2011-10-04T08:22:50-05:00 2011-06-30 THE MB GROUP LLC 5072 W PLANO PARKWAY SUITE 150 PLANO TX 75093 990 2010-07-01 752391148 NATIONAL BREAST CANCER FOUNDATION INC NATI 9722489200 2600 NETWORK BLVD NO 300 FRISCO TX 75034 JOHN T REECE II 9722489200 2011-09-29 1 4698651040 2011-09-29 2010 2016-03-07 17:11:31Z JANELLE HAIL 2600 NETWORK BLVD NO 300 FRISCO TX 75034 15532825 0 X WWW.NBCF.ORG X 1991 TX SAVE LIVES BY EARLY DETECTION, PROVIDING DIAGNOSTIC BREAST CARE SERVICES FOR THOSE IN NEED, INCREASING AWARENESS THROUGH EDUCATION, AND PROVIDING NURTURING SUPPORT SERVICES. 4 3 19 3 0 0 10003856 11732204 0 0 50000 190415 0 3 10053856 11922622 2033930 3664461 0 0 1627474 1960086 0 0 1029348 4471982 4771545 8133386 10396092 1920470 1526530 7722136 9332911 105723 100260 7616413 9232651 TO SAVE LIVES BY EARLY DETECTION, INCLUDING PROVIDING DIAGNOSTIC BREAST CARE SERVICES FOR THOSE IN NEED, INCREASING AWARENESS THROUGH EDUCATION, AND PROVIDING NURTURING SUPPORT SERVICES 0 0 3691921 2960388 0 FUNDING OF DIAGNOSTIC BREAST CARE SERVICES, INCLUDING MAMMOGRAMS, IN AUTHORIZED FACILITIES NATIONALLY WITH A CONCENTRATED EFFORT TO REACH UNDERSERVED/UNINSURED WOMEN AND TO INCREASE EARLY DETECTION OF BREAST CANCER IN THIS AT RISK GROUP BASED ON AN ACTUAL COUNT OF 32,865 FREE DIAGNOSTIC BREAST CARE SERVICES, INCLUDING MAMMOGRAMS, AND 28,775 PATIENT NAVIGATION SERVICES. 4148111 50000 0 DESIGNED AND DELIVERED EDUCATIONAL AND AWARENESS MATERIALS UTILIZED BY OVER 8,100,000 BREAST CANCER PATIENTS AND SUPPORTERS NATIONALLY AND INTERNATIONALLY, INCLUDING EDUCATIONAL AND AWARENESS MATERIALS ON NBCF.ORG, BEYOND THE SHOCK EDUCATIONAL PROGRAM, EARLY DETECTION PLAN, MYNBCF.ORG, BREASTCANCER.NET, BREAST CANCER EDUCATION BROCHURES, AND MEDIA PRESENTATIONS. 801709 654072 0 FUNDED BREAST CANCER RESEARCH INITIATIVES FOCUSED ON EARLY DETECTION, TREATMENT OR CURE OF BREAST CANCER. 8641741 1 1 0 0 0 0 0 0 0 1 1 0 1 1 0 1 0 0 0 1 1 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1 24 0 19 1 0 0 0 0 0 0 0 0 0 0 X 4 3 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 AL AK AR AZ CA CO CT DC FL GA HI IL KS KY ME MD MA MI MN MS ND NH NJ NM NY NC OH OK OR PA RI SC TN UT VA WA WV WI X X X JO ANN TIMBERLAKE VICE PRESIDENT ACCOUNTING 9722489200 2600 NETWORK BLVD STE 300 FRISCO TX 75034 JANELLE HAIL CEOPRES 40.00 X X 177912 0 57088 MYRA BROWN 2.00 X 0 0 0 RONALD BROOKS 2.00 X 0 0 0 STEVE ENGLE 2.00 X 0 0 0 KEVIN HAIL COO 40.00 X 141462 0 53760 JOHN REECE CFO 40.00 X 130486 0 44506 JO ANN TIMBERLAKE 40.00 X 101179 0 41618 551039 0 196972 4 0 1 0 OVEN BITS 840 LAKE CAROLYN PKWY STE 223 IRVING TX 75039 EDUCATIONAL VIDEO DEVELOPMENT 256878 BOOMERANG SUPPORT 5015 ADDISON CIRCLE STE 521 ADDISON TX 75001 IT SUPPORT 