2011-10-13T15:17:06-05:00 2011-05-31 LARSONALLEN LLP 220 SOUTH SIXTH STREET SUITE 300 MINNEAPOLIS MN 55402 990 2010-06-01 410693869 MEMORIAL BLOOD CENTERS INC MEMO 6513327000 737 PELHAM BOULEVARD ST PAUL MN 551141739 JOHN M BUSKE 6513327000 2011-10-08 1 JOHN TAUER 6123764500 2010 2016-03-07 17:11:31Z DONALD BERGLUND 737 PELHAM BOULEVARD ST PAUL MN 551141739 52987861 0 X WWW.MEMORIALBLOODCENTERS.ORG X 1947 MN SUPPLY BLOOD AND BLOOD COMPONENTS TO 32 HOSPITALS IN MINNESOTA AND WISCONSIN. 17 17 465 73000 0 0 465428 462287 48452009 47784057 18684 60469 622765 733537 49558886 49040350 0 0 0 0 20067120 20597469 0 0 167073 26872559 26329092 46939679 46926561 2619207 2113789 31149393 32476146 12799090 11667385 18350303 20808761 MEMORIAL BLOOD CENTERS IS A LOCALLY OPERATED, NONPROFIT COMMUNITY BLOOD CENTER THAT SERVES AS THE MAJOR SUPPLIER OF BLOOD AND BLOOD COMPONENTS TO 32 HOSPITALS IN THE TWIN CITIES METRO AREA, NORTHERN MINNESOTA AND NORTHWESTERN WISCONSIN. 0 0 40551745 0 47784057 MEMORIAL BLOOD CENTERS IS A LOCALLY OPERATED, NONPROFIT COMMUNITY BLOOD CENTER THAT SERVES AS THE MAJOR SUPPLIER OF BLOOD AND BLOOD COMPONENTS TO 32 HOSPITALS IN THE TWIN CITIES METRO AREA, NORTHERN MINNESOTA AND NORTHWESTERN WISCONSIN. MEMORIAL BLOOD CENTERS IS A LEADER IN TRANSFUSION MEDICINE, PROVIDING EXPERT TECHNICAL SERVICES TO CLIENTS THROUGHOUT THE COUNTRY. AMONG THE SERVICES MEMORIAL BLOOD CENTERS PROVIDES ARE CONSULTING, PARENTAGE TESTING, REFERENCE LABORATORY WORK, VIROLOGY TESTING, RESEARCH, AND ORGAN AND MARROW TRANSPLANTATION SUPPORT. 40551745 1 1 0 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1 33 0 1 465 1 0 0 0 0 0 0 0 0 0 0 X 17 17 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 MN WI X JOHN M BUSKE CFO VP OF FINANCE 6513327000 737 PELHAM BOULEVARD ST PAUL MN 551141739 THOMAS E BECKER MD 1.00 X X 0 0 0 PHILLIP MARTIN 1.00 X X 0 0 0 KENNETH E LACHANCE 1.00 X X 0 0 0 DANIEL BOULAY 1.00 X 0 0 0 JAMES CHERVENY 1.00 X 0 0 0 PATRICIA COPPO 1.00 X 0 0 0 PATRICK COURNEYA MD 1.00 X 0 0 0 MATTHEW DOKKEN 1.00 X 0 0 0 JAMES DOWIAK 1.00 X 0 0 0 ROGER GREEN MD 1.00 X 0 0 0 THOMAS F HEANEY 1.00 X 0 0 0 RITA KENYON JD SPHR 1.00 X 0 0 0 TIMOTHY KUCK 1.00 X 0 0 0 ERIK LINDELL 1.00 X 0 0 0 SCOTT LYNCH 1.00 X 0 0 0 TIMOTHY MYERS MD 1.00 X 0 0 0 JEFF A NELSON 1.00 X 0 0 0 THOMAS WHELAN 1.00 X 0 0 0 BRENT L WILDE 1.00 X 0 0 0 DONALD C BERGLUND 40.00 X 365627 0 55788 JOHN M BUSKE 40.00 X 227426 0 34132 ROVENA L CLAXTON 40.00 X 136002 0 15764 JED B GORLIN MD 40.00 X 324618 0 50574 JUDITH A PETERSEN 40.00 X 163224 0 12326 KENNETH P KIEFFER 40.00 X 0 0 0 ELIZABETH H PERRY MD 40.00 X 198059 0 3593 KRISTINE A BELANGER 40.00 X 124164 0 345 WENDY L CAPETZ 40.00 X 113620 0 0 FREDRICK W TEETER 40.00 X 102456 0 1396 JUDITH E WENZEL 40.00 X 105633 0 8196 1860829 0 182114 10 0 1 0 MCGOUGH FACILITY MANAGEMENT 2737 FAIRVIEW AVENUE NORTH ST PAUL MN 55113 FACILITIES MANAGEMENT 860091 OSU HUMAN IDENTITY TESTING LAB PO BOX 9576 TULSA