MEDICAL DEVICE INNOVATION CONSORTIUM: Form 990, tax year 2020
View the entire original 990 at ProPublica ↗
- Organization
- MEDICAL DEVICE INNOVATION CONSORTIUM (EIN 46-1465348)
- Tax period
- 2020-01-01 to 2020-12-31
- Filed
- 2021-11-04
- IRS object ID
- 202103089349302685
- Schema version
- 2020v4.1
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2021-11-04T14:00:25-05:00 | ReturnTs |
| Tax Period End | 2020-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 410746749 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLIFTONLARSONALLEN LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 220 S 6TH STREET SUITE 300 | AddressLine1Txt |
| City | MINNEAPOLIS | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55402 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2020-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 461465348 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE MEDICAL DEVICE INNOVATION CONSORTIUM | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | MEDI | BusinessNameControlTxt |
| Phone | 2028681600 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1501 WILSON BOULEVARD NO 910 | AddressLine1Txt |
| City | ARLINGTON | CityNm |
| State Abbreviation | VA | StateAbbreviationCd |
| ZIP | 22209 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | PAMELA W GOLDBERG | PersonNm |
| Person Title | PRESIDENT AND CEO | PersonTitleTxt |
| Phone | 2028681600 | PhoneNum |
| Signature | 2021-11-02 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | PAMELA | PersonFirstNm |
| Person Last | GOLDBERG | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | JOHN TAUER | PreparerPersonNm |
| PTIN | P00294068 | PTIN |
| Phone | 6123764500 | PhoneNum |
| Preparation | 2021-11-02 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 2 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2020 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | PAMELA W GOLDBERG | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1501 WILSON BOULEVARD NO 910 | AddressLine1Txt |
| City | ARLINGTON | CityNm |
| State Abbreviation | VA | StateAbbreviationCd |
| ZIP | 22209 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $21,447,770 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.MDIC.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2012 | FormationYr |
| Legal Domicile State | MN | LegalDomicileStateCd |
| Activity Or Mission | A PUBLIC-PRIVATE PARTNERSHIP WITH THE OBJECTIVE OF ADVANCING MEDICAL DEVICE REGULATORY SCIENCE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 22 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 22 | VotingMembersIndependentCnt |
| Total Employee | 42 | TotalEmployeeCnt |
| Total Volunteers | 25 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $7,482,503 | PYContributionsGrantsAmt |
| CY Contributions Grants | $21,429,766 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $4,071 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $1,741 | CYProgramServiceRevenueAmt |
| PY Investment Income | $1,418 | PYInvestmentIncomeAmt |
| CY Investment Income | $6,339 | CYInvestmentIncomeAmt |
| PY Other Revenue | $78,868 | PYOtherRevenueAmt |
| CY Other Revenue | $9,924 | CYOtherRevenueAmt |
| PY Total Revenue | $7,566,860 | PYTotalRevenueAmt |
| CY Total Revenue | $21,447,770 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $3,815,185 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $4,956,541 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $3,868,708 | PYOtherExpensesAmt |
| CY Other Expenses | $14,644,332 | CYOtherExpensesAmt |
| PY Total Expenses | $7,683,893 | PYTotalExpensesAmt |
| CY Total Expenses | $19,600,873 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$117,033 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $1,846,897 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $4,143,598 | TotalAssetsBOYAmt |