108094 2 99741 11632463 1409438 11732204 186390 186390 3614228 3607693 2510 6535 -2510 4025 4025 2 2 2 MISCELLANEOUS INCOME 900099 1 1 1 11922622 190418 0 0 3610388 3610388 54073 54073 456012 369173 41031 45808 876154 360752 271013 244389 256604 142180 67478 46946 267200 135164 79190 52846 104116 53671 26272 24173 7358 3945 3413 14317 14317 168753 73849 17902 77002 259170 8538 20065 230567 182989 63473 64010 55506 134191 64649 29803 39739 271582 175343 41614 54625 225564 137568 10039 77957 29805 16437 3297 10071 164138 106645 24864 32629 29847 21785 3605 4457 EDUCATION/AWARENESS 3234862 3234862 CONTRACT LABOR 25511 8019 9968 7524 LICENSES/MEMBERSHIP FEE 14315 1227 535 12553 ADWARDS/RECOGNITION 9143 9143 10396092 8641741 725003 1029348 187853 220461 357106 13824 1617208 737002 797 1691 900615 641660 334266 258955 5065315 7494683 159591 606295 7722136 9332911 62213 28845 43510 71415 105723 100260 X 7616413 9232651 7616413 9232651 7722136 9332911 X 1526530 89708 X X 0 1 1 X 0 X 5281436 7141274 8225984 8287900 10332766 39269360 5281436 7141274 8225984 8287900 10332766 39269360 1018881 38250479 99946 112484 71740 79437 186390 549997 24559 818 208 1 25586 39844943 0.96000 0.95150 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 234426 192052 42374 395765 289728 106037 270424 159880 110544 258955 US GOVERNMENT BACKED BONDS 2981552 F AAA/AA RATED CORPORATE BONDS 1746881 F MUTUAL FUNDS 1840410 F CERTIFICATES OF DEPOSITS 925840 F 7494683 OTHER RECEIVABLE 368712 PREPAID EXPENSES 237583 606295 DEFERRED RENT 36874 DEFERRED PTO LIABILITY 34541 71415 11922622 10396092 1526530 89708 89708 1616238 12014838 89708 -2 89706 11925132 -2510 -2510 11922622 10398601 -1 -1 10398602 -2510 -2510 10396092 PART XII, LINE 2D - OTHER ADJUSTMENTS: ROUNDING -2. PART XII, LINE 4B - OTHER ADJUSTMENTS: LOSS ON SALE OF EQUIPMENT -2,510. PART XIII, LINE 2D - OTHER ADJUSTMENTS: ROUNDING -1. PART XIII, LINE 4B - OTHER ADJUSTMENTS: LOSS ON SALE OF EQUIPMENT -2,510. 0 EUROPE SPOKE AT A MEDICAL SYMPOSIUM, PRESENTING BEYOND THE SHOCK(SEE SCH O FOR CONTINUATION) PROVIDED AN EDUCATIONAL RESOURCE FOR PROGRAM PROVIDERS TO GIVE TO BREAST CANCER PATIENTS AND SUPPORTERS INTERNATIONALLY AND NATIONALLY. 57833 0 0 0 57833 0 57833 X EUROPE MEMBERSHIP IN INTERNATIONAL MEDICAL CANCER SYMPOSIUM FOR CALENDAR YEAR 2010 35705 WIRE TRANSFER COST EUROPE MEMBERSHIP IN INTERNATIONAL MEDICAL CANCER SYMPOSIUM 5O% CALENDAR YEAR 2011 18367 WIRE TRANSFER COST 0 1 0 0 0 0 0 0 PROCEDURE FOR MONITORING GRANTS OUTSIDE THE U.S.: SCHEDULE F, PART I, LINE 2: THE SUBSTANTIATION OF THE AMOUNT OF ASSISTANCE PROVIDED TO ORGANIZATIONS IS BASED ON NEEDS EXPRESSED BY ORGANIZATIONS, BALANCED WITH THE TYPICAL RANGE OF NBCF GRANTS MADE TO ANY