2014-11-17T14:11:02-06:00 2014-06-30 476097913 SEIM JOHNSON LLP 18081 BURT STREET SUITE 200 OMAHA NE 680224722 990 2013-07-01 113669999 MOSAIC MOSA 4028963884 4980 SOUTH 118TH ST LIND CENTER NO A OMAHA NE 68137 CYNTHIA L SCHROEDER CFO & SENIOR VICE PRESIDENT 4028963884 2014-11-14 1 BARBARA J FAJEN P00400874 4023302660 2013 2015-11-30 17:44:51Z CYNTHIA L SCHROEDER 4980 SOUTH 118TH ST LIND CENTER NO A OMAHA NE 68137 220775705 0 X WWW.MOSAICINFO.ORG X 2003 NE EMBRACING GOD'S CALL TO SERVE IN THE WORLD, MOSAIC ADVOCATES FOR PEOPLE WITH INTELLECTUAL DISABILITIES AND PROVIDES OPPORTUNITIES FOR THEM TO ENJOY A FULL LIFE. 12 12 7754 0 76224 0 7504201 6660703 200856466 206114000 150581 1002220 3867703 3796268 212378951 217573191 2461110 337417 0 0 152782888 151865158 0 0 0 59929048 63517402 215173046 215719977 -2794095 1853214 107546734 103391362 50675365 44512813 56871369 58878549 X EMBRACING GOD'S CALL TO SERVE IN THE WORLD, MOSAIC ADVOCATES FOR PEOPLE WITH INTELLECTUAL DISABILITIES AND PROVIDES OPPORTUNITIES FOR THEM TO ENJOY A FULL LIFE. 0 0 61044339 66678515 INTERMEDIATE CARE FACILITIES (ICF)--ICF SERVICES PROVIDE 24/7 SUPPORT FOR VERY MEDICALLY FRAGILE INDIVIDUALS WITH INTELLECTUAL OR DEVELOPMENTAL DISABILITIES. MOSAIC SERVES APPROXIMATELY 740 INDIVIDUALS ACROSS THE UNITED STATES UNDER THIS SERVICE CATEGORY. 105294714 115013042 COMMUNITY BASED SERVICES PROVIDED TO PEOPLE WITH INTELLECTUAL AND DEVELOPMENTAL DISABILITIES ARE SERVICES THAT CAN EITHER BE ON-GOING OR INTERMITTENT SUCH AS RESPITE, FAMILY SUPPORT, FOSTER CARE, PHYSICAL THERAPIES, TRANSPORTATION, AND SUPPORTED EMPLOYMENT. MOSAIC SERVES APPROXIMATELY 1,929 INDIVIDUALS ACROSS THE UNITED STATES UNDER THIS SERVICE CATEGORY. 17330571 18930121 DAY AND VOCATIONAL SERVICES ARE PROVIDED TO INDIVIDUALS WITH INTELLECTUAL AND DEVELOPMENTAL DISABILITIES IN A VARIETY OF WAYS INCLUDING SUPPORTED EMPLOYMENT, WORK ENCLAVES, VOCATIONAL TRAINING AND SOME SHELTERED WORKSHOPS. MOSAIC SERVES APPROXIMATELY 1,111 INDIVIDUALS ACROSS THE UNITED STATES UNDER THIS SERVICE CATEGORY. 8433944 337417 8608240 MISCELLANEOUS SERVICES PROVIDED TO INDIVIDUALS WITH INTELLECTUAL AND DEVELOPMENTAL DISABILITIES. 8433944 337417 8608240 192103568 1 1 0 1 0 0 1 0 1 1 1 0 0 1 1 1 0 1 0 0 0 1 0 0 0 0 0 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 1 0 1 652 0 1 7754 1 1 1 1 BD 0 0 0 0 0 0 0 0 X 12 12 0 0 0 0 0 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 AZ TN UT X X CYNTHIA L SCHROEDER 4028963884 4980 SOUTH 118TH STREET OMAHA NE 68137 MAX MILLER CHAIRPERSON 1.50 X X 0 0 0 JAMES ZILS VICE CHAIRPERSON 1.50 X X 0 0 0 LISA NEGSTAD SECOND VICE CHAIRPERSON 1.50 X X 0 0 0 KATHY PATRICK SECRETARY 1.50 X X 0 0 0 KATHLEEN BENTON DIRECTOR 1.50 X 0 0 0 DR DOUGLAS HILLMAN DIRECTOR 1.50 X 0 0 0 REV KEITH HOHLY DIRECTOR 1.50 X 0 0 0 REV DANETTE JOHNS DIRECTOR 1.50 X 0 0 0 CAROL MILLER DIRECTOR 1.50 X 0 0 0 PAMELA SPADARO DIRECTOR 1.50 X 0 0 0 CONRAD T SWANSON DIRECTOR 1.50 X 0 0 0 JOSEPH TURKOWSKI DIRECTOR 1.50 