2012-11-09T13:35:29-06:00 2011-12-31 161003516 BROCK SCHECHTER & POLAKOFF LLP 726 EXCHANGE STREET SUITE 822 BUFFALO NY 14210 990 2011-01-01 161485974 UNIVERSITY GYNECOLOGISTS & OBSTETRICIANS UNIV 7168818050 239 BRYANT STREET BUFFALO NY 14222 VANESSA BARNABEI 7168818050 2012-11-08 1 THOMAS P GROGAN P00038022 7168545034 2012-11-08 2011 2016-02-24 21:20:13Z VANESSA BARNABEI 239 BRYANT STREET BUFFALO NY 14222 3176217 0 X WWW.UBOBGYN.COM X 1995 NY THE CORPORATION IS FORMED FOR THE PURPOSE OF SUPPORTING THE EDUCATIONAL PURPOSE OF THE STATE UNIVERSITY OF NEW YORK AT BUFFALO SCHOOL OF MEDICINE AND BIOMEDICAL SCIENCES BY PROVIDING CLINICAL INSTRUCTION AND SUPERVISION OF STUDENTS,INTERNS AND RESIDENTS AND RENDERING PROFESSIONAL SERVICES AND FURTHER TO PRACTICE THE PROFESSION OF MEDICINE. 6 0 26 0 0 0 0 0 2423183 1713039 28035 21017 1028213 1441437 3479431 3175493 0 0 0 0 2185622 2586020 0 0 0 883828 1005769 3069450 3591789 409981 -416296 4259066 4125735 332169 607258 3926897 3518477 TO PROVIDE THE HIGHEST QUALITY CARE TO WOMEN OF WESTERN NEW YORK IN THE SPECIALTY AREAS OF GENERAL AND HIGH RISK OBSTETRICS, GYNECOLOGY, AND REPRODUCTIVE ENDOCRINOLOGY & INFERTILITY. 0 0 3082679 3154476 THE CORPORATION PROVIDED VARIOUS MEDICAL SERVICES TO THE FEMALE POPULATION OF WESTERN NEW YORK SEEKING MEDICAL ATTENTION IN THE AREAS OF OBSTETRICS AND GYNECOLOGY. THE CORPORATION ALSO SUPPORTS THE EDUCATIONAL PURPOSE OF THE STATE UNIVERSITY OF NEW YORK AT BUFFALO SCHOOL OF MEDICINE AND BIOMEDICAL SCIENCES BY PROVIDING CLINICAL INSTRUCTION AND SUPERVISION OF STUDENTS,INTERNS AND RESIDENTS. 3082679 1 0 0 0 0 0 0 0 0 0 1 1 0 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 0 1 6 0 1 26 1 0 0 0 0 0 0 0 0 0 0 0 0 X 6 0 0 1 0 0 1 1 0 1 1 0 0 1 1 1 1 0 0 1 1 0 NY X X CATHERINE HERRICK 7168787578 219 BRYANT ST 3RD FLOOR ANNEX BUFFALO NY 14222 ARMANDO ARROYO 40.00 X X 277019 123371 41321 DENNIS MAURICIO 40.00 X X 208353 47101 25001 LATA SANTHAKUMAR 40.00 X X 192709 49181 41812 FAYE JUSTICIA-LINDE 40.00 X X 202772 49101 22304 AMOL LELE 40.00 X 350348 120347 47022 WILLIAM DILLON 40.00 X 0 132895 23046 MANDEEP BRAR 40.00 X 194747 68849 52786 MAJID SHAMAN 40.00 X 212676 47101 22907 1638624 637946 276199 7 0 1 0 0 CONTRACT REVENUE 624100 1639728 1639728 FEES FOR SERVICES 624100 73311 73311 1713039 21741 21741 724 -724 -724 -724 GRADUATE MEDICAL EDUCA 624100 1431670 1431670 MISCELLANEOUS INCOME 624100 9767 9767 1441437 3175493 3154476 0 21017 1329695 1309996 19699 1048448 984400 64048 52594 42075 10519 130527 104422 26105 24756 19805 4951 44401 44401 98343 98343 4968 4968 2865 2865 31156 10905 20251 97346 34538 62808 26351 26351 9495 9495 36349 36349 MALPRACTICE INSURANCE 286419 286419 0 CONTRACTUAL SERVICES 87497 87497 0 RESIDENT EXPENSES 79057 79057 0 CAO'S FUND 73132 0 73132 128390 94349 34041 3591789 3082679 509110 0 3385379 2742532 38670 37442 171572 296575 114992 128904 338488 54919 6750 283569 329823 345211 211880 291502 4259066 4125735 332169 342542 0 264716 332169 607258 X 0 0 0 0 3926897 3518477 3926897 3518477 4259066 4125735 X -416296 7876 X X 0 1 1 X 0 X 5555634 5594211 5445202 2423183 1713039 20731269 5555634 5594211 5445202 2423183 1713039 20731269 0 0 0 20731269 74757 5378 12135 25346 21741 139357 74757 5378 12135 25346 21741 139357 1028213 1441437 2469650 5630391 5599589 5457337 3476742 3176217 23340276 0.88820 0.95180 0.00600 0.00660 X SCHEDULE A, PART IV, SUPPLEMENTAL INFORMATION: SCHEDULE A, PART III, LINE 12: MISCELLANEOUS INCOME INCLUDES INCOME FROM OTHER HEALTH CARE RELATED ORGANIZATIONS AND PRODUCT SALES THAT ARE RELATED TO THE PRIMARY PURPOSE OF THE ORGANIZATION. GRADUATE MEDICAL REVENUE INCLUDES INCOME FROM AN AFFILIATED ORGANIZATION TO SUPPORT THE MEDICAL STUDENTS. 