ONE ORGANIZATION. THE $54,072 (37,500 EUROS) ASSISTANCE MADE TO THE MEDICAL SYMPOSIUM IS WITHIN THIS RANGE. THE ELIGIBILITY FOR ASSISTANCE IS DETERMINED BY A REVIEW OF THE ORGANIZATION'S PROGRAM OFFERINGS AND ITS ALIGNMENT WITH NBCF'S MISSION. THE NBCF MISSION IS TO SAVE LIVES THROUGH EARLY DETECTION AND TO PROVIDE MAMMOGRAMS FOR THOSE IN NEED. OUR MISSION INCLUDES INCREASING AWARENESS THROUGH EDUCATION, PROVIDING DIAGNOSTIC BREAST CARE SERVICES FOR THOSE IN NEED, AND PROVIDING NURTURING SUPPORT SERVICES. THE SYMPOSIUM PROGRAM WAS REVIEWED AND DETERMINED TO BE IN ALIGNMENT WITH OUR MISSION OF PROVIDING AWARENESS THROUGH EDUCATION, NURTURING SUPPORT SERVICES, AND EARLY DETECTION. THE SELECTION CRITERIA WAS BASED ON NBCF'S ABILITY TO EXTEND AND EXPAND ITS REACH OF FULFILLING ITS MISSION OF EARLY DETECTION AND AWARENESS OF BREAST CANCER. THE SYMPOSIUM IN PARTICULAR WAS ALSO RECOMMENDED BY AN ESTABLISHED PROGRAM PARTNER OF NBCF, AND WAS THE VENUE FOR LAUNCHING OUR MULTI-LANGUAGE EDUCATION PROGRAM. METHOD USED TO ACCCOUNT FOR EXPENDITURES: SCHEDULE F, PART I, LINE 3: COST 1 ADVENTIST MEDICAL CENTER 10123 SE MARKET STREET PORTLAND OR 97216 930429015 501(C)(3) 25000 NATIONAL MAMMOGRAPHY PROGRAM GRANT ALABAMA DEPARTMENT OF PUBLIC HEALTH RSA TOWER 201 MONROE STREET SUITE 1364 MONTGOMERY AL 36104 631106545 GOVERNMENT ENTITY 100000 NATIONAL MAMMOGRAPHY PROGRAM GRANT ALEXIAN BROTHERS FOUNDATION 3040 SALT CREEK LANE ARLINGTON HEIGHTS IL 60005 364251846 501(C)(3) 50000 NATIONAL MAMMOGRAPHY PROGRAM GRANT ALLEGHANY HIGHLANDS FREE CLINIC 103 OLD CHURCH ROAD LOW MOOR VA 24457 541904342 501(C)(3) 30000 NATIONAL MAMMOGRAPHY PROGRAM GRANT AMERICAN-ITALIAN CANCER FOUNDATION 112 EAST 71ST STREET SUITE 2B NEW YORK NY 10021 133035711 501(C)(3) 113583 NATIONAL MAMMOGRAPHY PROGRAM GRANT AND PATIENT NAVIGATION PROGRAM GRANT BAPTIST HEALTH FOUNDATION 9601 INTERSTATE 630 EXIT 7 LITTLE ROCK AR 72205 237166407 501(C)(3) 31000 NATIONAL MAMMOGRAPHY PROGRAM GRANT BRATTLEBORO MEMORIAL HOSPITAL 17 BELMONT AVE BRATTLEBORO VT 05301 030107300 501(C)(3) 20400 PATIENT NAVIGATION PROGRAM GRANT BAYHEALTH FOUNDATION 640 S STATE STREET DOVER DE 19901 222559843 501(C)(3) 31000 NATIONAL MAMMOGRAPHY PROGRAM GRANT BETHESDA FOUNDATION 10500 MONTGOMERY ROAD CINCINNATI OH 45242 310537122 501(C)(3) 45000 NATIONAL MAMMOGRAPHY PROGRAM GRANT BOCA RATON COMMUNITY HOSPITAL 690 MEADOWS ROAD BOCA RATON FL 33486 591006663 501(C)(3) 35000 NATIONAL MAMMOGRAPHY PROGRAM GRANT BREAST CANCER CONNECTIONS 390 CAMBRIDGE AVENUE PALO ALTO CA 94306 770417605 501(C)(3) 76000 PATIENT NAVIGATION PROGRAM GRANT AND NATIONAL MAMMOGRAPHY PROGRAM GRANT NATIONAL MAMMOGRAPHY PROGRAM GRANT BREAST CANCER RESOURCE CENTER PARK ST DAVIDS 900 EAST 