| Total Assets EOY | $6,445,785 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $1,099,041 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $1,554,331 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $3,044,557 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $4,891,454 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | MDIC WILL BENEFIT THE PUBLIC IN THE UNITED STATES BY CONDUCTING RESEARCH THAT WILL ENSURE THAT: 1) SAFE AND EFFECTIVE DEVICES ARE AVAILABLE TO THE PUBLIC AS SOON AS POSSIBLE, AND AS COST-EFFECTIVELY AS POSSIBLE, IN ORDER TO ALLOW PATIENTS IN THE U. S. TO BENEFIT FROM ADVANCES IN SAFE AND EFFECTIVE MEDICAL TECHNOLOGY AT LEAST AS SOON AS PATIENTS IN OTHER PARTS OF THE WORLD, WHERE DEVICES ARE TYPICALLY APPROVED MORE QUICKLY THAN IN THE U. S.; 2) SAFE AND EFFECTIVE DEVICES ARE REIMBURSED BY FEDERAL HEALTH CARE PROGRAMS ON A MORE TIMELY AND SCIENTIFIC BASIS; AND 3) LIMITED FEDERAL RESEARCH FUNDS ARE DEVOTED TO PROMOTE FURTHER IMPROVEMENTS IN MEDICAL TECHNOLOGY THAT HAVE A REASONABLE POTENTIAL TO IMPROVE MEDICAL TECHNOLOGY. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $15,291,160 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $0 | RevenueAmt |
| Desc | NATIONAL EVALUATION SYSTEM FOR HEALTH TECHNOLOGY COORDINATING CENTER:THE NATIONAL EVALUATION SYSTEM FOR HEALTH TECHNOLOGY (NEST) IS AN INITIATIVE OF MDIC WHICH SERVES AS A CATALYST IN ESTABLISHING FUNCTIONAL AND EFFICIENT PATHWAYS FOR KEY STAKEHOLDERS TO GENERATE LOWER-COST, NEARER REAL-TIME REAL-WORLD EVIDENCE (RWE) OF SUFFICIENT QUALITY FOR REGULATORY, COVERAGE, PATIENT, AND CLINICAL DECISION-MAKING. BY SOLVING THE CHALLENGES THAT HAVE SLOWED MEDICAL DEVICE INNOVATION, DELAYED THE DETECTION OF SAFETY SIGNALS, AND CREATED INEFFICIENCIES, NESTCC COULD IMPROVE PATIENTS' TIMELY ACCESS TO SAFE MEDICAL DEVICES AND THEIR QUALITY OF LIFE. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $2,123,075 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $1,741 | RevenueAmt |
| Desc | CLINICAL SCIENCE TECHNOLOGY:MDIC'S FOCUS ON CLINICAL SCIENCE IS THE DEVELOPMENT OF TOOLS AND METHODS TO DRIVE EFFICIENCIES (TIME AND RESOURCES), QUALITY, AND A PREDICTABLE PATH IN DATA COLLECTION AND EVIDENCE DEVELOPMENT. THE ORGANIZATION'S CLINICAL SCIENCE PROGRAM AIM TO IMPROVE DIAGNOSTIC TESTING AND PRODUCT DEVELOPMENT BY SUPPORTING MANUFACTURES IN OBTAINING CREDIBLE CLINICAL EVIDENCE, AND THE FACILITATION OF FIRST-IN-WORLD PATIENT ACCESS TO SAFE AND EFFECTIVE NEW TECHNOLOGIES OF SIGNIFICANT HEALTH IMPORTANCE. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $289,579 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $0 | RevenueAmt |
| Desc | HEALTH ECONOMICS & PATIENT ACCESS:MDIC'S VALUE-BASED HEALTHCARE PROJECTS ARE DEVELOPED TO IMPROVE THE INDUSTRY'S ABILITY TO INCLUDE PATIENT PERSPECTIVES IN THE DEVELOPMENT, PRE-MARKET APPROVAL, AND POST-MARKET EVALUATION OF MEDICAL DEVICES AND SUPPORT A MORE PREDICTABLE PATHWAY IN REIMBURSEMENT DECISIONS UNDER FEDERAL HEALTH CARE PROGRAMS. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $17,703,814 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 26 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 42 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 22 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 22 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | MN | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLIFTONLARSONALLEN | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 6123764800 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 220 SOUTH SIXTH STREET SUITE 300 | AddressLine1Txt |
| City | MINNEAPOLIS | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55402 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (35 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| PAMELA GOLDBERG | ||||||||
| PRESIDENT AND CEO | 40.00 | Yes (X) | Yes (X) | $424,577 | $0 | $35,361 | ||
| JON HUNT | ||||||||