12997 765 12232 324574 53237 271337 917 917 0 283569 OTHER INVESTMENTS - M&T 345211 F 345211 CAPITAL CONTRIBUTIONS 211880 SECURITY DEPOSIT 3000 LONG-TERM PREPAIDS 76622 291502 3175493 3591789 -416296 7876 7876 -408420 3184093 7876 7876 3176217 -724 -724 3175493 3592513 724 724 3591789 0 3591789 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: THE PRACTICE PLAN HAS ADOPTED ACCOUNTING STANDARDS RELATED TO UNCERTAIN TAX POSITIONS. GENERALLY, THE PRACTICE PLANS PRIOR THREE TAX YEARS ARE OPEN AND SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE AND MOST OF THE STATES THE PRACTICE PLAN OPERATES IN. HOWEVER, THE PRACTICE PLAN IS NOT CURRENTLY UNDER AUDIT, NOR HAS THE PRACTICE PLAN BEEN CONTACTED BY ANY OF THESE JURISDICTIONS. PART XII, LINE 4B - OTHER ADJUSTMENTS: LOSS ON DISPOSAL OF ASSETS -724. PART XIII, LINE 2D - OTHER ADJUSTMENTS: LOSS ON DISPOSAL OF ASSETS 724. X 0 0 0 0 0 0 0 0 0 ARMANDO ARROYO 247019 123371 30000 0 0 0 22161 15994 0 3166 299180 142531 0 0 DENNIS MAURICIO 178353 47101 30000 0 0 0 16668 5167 0 3166 225021 55434 0 0 LATA SANTHAKUMAR 162709 49181 30000 0 0 0 15417 22529 0 3866 208126 75576 0 0 FAYE JUSTICIA-LINDE 172772 49101 30000 0 0 0 16222 5386 0 696 218994 55183 0 0 AMOL LELE 320348 120347 30000 0 0 0 28028 18002 0 992 378376 139341 0 0 WILLIAM DILLON 0 132895 0 0 0 0 0 19880 0 3166 0 155941 0 0 MANDEEP BRAR 194747 68849 0 0 0 0 15580 34040 0 3166 210327 106055 0 0 MAJID SHAMAN 182676 47101 30000 0 0 0 17014 5167 0 726 229690 52994 0 0 ARMINDA MAURICIO SPOUSE OF DENNIS MAURICIO 57500 WAGES 0 JOCELYN ARROYO SPOUSE OF ARMANDO ARROYO 2279 WAGES 0 FORM 990, PART VI, SECTION A, LINE 3 THE ORGANIZATION DELEGATES CERTAIN MANAGEMENT FUNCTIONS TO A RELATED PARTY, UB ASSOCIATES, INC. IN EXCHANGE FOR A FEE. FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION HAS MEMBERS. FORM 990, PART VI, SECTION A, LINE 7A THE ORGANIZATION HAS MEMBERS THAT MAY ELECT OTHER MEMBERS TO THE GOVERNING BOARD. FORM 990, PART VI, SECTION B, LINE 11 A COPY OF THE FORM 990 WAS GIVEN TO EACH BOARD MEMBER FOR REVIEW BEFORE THE 990 WAS FILED. THIS WAS DONE VIA BOARD MEETING AND EMAIL. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION REQUIRES DISCLOSURE OF ANY CONFLICTS OF INTEREST ON AN ANNUAL BASIS. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION IS GOVERNED BY ARTICLE XVI OF THE STATE UNIVERSITY OF NEW YORK. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED GAINS ON INVESTMENTS: 7,876. FORM 990, PART XII, LINE 2C THE PROCESS HAS NOT CHANGED SINCE THE PRIOR YEAR. UB ASSOCIATES INC UB DOWNTOWN GATEWAY BUILDING 77 GOO BUFFALO NY 14203 161559460 PROVIDE ADMIN SUPPORT TO SUNY BUFFALO MEDICAL SCHOOL PRACTICE PLAN NY 501(C)(3) LINE 9 N/A 0 STATE OF NEW YORK ONE COMMERCE PLAZA 99 WASHINGTON A ALBANY NY 12231 146013200 GOVERNMENT NY 501(C)(1) N/A 0 0 0 0 0 1 0 0 0 0 1 0 1 0 0 1 0 0 0 UB ASSOCIATES INC J 71105 MARKET VALUE UB ASSOCIATES INC L 78908 MARKET VALUE UB ASSOCIATES INC O 11432 MARKET VALUE STATE OF NEW YORK O 73132 MARKET VALUE STATE OF NEW YORK E 2850 MARKET VALUE