30TH STREET SUITE 108 AUSTIN TX 78705 742743333 501(C)(3) 35000 NATIONAL MAMMOGRAPHY PROGRAM GRANT CHARLESTON BREAST CENTER - RETURNED PRIOR YEAR GRANT 1930 CHARLIE HALL BLVD CHARLESTON SC 29414 203015793 501(C)(3) -9251 UNUSED NATIONAL MAMMOGRAPHY PROGRAM GRANT REFUNDED CONVOY OF HOPE 330 S PATTERSON AVE SPRINGFIELD MO 65802 680051386 501(C)(3) 50000 BREAST CANCER AWARENESS/ EDUCATION GRANT FRED HUTCHINSON CANCER RESEARCH CENTER 1100 FAIRVIEW AVE N J5-200 SEATTLE WA 98109 237156071 501(C)(3) 25000 NATIONAL MAMMOGRAPHY PROGRAM GRANT FROEDTERT HOSPITAL FOUNDATION 9200 WEST WISCONSIN AVE MILWAUKEE WI 53226 396105970 501(C)(3) 12000 NATIONAL MAMMOGRAPHY PROGRAM GRANT GENESIS HEALTHCARE SYSTEMS 1135 MAPLE AVENUE ZANESVILLE OH 43701 311629304 501(C)(3) 25000 NATIONAL MAMMOGRAPHY PROGRAM GRANT HACKENSACK UNIVERSITY MEDICAL CENTER FOUNDATION 360 ESSEX ST SUITE 301 HACKENSACK NJ 076018566 221487576 501(C)(3) 12500 NATIONAL MAMMOGRAPHY PROGRAM GRANT KINGMAN REGIONAL MEDICAL CENTER FOUNDATION 3269 STOCKTON HILL ROAD KINGMAN AZ 864093619 742388735 501(C)(3) 63347 PATIENT NAVIGATION PROGRAM GRANT LIGA CONTRA EL CANCERLEAGUE AGAINST CANCER 2180 SW 12 AVENUE MIAMI FL 33129 591629554 501(C)(3) 30000 NATIONAL MAMMOGRAPHY PROGRAM GRANT LOS ANGELES CHRISTIAN HEALTH CENTERS 311 WINSTON STREET LOS ANGELES CA 90013 954315734 501(C)(3) 50000 PATIENT NAVIGATION PROGRAM GRANT LRGHEALTHCARE 80 HIGHLAND STREET LACONIA NH 03246 020222150 501(C)(3) 17500 NATIONAL MAMMOGRAPHY PROGRAM GRANT LSUHSC FOUNDATION 1615 POYDRAS ST STE 1400 NEW ORLEANS LA 70112 721115391 501(C)(3) 15000 NATIONAL MAMMOGRAPHY PROGRAM GRANT MAD RIVER COMMUNITY HOSPITAL 3800 JANES ROAD ARCATA CA 95521 941698406 501(C)(3) 35000 NATIONAL MAMMOGRAPHY PROGRAM GRANT MAGEE WOMEN'S FOUNDATION 3339 WARD STREET PITTSBURGH PA 15213 251462312 501(C)(3) 45000 PATIENT NAVIGATION PROGRAM GRANT MAINE MEDICAL CENTER 100 CAMPUS DRIVE UNIT 110 SCARBOROUGH ME 04074 010238552 501(C)(3) 49546 PATIENT NAVIGATION PROGRAM GRANT MARTIN MEMORIAL HEALTH SYSTEMS 2135 SE OCEAN BLVD STUART FL 349969010 592307522 501(C)(3) 12500 NATIONAL MAMMOGRAPHY PROGRAM GRANT MAYO FOUNDATION-ROCHESTER 200 1ST STREET SW ROCHESTER MN 55902 416011702 501(C)(3) 125000 NATIONAL MAMMOGRAPHY PROGRAM GRANT AND PATIENT NAVIGATION PROGRAM GRANT METROHEALTH FOUNDATION INC 2500 METROHEALTH DRIVE C-2110 CLEVELAND OH 44109 346607695 501(C)(3) 65000 NATIONAL MAMMOGRAPHY PROGRAM GRANT MISSISSIPPI STATE DEPARTMENT OF HEALTH 570 E WOODROW WILSON JACKSON MS 392151700 646000775 GOVERNMENT ENTITY 50000 NATIONAL MAMMOGRAPHY PROGRAM GRANT MONTANA DEPARTMENT OF PUBLIC HEALTH MONTANA CANCER CONTROL PROGRAMS 1400 BROADWAY RM C317 HELENA MT 596202951 810302402 GOVERNMENT ENTITY 15000 