| VP, CLINICAL SCIENCE & TECHNOLOGY | 40.00 | $304,846 | $0 | $42,116 | Yes (X) | |||
| LENWOOD FAULCON | ||||||||
| GENERAL COUNSEL | 40.00 | $206,673 | $0 | $36,019 | Yes (X) | |||
| FLORA SIAMI | ||||||||
| SENIOR VICE PRESIDENT, NESTCC | 40.00 | $173,808 | $0 | $18,153 | Yes (X) | |||
| JITHESH VELICHAMTHOTU VEETIL | ||||||||
| DIRECTOR, DATA SCIENCE & TECHNOLOGY | 40.00 | $170,162 | $0 | $14,591 | Yes (X) | |||
| ALAN BAUMEL | ||||||||
| PROGRAM DIRECTOR, CASE FOR QUALITY | 40.00 | $158,589 | $0 | $28,137 | Yes (X) | |||
| ROBBERT ZUSTERZEEL | ||||||||
| DIRECTOR DATA NETWORK NEST | 40.00 | $149,047 | $0 | $0 | Yes (X) | |||
| CAROL ALLIS | ||||||||
| COUNSEL, NESTCC | 40.00 | $147,076 | $0 | $14,616 | Yes (X) | |||
| LILIANA RINCON-GONZALEZ | ||||||||
| PROGRAM DIRECTOR, CLINICAL SCIENCE | 40.00 | $137,881 | $0 | $15,884 | Yes (X) | |||
| LEAH DERGACHEV | ||||||||
| ASSISTANT VP, MEMBERSHIP & MARKETING | 40.00 | $128,202 | $0 | $22,769 | Yes (X) | |||
| SEAN MCNABB | ||||||||
| DIRECTOR OF MARKETING | 40.00 | $126,260 | $0 | $9,158 | Yes (X) | |||
| NADIM YARED | ||||||||
| BOARD CHAIR | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| PETER ARDUINI | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| WES CETNAROWSKI | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| ANDREW CLEELAND | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| STEVE FERGUSON | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| RICK GEOFFRION | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| CHIP HANCE | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| JIJO JAMES | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| TAMARA SYREK JENSEN | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| GARY JOHNSON | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| KRIS KANDARPA | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| SAM KHICHI | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| ESTHER KROFAH | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| RICHARD KUNTZ | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| DANA MCMAHON | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| MIKE MINOGUE | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| CAROL NEUBAUER | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| BRYAN OLIN | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| SHACEY PETROVIC | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| JODY POWELL | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| PETER SALTONSTALL | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| RANDALL SCHIESTL | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| JEFFREY SHUREN | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| JEAN SLUTSKY | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,127,121 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $236,804 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 14 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (3 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| VERRILL | |||||
| ONE PORTLAND SQUARE | PORTLAND | ME | 04101 | LEGAL SERVICES | $127,641 |
| CLIFTONLARSONALLEN LLP | |||||
| 220 S 6TH ST SUITE 300 | MINNEAPOLIS | MN | 55402 | ACCOUNTING SERVICES | $124,173 |
| WS COLLABORATIVE LLC | |||||
| 934 BELLVIEW ROAD | MCLEAN | VA | 22102 | CONSULTING SERVICES | $120,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 3 | CntrctRcvdGreaterThan100KCnt |
| Membership Dues | $3,244,166 | MembershipDuesAmt |
| Government Grants | $18,085,600 | GovernmentGrantsAmt |
| All Other Contributions | $100,000 | AllOtherContributionsAmt |
| Total Contributions | $21,429,766 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | CFQ FORUM | Desc |
| Business | 541900 | BusinessCd |
| Total Revenue Column | $1,741 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,741 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $1,741 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $6,339 | TotalRevenueColumnAmt |