OK 741570576 TESTING SERVICES 208110 FEDERAL EXPRESS CORPORATION PO BOX 94515 PALATINE IL 600944515 COURIER SERVICES 204136 LABORATORY CORPORATION PO BOX 12140 BURLINGTON NC 272162140 TESTING SERVICES 188080 UNITED PARCEL SERVICE PO BOX 577 CAROL STREAM IL 601320577 COURIER SERVICES 186996 10 75235 387052 47247 462287 SERVICE FEE - UNIT 621500 33585421 33585421 LABORATORY SERVICES 621500 9506554 9506554 PLASMA AND ANTISERUM 621500 3163276 3163276 REAGENT SALES 621500 1246958 1246958 RESEARCH PROJECTS 621500 188415 188415 93433 93433 47784057 12692 12692 3881461 8215 3839626 2273 41835 5942 47777 47777 73261 75235 105612 -32351 -32351 MISCELLANEOUS 900099 765888 765888 765888 49040350 47784057 0 794006 1277377 505249 772128 14612962 12452276 2077370 83316 409558 383067 11025 15466 3275160 2496019 773617 5524 1022412 823753 192826 5833 38800 38800 38226 38226 39190 39190 624227 247464 376206 557 109568 58461 36298 14809 1691206 1319029 362988 9189 463668 318404 139122 6142 1429692 977401 451099 1192 638690 534270 101042 3378 101432 79294 14223 7915 286501 247078 37761 1662 2039825 1850406 187146 2273 248951 118823 130128 REAGENTS 11372015 11372015 MEDICAL SUPPLIES 5483763 5475069 8694 EQUIP RENTAL/MAINT 937171 858001 78563 607 DONOR & EMPL RECOGNITIO 306879 201519 98681 6679 FEES, DUES, & SUBSCRIPT 187207 42236 144141 830 292081 191911 98469 1701 46926561 40551745 6207743 167073 4771078 6692195 5483824 6281271 1853510 1515814 369691 319102 22292570 8700203 14415971 13592367 3980319 3800397 275000 275000 31149393 32476146 7103347 6602458 114570 113782 3906913 3509694 1193526 1031102 371054 308994 109680 101355 12799090 11667385 X 18327136 20790517 23167 18244 18350303 20808761 31149393 32476146 X 2113789 344669 X 0 1 1 X 0 X 363186 400532 525531 465428 462287 2216964 39088748 44734432 48526003 48520947 47857318 228727448 39451934 45134964 49051534 48986375 48319605 230944412 9015 8861 16801 11839 13570 60086 22058012 22306781 25428275 24382504 25028021 119203593 22067027 22315642 25445076 24394343 25041591 119263679 111680733 557213 68999 24280 3124 12692 666308 557213 68999 24280 3124 12692 666308 45303 146330 23475 630054 656016 1501178 40054450 45350293 49099289 49619553 48988313 233111898 0.47910 0.47170 0.00290 0.00440 X SCHEDULE A, PART II, LINE 12, EXPLANATION OF OTHER INCOME: OTHER INCOME ASSET IMPAIRMENT LOSS RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 990396 990396 9898408 2662915 7235493 1777461 1187660 589801 9148037 4849628 4298409 478268 478268 13592367 DEFERRED COMPENSATION 61423 ASSET RETIREMENT OBLIGATION 39932 101355 49040350 46926561 2113789 -3799 348468 344669 2458458 48937667 -3799 9413 105612 111226 48826441 213909 213909 49040350 39794396 9413 105612 115025 39679371 7247190 7247190 46926561 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: THE BLOOD CENTER IS A NONPROFIT ORGANIZATION AND IS EXEMPT, AS A PUBLIC CHARITY, FROM TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND APPLICABLE STATE STATUTES. THE BLOOD CENTER FOLLOWS THE ACCOUNTING STANDARDS FOR CONTINGENCIES IN EVALUATING UNCERTAIN TAX POSITIONS. THIS GUIDANCE PRESCRIBES RECOGNITION THRESHOLD PRINCIPLES FOR THE FINANCIAL STATEMENT RECOGNITION OF TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN ON A TAX RETURN THAT ARE NOT CERTAIN TO BE REALIZED. THE BLOOD CENTER'S TAX RETURNS ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL AND STATE AUTHORITIES. THE TAX RETURNS FOR THE YEARS 2007 THROUGH 2010 ARE OPEN TO EXAMINATION BY FEDERAL AND STATE AUTHORITIES. PART XI, LINE 8 - OTHER ADJUSTMENTS: PENSION LIABILITY ADJUSTMENT 458,340. LOSS ON IMPAIRMENT OF FIXED ASSETS -109,872. PART XII, LINE 2D - OTHER ADJUSTMENTS: SPECIAL FUNDRAISING EVENT EXPENSES 105,612. PART XII, LINE 4B - OTHER ADJUSTMENTS: INVESTMENT INCOME 51,152. IN-KIND CONTRIBUTIONS 56,660. DEBT FORGIVENESS 100,155. GAIN ON DISPOSAL OF ASSETS 5,942. PART XIII, LINE 2D - OTHER ADJUSTMENTS: SPECIAL FUNDRAISING EVENT EXPENSES 105,612. PART XIII, LINE 4B - OTHER ADJUSTMENTS: INTEREST EXPENSE 286,500. OPERATING EXPENSES 6,960,690. WHAT'S YOUR TYPE METRO 112754 47357 65397 0 0 2828 1298 4785 90880 WHAT'S YOUR TYPE NORTHLAND 35742 27879 7863 0 0 2828 216 0 5455 148496 75236 73260 5656 1514 4785 96335 108290 -35030 X X X X X 0 1 0 0 0 0 0 0 0 DONALD C BERGLUND 276389 0 40253 0 48985 0 52318 0 3470 0 421415 0 0 0 JOHN M BUSKE 173358 0 23700 0 30368 0 31430 0 2702 0 261558 0 0 0 ROVENA L CLAXTON 105109 0 17414 0 13479 0 11950 0 3814 0 151766 0 0 0 JED B GORLIN MD 249252 0 33496 0 41870 0 44163 0 6411 0 375192 0 0 0 JUDITH A PETERSEN 130504 0 16506 0 16214 0 10022 0 2304 0 175550 0 0 0 ELIZABETH H PERRY MD 167593 0 13966 0 16500 0 0 0 3593 0 201652 0 0 0 PART I, LINE 4B MEMORIAL BLOOD CENTERS HAS IN PLACE A 457(F) PLAN WHICH DOES COVER VARIOUS INDIVIDUALS OF MANAGEMENT. IN 2010, INVOLVEMENT IN THE PLAN OCCURED AS FOLLOWS: NAME CONTRIBUTIONS WITHDRAWALS DONALD C. BERGLUND $52,318 $48,985 JOHN M. BUSKE $31,430 $30,368 ROVENA L. CLAXTON $11,950 $13,479 JED B. GORLIN, MD $44,163 $41,870 JUDITH A. PETERSON $10,022 $16,214 CITY OF MINNEAPOLIS MN 416005375 584991AA1 2003-11-20 680000 BUILDING RENOVATION 2304 PARK AVENUE, MINNEAPOLIS, MN 0 0 0 PORT AUTHORITY OF THE CITY OF ST PAUL MN 416005524 584991AC7 2005-11-08 4500000 BUILDING ACQUISITION & RENOVATION 737 PELHAM BLVD, ST. PAUL, MN 0 0 0 PORT AUTHORITY OF THE CITY OF ST PAUL MN 416005524 584991AB9 2005-11-08 510000 BUILDING ACQUISITION & RENOVATION 737 PELHAM BLVD, ST. PAUL, MN 0 0 0 680000 680000 2003 0 0 1 1 4500000 30000 4500000 2005 0 0 1 1 510000 10000 510000 2005 0 0 1 1 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 66 16286 FAIR MARKET VALUE X 7 2681 ESTIMATED VALUE X DVDS 21 350 ESTIMATED VALUE X GIFT CARDS 147 27930 FACE VALUE 0 0 0 0 FORM 990, PART VI, SECTION A, LINE 1 THE EXECUTIVE COMMITTEE IS COMPOSED OF THE CHAIR, VICE CHAIR, SECRETARY AND OTHER DIRECTOR(S) DESIGNATED