NATIONAL MAMMOGRAPHY PROGRAM GRANT NEBRASKA MEDICAL CENTER 987421 NEBRASKA MEDICAL CENTER OMAHA NE 681987421 911858433 501(C)(3) 15000 NATIONAL MAMMOGRAPHY PROGRAM GRANT NEVADA HEALTH CENTERS 1802 N CARSON ST STE 100 CARSON CITY NV 89701 943199117 501(C)(3) 90000 NATIONAL MAMMOGRAPHY PROGRAM GRANT NEW JERSEY DEPARTMENT OF HEALTH AND SENIOR SERVICES 50 E STATE STREET - 6TH TRENTON NJ 086250364 216000928 GOVERNMENT ENTITY 40345 NATIONAL MAMMOGRAPHY PROGRAM GRANT OHIOHEALTH FOUNDATION 180 E BROAD STREET 31 FL COLUMBUS OH 43215 237446919 501(C)(3) 45000 NATIONAL MAMMOGRAPHY PROGRAM GRANT OKLAHOMA UNIVERSITY MEDICAL CENTER 1000 STANTON L YOUNG BLVD BIRD LIBRARY STE 162 OKLA CITY OK 73117 731477155 115(A) 60000 NATIONAL MAMMOGRAPHY PROGRAM GRANT PARKLAND HOSPITAL FOUNDATION 2777 N STEMMONS FRWY SUITE 1700 DALLAS TX 75207 752089180 501(C)(3) 175000 NATIONAL MAMMOGRAPHY PROGRAM GRANT POH RILEY FOUNDATION - REGIONAL MEDICAL CENTER POH RILEY FOUNDATION 50 NORTH PERRY STREET PONTIAC MI 48342 381428164 501(C)(3) 25000 NATIONAL MAMMOGRAPHY PROGRAM GRANT PRESBYTERIAN HOSPITAL FOUNDATION 108 PROVIDENCE ROAD CHARLOTTE NC 28207 581413074 501(C)(3) 77000 NATIONAL MAMMOGRAPHY PROGRAM GRANT QUEENS MEDICAL CENTER 1301 PUNCHBOWL STREET HONOLULU HI 96813 990073524 501(C)(3) 7821 PATIENT NAVIGATION PROGRAM GRANT SHARP HEALTHCARE FOUNDATION 8695 SPECTRUM CENTER BOULEVARD SAN DIEGO CA 92123 952367304 501(C)(3) 15000 NATIONAL MAMMOGRAPHY PROGRAM GRANT SOUTH DAKOTA DEPARTMENT OF HEALTH ALL WOMEN COUNT 615 EAST 4TH STREET PIERRE SD 57501 466000364 GOVERNMENT ENTITY 30000 NATIONAL MAMMOGRAPHY PROGRAM GRANT SPECTRUM HEALTH FOUNDATION 100 MICHIGAN STREET NE-MC004 GRAND RAPIDS MI 49503 381360529 501(C)(3) 75000 NATIONAL MAMMOGRAPHY PROGRAM GRANT SPRINGFIELD MEDICAL CARE SYSTEMS 25 RIDGEWOOD ROAD SPRINGFIELD VT 05156 030284813 501(C)(3) 20000 NATIONAL MAMMOGRAPHY PROGRAM GRANT ST ALPHONSUS 6200 WEST EMERALD BOISE ID 83706 820200895 501(C)(3) 100000 NATIONAL MAMMOGRAPHY PROGRAM GRANT ST JOSEPH HEALTH SERVICES OF RI 200 HIGH SERVICE AVENUE NORTH PROVIDENCE RI 02904 050259026 501(C)(3) 45777 PATIENT NAVIGATION PROGRAM GRANT ST LUKE'S BREAST CARE CENTER ST LUKES HOSPITAL 232 SOUTH WOODS MILL ROAD CHESTERFIELD MO 63017 430652680 501(C)(3) 50000 NATIONAL MAMMOGRAPHY PROGRAM GRANT ST ROSE DOMINICAN HOSPITAL WOMENSCARE CENTER 100 N GREEN VALLEY PKWY SUITE 300 HENDERSON NV 89074 886164903 501(C)(3) 76006 NATIONAL MAMMOGRAPHY PROGRAM GRANT ST VINCENT HOSPITAL FOUNDATION 8402 HARCOURT ROAD SUITE 210 INDIANAPOLIS IN 46260 356088862 501(C)(3) 65000 NATIONAL MAMMOGRAPHY PROGRAM GRANT ST VINCENT'S MEDICAL CENTER 2800 MAIN STREET BRIDGEPORT CT 06606 222558132 501(C)(3) 25000 NATIONAL MAMMOGRAPHY PROGRAM GRANT SWEDISH