| Exclusion | $6,339 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $3,203 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $3,203 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $3,203 | TotalRevenueColumnAmt |
| Exclusion | $3,203 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MISCELLANEOUS REVENUE | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $6,721 | TotalRevenueColumnAmt |
| Exclusion | $6,721 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $6,721 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $21,447,770 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,741 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $16,263 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $646,665 | TotalAmt |
| Program Services | $531,680 | ProgramServicesAmt |
| Management And General | $114,985 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,572,262 | TotalAmt |
| Program Services | $2,661,100 | ProgramServicesAmt |
| Management And General | $911,162 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $126,259 | TotalAmt |
| Program Services | $157,444 | ProgramServicesAmt |
| Management And General | -$31,185 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $320,919 | TotalAmt |
| Program Services | $166,602 | ProgramServicesAmt |
| Management And General | $154,317 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $290,436 | TotalAmt |
| Program Services | $231,511 | ProgramServicesAmt |
| Management And General | $58,925 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $143,644 | TotalAmt |
| Program Services | $137,449 | ProgramServicesAmt |
| Management And General | $6,195 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $33,265 | TotalAmt |
| Program Services | $16,633 | ProgramServicesAmt |
| Management And General | $16,632 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,652,309 | TotalAmt |
| Program Services | $5,495,690 | ProgramServicesAmt |
| Management And General | $156,619 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $43,817 | TotalAmt |
| Program Services | $14,192 | ProgramServicesAmt |
| Management And General | $29,625 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $77,045 | TotalAmt |
| Program Services | $24,460 | ProgramServicesAmt |
| Management And General | $52,585 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $216,324 | TotalAmt |
| Program Services | $112,727 | ProgramServicesAmt |
| Management And General | $103,597 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $502,427 | TotalAmt |
| Program Services | $342,237 | ProgramServicesAmt |
| Management And General | $160,190 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $36,999 | TotalAmt |
| Program Services | $26,721 | ProgramServicesAmt |
| Management And General | $10,278 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $97,467 | TotalAmt |
| Program Services | $47,790 | ProgramServicesAmt |
| Management And General | $49,677 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| PROJECT EXPENSES | $7,712,236 | $7,712,236 | |
| FACILITIES AND EQUIPMEN | $104,949 | $20,963 | $83,986 |
| MISCELLANEOUS EXPENSES | $23,850 | $4,379 | $19,471 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,600,873 | TotalAmt |
| Program Services | $17,703,814 | ProgramServicesAmt |
| Management And General | $1,897,059 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,280,992 | BOYAmt |
| EOY | $4,564,523 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,508,202 | BOYAmt |
| EOY | $1,599,190 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $152,360 | BOYAmt |
| EOY | $128,794 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $308,988 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $197,238 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $160,516 | BOYAmt |
| EOY | $111,750 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $41,528 | BOYAmt |
