumberOfContractorsGT100K

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionMEDICAL SERVICES FEESDescription
Business Code621990BusinessCode
Total Revenue Column1129900TotalRevenueColumn
Related Or Exempt Function Income1129900RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue1129900TotalProgramServiceRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column1129900TotalRevenueColumn
Related Or Exempt Function Income1129900RelatedOrExemptFunctionIncome

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total7930Total
Management And General7930ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total234502Total
Program Services228825ProgramServices
Management And General5677ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total18646Total
Program Services17661ProgramServices
Management And General985ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total5393Total
Program Services5393ProgramServices

Interest Interest

FieldValueIRS element (for citing)
Total21487Total
Program Services21487ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total490568Total
Program Services484683ProgramServices
Management And General5885ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total24512Total
Management And General24512ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
VEHICLE REPAIR AND FUEL260267260267
ELECTRICITY FOR PET MACHI1813018130
LICENSE FEES59905990
OTHER TAXES550550

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total418Total
Program Services418ProgramServices

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total1088393Total
Program Services1036864ProgramServices
Management And General51529ManagementAndGeneral
Fundraising0Fundraising

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY183347BOY
EOY129237EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY121300BOY
EOY140620EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY21904BOY
EOY35910EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis2424123LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec1495148LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY1413658BOY
EOY928975EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY18146BOY
EOY12260EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY1758355BOY
EOY1247002EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY51837BOY
EOY30927EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY1418535BOY
EOY886585EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY1470372BOY
EOY917512EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY287983BOY
EOY329490EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY287983BOY
EOY329490EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY1758355BOY
EOY1247002EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses41507ReconcilationRevenueExpenses
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedfalseFSAudited
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Disclosed Orgs Legal ControlfalseDisclosedOrgsLegalControl
Disclosed For Charitable PurposesfalseDisclosedForCharitablePurposes
Written Policy MonitoringfalseWrittenPolicyMonitoring
Sect170h Requirements SatisfiedfalseSect170hRequirementsSatisfied
Solicited Assets For SalefalseSolicitedAssetsForSale
Agent Trustee EtcfalseAgentTrusteeEtc
Included On FSfalseIncludedOnFS
Endowments Held By Unrelated OrgsfalseEndowmentsHeldByUnrelatedOrgs
Endowments Held By Related OrgsfalseEndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule RfalseAreRelatedOrgsListedScheduleR

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis2424123OtherCostOrOtherBasis
Depreciation1495148Depreciation
Book Value928975BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings928975TotalOfBookValueLandBuildings

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (6 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
RELATED PARTY INFORMATION AMONG OFFICERSFORM 990, PAGE 6, PART VI, LINE 2MUNSON MOBILE IMAGING MUNSON MOBILE IMAGING TRUSTEE DIRECTOR DIRECTOR OF BOTH COMPANIES GREAT LAKES MOBILE PET NORTHERN MICHIGAN HOSPITAL, MEMBER TRUSTEE EMPLOYEE BUSINESS RELATION EMPLOYEE GREAT LAKES MOBILE PET ALPENA GENERAL HOSPITAL, MEMBER TRUSTEE EMPLOYEE BUSINESS RELATION EMPLOYEE GREAT LAKES MOBILE PET NORTHERN MICHIGAN HOSPITAL, MEMBER TRUSTEE EMPLOYEE BUSINESS RELATION EMPLOYEE
CLASSES OF MEMBERS OR STOCKHOLDERSFORM 990, PAGE 6, PART VI, LINE 6GREAT LAKES MOBILE PET IS ORGANIZED AS A NON-STOCK MEMBERSHIP CORPORATION.
ELECTION OF MEMBERS AND THEIR RIGHTSFORM 990, PAGE 6, PART VI, LINE 7AEACH MEMBER OF THE CORPORATION SHALL APPOINT TWO TRUSTEES TO THE BOARD OF TRUSTEES.
DECISIONS SUBJECT TO APPROVAL OF MEMBERSFORM 990, PAGE 6, PART VI, LINE 7BMEMBER ORGANIZATIONS APPROVE THE DECISIONS OF THE BOARD OF TRUSTEES.
ORGANIZATION'S PROCESS USED TO REVIEW FORM 990FORM 990, PAGE 6, PART VI, LINE 11BONE MEMBER ORGANIZATION PREPARES THE FORM 990 AT THE CORPORATE OFFICE. MANAGEMENT AT THE ORGANIZATION, KNOWLEDGEABLE ABOUT THE REQUIREMENTS FOR FORM 990, REVIEWS THE RETURN FOR ACCURACY. THE VICE PRESIDENT OF GENERAL COUNSEL FOR THAT MEMBER ORGANIZATION REVIEWS THE GOVERNANCE PORTION OF THE RETURN. A COPY OF THE RETURN IS PROVIDED TO THE MEMBERS OF THE BOARD PRIOR TO ITS FILING WITH THE IRS. ANY QUESTIONS ARE CLARIFIED PRIOR TO FILING.
GOVERNING DOCUMENTS DISCLOSURE EXPLANATIONFORM 990, PAGE 6, PART VI, LINE 19THE ORGANIZATION DOES NOT MAKE ITS BYLAWS, CONFLICT OF INTEREST POLICY OR FINANCIALS STATEMENTS AVAILABLE TO THE PUBLIC.