COVENANT HOSPITAL 5145 NORTH CALIFORNIA AVENUE CHICAGO IL 60625 362179813 501(C)(3) 100000 NATIONAL MAMMOGRAPHY PROGRAM GRANT THE CLEVELAND CLINIC FOUNDATION 9500 EUCLID AVENUE EE35 CLEVELAND OH 44195 340714585 501(C)(3) 150000 BREAST CANCER RESEARCH GRANT THE UNIVERSITY OF TEXAS MD ANDERSON CANCER CENTER 6900 FANNIN SUITE 61000 HOUSTON TX 77030 746001118 170(C)(1) & 115 564098 NATIONAL MAMMOGRAPHY PROGRAM GRANT AND BREAST CANCER RESEARCH GRANT THOMAS JEFFERSON UNIVERSITY 1015 CHESTNUT STREET SUITE 617 PHILADELPHIA PA 19107 232829095 501(C)(3) 50000 NATIONAL MAMMOGRAPHY PROGRAM GRANT UNIVERSITY HEALTH CARE FOUNDATION 2100 CENTRAL AVENUE SUITE D-1 AUGUSTA GA 30904 581343550 501(C)(3) 50000 NATIONAL MAMMOGRAPHY PROGRAM GRANT UNIVERSITY HEALTH SYSTEM INC 1934 ALCOA HWY SUITE 473 KNOXVILLE TN 37920 311626179 501(C)(3) 55216 NATIONAL MAMMOGRAPHY PROGRAM GRANT UNIVERSITY HOSPITAL FOUNDATION 50 NORTH MEDICAL DRIVE SALT LAKE CITY UT 84112 870474422 501(C)(3) 25000 NATIONAL MAMMOGRAPHY PROGRAM GRANT UNIVERSITY OF KANSAS CANCER CENTER 2330 SHAWNEE MISSION STE 1102 WESTWOOD KS 66205 480547734 501(C)(3) 50000 PATIENT NAVIGATION PROGRAM GRANT UNIVERSITY OF NEW MEXICO HOSPITAL 700 LOMAS BLVD NE TWO WOODWARD CENTER SUITE 108 ALBUQUERQUE NM 87102 850275408 501(C)(3) 12500 NATIONAL MAMMOGRAPHY PROGRAM GRANT VANDERBILT UNIVERSITY BREAST CANCER 719 THOMPSON LANE SUITE 25008 NASHVILLE TN 37204 620476822 501(C)(3) 40000 NATIONAL MAMMOGRAPHY PROGRAM GRANT WHITE MEMORIAL MEDICAL CENTER 1720 CESAR E CHAVEZ AVENUE LOS ANGELES CA 90033 953760201 501(C)(3) 100000 NATIONAL MAMMOGRAPHY PROGRAM GRANT WINTHROP P ROCKEFELLER CANCER INSTITUTE FOUNDATION 4301 W MARKHAM STREET MS 623F LITTLE ROCK AR 72205 716056774 501(C)(3) 60000 NATIONAL MAMMOGRAPHY PROGRAM GRANT WOMEN'S CENTER CENTER FOR BREAST CARE BRCH 609 MEADOWS ROAD BOCA RATON FL 33486 591006663 501(C)(3) 12500 NATIONAL MAMMOGRAPHY PROGRAM GRANT WYOMING DEPARTMENT OF HEALTH 6101 YELLOWSTONE RD SUITE 259A CHEYENNE WY 82002 830208667 GOVERNMENT ENTITY 24000 NATIONAL MAMMOGRAPHY PROGRAM GRANT 62 2 PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: THE NATIONAL MAMMOGRAPHY PROGRAM (NMP) NETWORK PARTNER-MEDICAL FACILITY PROVIDER GRANT APPLICATION REQUIRES THE GRANTEE ORGANIZATIONS TO DOCUMENT THEIR QUALIFICATION FOR A NMP GRANT. AMONG OTHER CRITERIA, THE FACILITIES MUST BE CAPABLE TO DELIVER MAMMOGRAMS, HAVE THE CAPACITY TO RUN A NCBF MAMMOGRAPHY PROGRAM, AND HAVE A POTENTIAL POOL OF RECIPIENTS CONSISTENT WITH THE NBCF TARGET DEMOGRAPHIC OF UNDERSERVED WOMEN UNDER MEDICARE AGE. OUR FUNDING IS RESTRICTED EXCLUSIVELY FOR SCREENING AND DIAGNOSTIC MAMMOGRAMS AND ULTRASOUNDS, CLINICAL BREAST EXAMS AND CAD READINGS. GRANTEE ORGANIZATIONS ARE