| EOY | $41,528 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,143,598 | BOYAmt |
| EOY | $6,445,785 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $984,490 | BOYAmt |
| EOY | $1,196,152 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $114,551 | BOYAmt |
| EOY | $77,432 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $280,747 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,099,041 | BOYAmt |
| EOY | $1,554,331 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,726,516 | BOYAmt |
| EOY | $4,511,454 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $318,041 | BOYAmt |
| EOY | $380,000 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,044,557 | BOYAmt |
| EOY | $4,891,454 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,143,598 | BOYAmt |
| EOY | $6,445,785 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $1,846,897 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $2,332,677 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $4,713,194 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $6,835,051 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $7,482,503 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $21,429,766 | CurrentTaxYearAmt |
| Total | $42,793,191 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $303,956 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $22,238 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $14,696 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $4,071 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,741 | CurrentTaxYearAmt |
| Total | $346,702 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $2,636,633 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $4,735,432 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $6,849,747 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $7,486,574 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $21,431,507 | CurrentTaxYearAmt |
| Total | $43,139,893 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $575,000 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $775,000 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,654,167 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $500,000 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $895,833 | CurrentTaxYearAmt |
| Total | $4,400,000 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $575,000 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $775,000 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,654,167 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $500,000 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $895,833 | CurrentTaxYearAmt |
| Total | $4,400,000 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $38,739,893 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus3 Years | $21,813 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $44,396 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $48,746 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $9,542 | CurrentTaxYearAmt |
| Total | $124,497 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus3 Years | $21,813 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $44,396 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $48,746 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $9,542 | CurrentTaxYearAmt |
| Total | $124,497 | TotalAmt |
Other Income509 OtherIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $183 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $48,897 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,820 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $31,540 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $6,721 | CurrentTaxYearAmt |
| Total | $90,161 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $2,636,816 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $4,806,142 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $6,896,963 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $7,566,860 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $21,447,770 | CurrentTaxYearAmt |