BY THE BOARD OF DIRECTORS TO SERVE ON THE COMMITTEE. THE EXECUTIVE COMMITTEE HAS THE AUTHORITY OF THE BOARD OF DIRECTORS IN THE MANAGEMENT OF THE BUSINESS OF THE ORGANIZATION BETWEEN MEETINGS OF THE BOARD OF DIRECTORS, BUT IS SUBJECT TO THE CONTROL AND DIRECTION OF THE BOARD. FORM 990, PART VI, SECTION B, LINE 11 THE FINANCE COMMITTEE OF THE BOARD OF DIRECTORS REVIEWED AND APPROVED THE 990. THE FORM 990 WAS THEN SENT TO THE FULL BOARD OF DIRECTORS BEFORE FILING. FORM 990, PART VI, SECTION B, LINE 12C DIRECTORS AND OFFICERS MUST DISCLOSE ALL CONFLICTS OF INTEREST AND MUST ANNUALLY COMPLETE AND RETURN TO THE NOMINATING AND GOVERNANCE COMMITTEE THE QUESTIONNAIRE WHICH IS A PART OF THE ORGANIZATION'S CONFLICT OF INTEREST POLICY. WHENEVER IN THE COURSE OF EVENTS A DIRECTOR'S OR OFFICER'S CIRCUMSTANCES CHANGE, SO THAT HE OR SHE KNOWS OR HAS REASON TO KNOW THAT AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST MAY ARISE, SUCH DIRECTOR OR OFFICER SHALL PROMPTLY DISCLOSE THE POTENTIAL CONFLICT TO THE NOMINATING AND GOVERNANCE COMMITTEE. THE DIRECTOR OR OFFICER SHALL NOT PARTICIPATE IN, TAKE ANY ACTION UPON, OR VOTE UPON SUCH MATTERS UNTIL THE QUESTION OF THE EXISTENCE OF THE CONFLICT OF INTEREST HAS BEEN DETERMINED BY THE NOMINATING AND GOVERNANCE COMMITTEE. WHEN A CONFLICT OF INTEREST DOES IN FACT EXIST UNDER THE DEFINITION SET FORTH ABOVE, THE PERSON WITH THE CONFLICT OF INTEREST SHALL NOT BE COUNTED FOR DETERMINING THE PRESENCE OF A QUORUM, EVEN WHEN PERMITTED BY LAW AND SHALL NOT PARTICIPATE IN ANY WAY IN, OR BE PRESENT DURING, THE DELIBERATIONS AND DECISION-MAKING VOTE WITH RESPECT TO THE MATTER. NEVERTHELESS, THE INTERESTED PARTY SHALL HAVE AN OPPORTUNITY TO PROVIDE FACTUAL INFORMATION ABOUT THE MATTER. THE MINUTES OF THE MEETING SHOULD REFLECT THAT THE DIRECTOR OR OFFICER HAVING A CONFLICT DISCLOSED SUCH INTEREST AND ABSTAINED VOTING ON THE MATTER AND THAT A QUORUM WAS PRESENT FOR SUCH ACTION. FORM 990, PART VI, SECTION B, LINE 15 THE HUMAN RESOURCES COMMITTEE OF THE BOARD OF DIRECTORS, COMPOSED ENTIRELY OF INDEPENDENT PERSONS, OVERSEES EXECUTIVE COMPENSATION AND, IN DOING SO, RETAINS AN EXTERNAL PARTY TO CONDUCT AN INDEPENDENT MARKET SURVEY ON A REGULAR BASIS (EVERY 2 - 3 YEARS). THE PROCESS INCLUDED REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA AND CONTEMPORANEOUS SUBSTANTIATION IN 2008 FOR THE CEO, D. BERGLUND; CFO, J. BUSKE, VP OF HR AND ORGANIZATIONAL DEVELOPMENT, R. CLAXTON; VP OF MEDICAL & QUALITY AFFAIRS, J. GORLIN; VP OF TECHNOLOGY OPERATIONS, J. PETERSEN; VP OF RECRUITMENT, COLLECTION & PRODUCTION PLANNING, K. KIEFFER; AND ASSOCIATE MEDICAL DIRECTOR, E. PERRY. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY OR FINANCIAL STATEMENTS OPEN TO THE PUBLIC. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED LOSSES ON INVESTMENTS: -3,799. PENSION LIABILITY ADJUSTMENT 458,340. LOSS ON IMPAIRMENT OF FIXED ASSETS -109,872. TOTAL TO FORM 990, PART XI, LINE 5: 344,669.