ENCOURAGED TO DEVELOP A PROCESS FOR A FULL CONTINUUM OF BREAST CARE NEEDED, INCLUDING BIOPSIES, MRI'S AND SURGICAL AND CANCER TREATMENT AS NEEDED. THE APPLICATION FORM IS DESIGNED TO IDENTIFY THOSE MEDICAL FACILITIES WHICH PROVIDE THE SERVICES NEEDED TO THE POPULATION TARGETED BY THE NBCF MISSION, AND ALSO, COMPLY WITH THE ESTABLISHED FACILITY CRITERIA. OTHER INFORMATION: PART IV: THE NATIONAL MAMMOGRAPHY PROGRAM - RESULTS SUBMISSION FORM IS A REQUIREMENT OF GRANT RECIPIENTS FOR SEMI-ANNUAL MONITORING OF GRANTS AWARDED. GRANTEE ORGANIZATIONS ARE REQUIRED TO REPORT THE AMOUNT OF GRANT FUNDS USED TO-DATE, AND THE NUMBER OF PATIENTS SERVED. IF THE MEDICAL PROVIDER IS SUCCESSFUL IN FULFILLING THE NBCF MISSION WHILE COMPLYING WITH THE ESTABLISHED FACILITY CRITERIA, AND NEEDS ADDITIONAL FUNDS FOR THEIR PROGRAM, NBCF WILL ENCOURAGE THEM TO APPLY FOR ADDITIONAL GRANTS. IN THE RARE EVENT THAT A MEDICAL PROVIDER FINDS THEY ARE UNABLE TO USE THE GRANT PER THE GRANT RESTRICTIONS, NBCF HAS THE GRANT REFUNDED TO NBCF AND RE-DISTRIBUTES THE FUNDS TO ANOTHER MEDICAL PROVIDER THROUGH THE APPLICATION PROCESS. GRANTEE ORGANIZATIONS RECEIVING NMP PATIENT NAVIGATION PROGRAM GRANTS MUST REPORT THE FOLLOWING TO NBCF: PROGRAM COORDINATOR ACTIVITIES, PROCESSES, TYPES OF SERVICES PROVIDED, NUMBER OF WOMEN SERVICED THROUGH NAVIGATION, TIMELINESS OF CARE, AND THE AMOUNT OF GRANT FUNDS USED TO-DATE. NBCF STAYS IN CLOSE CONTACT WITH FACILITIES RECEIVING BREAST CANCER RESEARCH GRANTS TO CONFIRM THE GRANTS ARE FURTHERING RESEARCH PROJECTS WHICH ARE FOCUSED ON EARLY DETECTION, TREATMENT OR CURE OF BREAST CANCER. X X X 0 0 0 0 0 0 0 0 0 JANELLE HAIL CEOPRES 177912 0 0 0 0 0 42882 0 14206 0 235000 0 0 0 KEVIN HAIL COO 141462 0 0 0 0 0 32649 0 21111 0 195222 0 0 0 JOHN REECE CFO 130486 0 0 0 0 0 23449 0 21057 0 174992 0 0 0 X 1 571 FAIR MARKET VALUE X EDUCATIONAL MATERIALS 91 1064371 FAIR MARKET VALUE X AWARENESS EVENT ITEMS 27 132874 FAIR MARKET VALUE X EVENT GIFT BAG ITEMS 248 2472 FAIR MARKET VALUE X DIAGNOSTIC MEDICAL EQUIPMENT SYSTEM 1 209000 FAIR MARKET VALUE X GIFT CARDS 2 150 FAIR MARKET VALUE 0 1 0 FORM 990, PART VI, SECTION A, LINE 2 THE CEO AND CO-FOUNDER ARE RELATED THROUGH MARRIAGE AND EMPLOYED BY THE ORGANIZATION. ADDITIONALLY, TWO OF THEIR SONS ARE EMPLOYED BY THE ORGANIZATION, ONE AS COO AND THE OTHER AS SENIOR VP DEVELOPMENT. FORM 990, PART VI, SECTION B, LINE 11 A DRAFT OF THE TAX RETURN IS PROVIDED TO THE ORGANIZATION BY THE CPA FIRM. THE TAX RETURN IS REVIEWED BY THE CEO, COO, AND THE CFO IN DETAIL AFTER THE VICE PRESIDENT, ACCOUNTING IS SATISFIED WITH IT. ONCE THE CEO, COO, AND CFO HAVE APPROVED IT, THE RETURN IS FORWARDED TO ALL OF THE BOARD MEMBERS ELECTRONICALLY. COMMENTS