| Total | $43,354,551 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.89360 | PublicSupportCY509Pct |
| Public Support PY509 | 0.83000 | PublicSupportPY509Pct |
| Investment Income CY | 0.00290 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00480 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: | FormAndLineReferenceDesc |
| Explanation | MISCELLANEOUS REVENUE | ExplanationTxt |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $149,213 | OtherCostOrOtherBasisAmt |
| Depreciation | $91,354 | DepreciationAmt |
| Book Value | $57,859 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $159,775 | OtherCostOrOtherBasisAmt |
| Depreciation | $105,884 | DepreciationAmt |
| Book Value | $53,891 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $111,750 | TotalBookValueLandBuildingsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $21,447,770 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $21,447,770 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $21,447,770 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $19,600,873 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $19,600,873 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $19,600,873 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | THE ORGANIZATION IS GENERALLY EXEMPT FROM FEDERAL INCOME TAXES UNDER THE PROVISIONS OF SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS ONLY SUBJECT TO INCOME TAXES ON NET UNRELATED BUSINESS INCOME. SINCE THE ORGANIZATION HAD NO UNRELATED BUSINESS TAXABLE INCOME DURING THE YEARS ENDED DECEMBER 31, 2020 AND 2019, THE ACCOMPANYING FINANCIAL STATEMENTS DO NOT INCLUDE ANY PROVISION FOR INCOME TAXES. IN ADDITION, THE ORGANIZATION HAS BEEN CLASSIFIED AS AN ORGANIZATION THAT IS NOT A PRIVATE FOUNDATION. MANAGEMENT EVALUATED THE ORGANIZATION'S TAX POSITIONS AND CONCLUDED THAT THE ORGANIZATION HAD TAKEN NO UNCERTAIN TAX POSITIONS THAT REQUIRE ADJUSTMENT TO THE FINANCIAL STATEMENTS. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Housing Allowance Or Residence | Yes (X) | HousingAllowanceOrResidenceInd |
| Written Policy Ref T And E Expnss | 0 | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | 0 | SubstantiationRequiredInd |
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (9 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| PAMELA GOLDBERG | ||||||||||||||
| PRESIDENT AND CEO | $365,707 | $0 | $52,800 | $0 | $6,070 | $0 | $21,787 | $0 | $13,574 | $0 | $459,938 | $0 | $0 | $0 |
| JON HUNT | ||||||||||||||
| VP, CLINICAL SCIENCE & TECHNOLOGY | $254,276 | $0 | $44,500 | $0 | $6,070 | $0 | $19,750 | $0 | $22,366 | $0 | $346,962 | $0 | $0 | $0 |
| LENWOOD FAULCON | ||||||||||||||
| GENERAL COUNSEL | $172,468 | $0 | $27,535 | $0 | $6,670 | $0 | $14,400 | $0 | $21,619 | $0 | $242,692 | $0 | $0 | $0 |
| FLORA SIAMI | ||||||||||||||
| SENIOR VICE PRESIDENT, NESTCC | $167,738 | $0 | $0 | $0 | $6,070 | $0 | $5,273 | $0 | $12,880 | $0 | $191,961 | $0 | $0 | $0 |
| JITHESH VELICHAMTHOTU VEETIL | ||||||||||||||
| DIRECTOR, DATA SCIENCE & TECHNOLOGY | $155,907 | $0 | $7,885 | $0 | $6,370 | $0 | $11,943 | $0 | $2,648 | $0 | $184,753 | $0 | $0 | $0 |
| ALAN BAUMEL | ||||||||||||||
| PROGRAM DIRECTOR, CASE FOR QUALITY | $152,819 | $0 | $0 | $0 | $5,770 | $0 | $10,988 | $0 | $17,149 | $0 | $186,726 | $0 | $0 | $0 |
| CAROL ALLIS | ||||||||||||||
| COUNSEL, NESTCC | $140,706 | $0 | $0 | $0 | $6,370 | $0 | $4,513 | $0 | $10,103 | $0 | $161,692 | $0 | $0 | $0 |
| LILIANA RINCON-GONZALEZ | ||||||||||||||
| PROGRAM DIRECTOR, CLINICAL SCIENCE | $128,811 | $0 | $3,300 | $0 | $5,770 | $0 | $9,656 | $0 | $6,228 | $0 | $153,765 | $0 | $0 | $0 |
| LEAH DERGACHEV | ||||||||||||||
| ASSISTANT VP, MEMBERSHIP & MARKETING | $115,791 | $0 | $5,741 | $0 | $6,670 | $0 | $9,114 | $0 | $13,655 | $0 | $150,971 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 1A | PAMELA GOLDBERG WAS PROVIDED A MONTHLY HOUSING ALLOWANCE OF $3,000. |