ARE SUBMITTED. IF ANY CHANGES ARE MADE, THE REVIEW PROCESS IS REPEATED UNTIL THERE ARE NO CHANGES. FORM 990, PART VI, SECTION B, LINE 12C NBCF ENFORCES COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY BY HAVING EACH MEMBER OF THE BOARD READ THE DOCUMENT ANNUALLY AND RESPOND IN WRITING AS TO WHETHER OR NOT THERE ARE CONFLICTS. EACH BOARD MEMBER SIGNS THE DOCUMENT STATING THAT THEY HAVE READ AND UNDERSTAND THE CONFLICT OF INTEREST POLICY AND AGREE TO BE BOUND BY IT. IN ADDITION, THE IMPORTANCE OF THE CONFLICT OF INTEREST POLICY IS OPENLY DISCUSSED IN THE BOARD MEETINGS AND BOARD MEMBERS ARE ASKED IF THEY HAVE ANY ACTIVITIES FOR WHICH THEY NEED TO CONFIRM WHETHER A CONFLICT OF INTEREST EXISTS. IF A CONFLICT OF INTEREST IS FOUND TO EXIST, APPROPRIATE ACTION IS TAKEN SUCH AS THE CONFLICTED BOARD MEMBER NOT PARTICIPATING IN DISCUSSIONS OR VOTING ON RELATED ISSUES. DEPENDENT ON THE NATURE OF THE CONFLICT, THE NON-CONFLICTED BOARD MEMBERS MAY PROPOSE AND VOTE ON A MOTION CONCERNING THE RESOLUTION OF CONFLICT. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD OF DIRECTORS APPROVES THE COMPENSATION FOR THE OFFICERS OF THE ORGANIZATION AFTER COMPARING THE SALARIES WITH OTHER ORGANIZATIONS, AS WELL AS COMPARISON WITH COMPENSATION SURVEYS AND STUDIES. THE ACTION OF THE BOARD OF DIRECTORS IS THEN DOCUMENTED IN THE BOARD MINUTES. FORM 990, PART VI, SECTION C, LINE 19 NBCF MAKES THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST STATEMENT AND AUDITED FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. THEY OFFER TO FAX, U.S. FIRST CLASS MAIL OR EMAIL THE DOCUMENTS TO INTERESTED PARTIES. NBCF'S FORM 1023, IRS DETERMINATION LETTER, ANNUAL REPORT, FORM 990, AND FINANCIAL STATEMENTS WITH INDEPENDENT AUDITOR'S REPORT ARE ALSO AVAILABLE ON THE NBCF'S WEBSITE, WWW.NBCF.ORG. NBCF'S FORM 990 IS AVAILABLE ON THE WEBSITE WWW.GUIDESTAR.ORG. FINANCIAL AND OTHER INFORMATION ABOUT NBCF IS AVAILABLE ON THE WEBSITE WWW.CHARITYNAVIGATOR.ORG. FORM 990, PART VI, LINE 17, ADDITONAL INFORMATION FOR THE LIST OF STATES RECEIVING FORM 990, ID, DE, IN, IA, LA, MO, MT, NE, NV, SD, TX, VT, AND WY DO NOT REQUEST OR REQUIRE A COPY OF THE FORM 990 TO BE FILED. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED GAINS ON INVESTMENTS: 89,708. FORM 990, PART XII, QUESTION 2C: THE FINANCE AND AUDIT COMMITTEE WAS FORMED TO COORDINATE THE BOARD'S FINANCIAL OVERSIGHT RESPONSIBILITIES, WHICH INCLUDE PROVIDING THE BOARD OVERSIGHT OF THE ORGANIZATION'S FINANCIAL AUDIT. THE FINANCE AND AUDIT COMMITTEE CURRENTLY CONSIST OF THE TREASURER, CEO, AND CFO. EUROPE TRIP FORM 990, SCHEDULE, F, PART 1, QUESTION 3(D): VIDEO TO DOCTORS AS AN INTERNATIONAL BREAST CANCER AWARENESS AND EDUCATIONAL RESOURCE.