| PART I, LINE 1B | THERE IS NO WRITTEN POLICY FOLLOWED BUT THERE IS BOARD APPROVAL OF THE HOUSING ALLOWANCE. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 1 | THE BOARD MAY DESIGNATE AN EXECUTIVE COMMITTEE COMPRISED OF THE PRESIDENT AND SUCH OTHER PERSONS AS MAY BE APPOINTED BY THE BOARD; PROVIDED THAT NO MORE THAN SEVENTY-FIVE PERCENT (75%) OF THE MEMBERS OF THE EXECUTIVE COMMITTEE MAY REPRESENT FOR-PROFIT MEMBERS OF THE MDIC. THE EXECUTIVE COMMITTEE SHALL HAVE AND MAY EXERCISE ALL OF THE AUTHORITY AND POWERS OF THE BOARD IN THE MANAGEMENT OF THE BUSINESS OF THE MDIC IN THE INTERVAL BETWEEN MEETINGS OF THE BOARD, EXCEPT THAT THE EXECUTIVE COMMITTEE SHALL NOT HAVE THE AUTHORITY AND POWER TO CREATE ADDITIONAL DIRECTOR POSITIONS, ELECT OR REMOVE DIRECTORS, CREATE NEW OFFICER POSITIONS, ELECT OR REMOVE OFFICERS, AMEND THE ARTICLES OF INCORPORATION OR BYLAWS, ADOPT A PLAN OF MERGER OR CONSOLIDATION, AUTHORIZE THE SALE OR OTHER DISPOSITION OF ALL OR SUBSTANTIALLY ALL OF THE PROPERTY AND ASSETS OF THE MDIC, AUTHORIZE OR REVOKE A VOLUNTARY DISSOLUTION OF THE MDIC, TAKE ANY ACTION THAT REQUIRES A TWO-THIRDS AFFIRMATIVE VOTE OF THE DIRECTORS VOTING ON A MATTER UNDER THESE BYLAWS OR TAKE ANY OTHER ACTION THAT APPLICABLE LAW REQUIRES BE CONSIDERED BY THE FULL BOARD. DAY-TO-DAY OPERATIONS OF THE MDIC WILL BE MANAGED BY THE PRESIDENT WITH OVERSIGHT AND APPROVAL, AS NECESSARY, BY THE EXECUTIVE COMMITTEE. REPORTS OF EXECUTIVE COMMITTEE ACTIONS SHALL BE PROVIDED REGULARLY TO THE BOARD. THE EXECUTIVE COMMITTEE SHALL AT ALL TIMES BE SUBJECT TO THE CONTROL AND DIRECTION OF THE BOARD. |
| FORM 990, PART VI, SECTION A, LINE 6 | THE MDIC HAS NON-VOTING MEMBERS IN ACCORDANCE WITH THEIR BYLAWS. MEMBERSHIP IS OPEN TO ORGANIZATIONS THAT ARE SUBSTANTIALLY INVOLVED IN MEDICAL AND/OR MEDICAL DEVICE RESEARCH, DEVELOPMENT, TREATMENT OR EDUCATION; THE PROMOTION OF PUBLIC HEALTH; AND REGULATORY SCIENCE. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE FORM 990 IS PREPARED BY AN INDEPENDENT PUBLIC ACCOUNTING FIRM USING INFORMATION PROVIDED BY THE ORGANIZATION. ONCE A DRAFT IS READY, THE FORM 990 WILL BE REVIEWED BY THE CEO, COUNSEL AND FINANCE COMMITTEE, WITH AN ELECTRONIC COPY PROVIDED TO THE FULL BOARD OF DIRECTORS PRIOR TO SUBMISSION TO THE IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | EACH BOARD MEETING AGENDA INCLUDES A STANDING ITEM REQUESTING UPDATES ON POTENTIAL CONFLICTS OF INTEREST. OFFICERS, DIRECTORS, AND KEY EMPLOYEES ARE REQUIRED TO DISCLOSE POTENTIAL CONFLICTS OF INTEREST AS THEY ARISE. THE BOARD REVIEWS AND APPROVES ALL TRANSACTIONS THAT HAVE A POTENTIAL CONFLICT OF INTEREST. NO DIRECTOR OF THE MEDICAL DEVICE INNOVATION CONSORTIUM SHALL VOTE ON ANY MATTER IN WHICH HE OR SHE, OR HIS OR HER EMPLOYER, HAS A MATERIAL INTEREST OR FINANCIAL INTEREST THAT WILL BE AFFECTED BY THE OUTCOME OF THE VOTE. ALL PROCEEDINGS RELATED TO CONFLICTS OF INTEREST ARE DOCUMENTED IN THE MEETING MINUTES. |
| FORM 990, PART VI, SECTION B, LINE 15 | MDIC BOARD MEMBERS ARE NOT COMPENSATED. COMPENSATION OF THE CEO IS REVIEWED AND APPROVED BY THE EXECUTIVE COMMITTEE AND REPORTED TO THE BOARD OF DIRECTORS WHICH IS RECORDED IN THE BOARD MEETING MINUTES. THE MOST RECENT REVIEW INCLUDING COMPARABILITY DATA OCCURRED 2020. COMPENSATION OF KEY EMPLOYEES IS REVIEWED AND APPROVED BY THE EXECUTIVE COMMITTEE AND RECORDED IN THE EXECUTIVE COMMITTEE MINUTES OR OTHER COMMITTEE DOCUMENTS. A REVIEW INCLUDING COMPENSATIONS REPORTS AND OPINIONS FROM RECRUITING CONSULTANTS OCCURED IN 2020. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON WRITTEN REQUEST. |
| FORM 990, PART IX, LINE 11G | OTHER CONSULTANTS AND CONTRACT LABOR: PROGRAM SERVICE EXPENSES 5,495,690. MANAGEMENT AND GENERAL EXPENSES 156,619. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,652,309. |