X 0 0 0 LINDA TIMMONS CEO & PRESIDENT 39.70 0.30 X 451757 0 37176 CINDY SCHROEDER CFO & SVP 39.70 0.30 X 307472 0 29796 RAUL SALDIVAR CHIEF OPERATING OFFICER 40.00 X 395472 0 34672 KEITH SCHMODE SVP OF MISSION ADVANCEMENT 39.90 0.10 X 299956 0 34396 HOLLY MORRISON SVP OF OPERATIONS 40.00 X 213468 0 25412 SCOTT HOFFMAN SVP OF FINANCE 39.80 0.20 X 175576 0 28826 DONNA WERNER SVP OF ORGANIZATIONAL DEVELOPMENT 40.00 X 170694 0 33024 PAMELA BENNER SVP OF HUMAN RESOURCES 40.00 X 160732 0 13556 TAMMY WESTFALL REGIONAL VP 40.00 X 135727 0 21996 NANCY DAVIS REGIONAL VP 40.00 X 137929 0 15512 MARVA WEAVER REGIONAL VP 40.00 X 129838 0 21996 MARLIN WILKERSON REGIONAL VP 40.00 X 135361 0 14996 KATIE GIVENS VP OF INFORMATION TECHNOLOGY 40.00 X 122749 0 13756 DAVID JACOX FORMER EXECUTIVE VP 40.00 X 353063 0 11736 3189794 0 336850 29 1 1 0 DJ CONSTRUCTION CO INC 3414 ELKHART ROAD GOSHEN IN 46526 CONSTRUCTION SERVCIES 877225 BENEVON 4528 8TH AVE NE STE 1A SEATTLE WA 98105 CONSULTING 799591 ADP INC PO BOX 842875 BOSTON MA 022842875 PAYROLL SERVICES 392966 PJW NURSING CONSULTANTS LLC 28 CUMBERLAND ROAD WEST HARTFORD CT 06119 NURSING 338364 RICOH PO BOX 827164 LEGAL DEPT SERVICES N PHILADELPHIA PA 191827164 MAILROOM, RECEPTION, COPIER MAINTENANCE 297775 18 6467552 193151 6660703 MEDICARE/MEDICAID PAYM 624100 199179308 199179308 PROGRAM SERVICE REVENU 624100 5180253 5180253 RENTAL INCOME 532000 1087928 1087928 MANAGEMENT FEES 541610 666511 666511 206114000 166630 166630 604126 0 604126 604126 604126 1141932 2896172 892844 2309670 249088 586502 835590 835590 CONSULTING INCOME 541610 2630700 2630700 PURCHASING CARD REBATE 900099 156377 156377 405065 328841 76224 3192142 217573191 209229918 76224 1606346 X 110146 110146 227271 227271 2133102 2133102 116710183 106338836 10371347 397812 397812 23928061 22416942 1511119 8696000 7854725 841275 218964 46539 172425 289792 61592 228200 7886 7193 693 22339949 19615811 2724138 15361000 13850491 1510509 9254327 8825963 428364 3704985 2439870 1265115 107180 107180 1114465 1079721 34744 5061748 3863170 1198578 2072109 2036673 35436 OTHER EXPENSES 1976819 1434829 541990 DUES & MEMBERSHIPS 798059 368721 429338 CFR EXPENSE 709585 636489 73096 FARM EXPENSE 342683 342683 157851 148091 9760 215719977 192103568 23616409 0 17232928 16088972 1502341 1516175 20251849 20263992 1993298 3030662 112516533 64828751 51631312 47687782 5087257 4871268 9847749 9932511 107546734 103391362 17940066 18221344 1020910 356483 22766081 20128558 8948308 5806428 50675365 44512813 X 56093076 57947202 778293 931347 56871369 58878549 107546734 103391362 X 1853214 -131666 285632 X X 0 1 X 1 1 1 X 2500657 4423726 11987089 7504201 6660703 33076376 179757724 190885502 191867535 200856466 206208000 969575227 182258381 195309228 203854624 208360667 212868703 1002651603 2231 3964 5012 3536 2385 17128 0 2231 3964 5012 3536 2385 17128 1002634475 105807 228597 268804 135576 166630 905414 67279 76224 143503 105807 228597 268804 202855 242854 1048917 3664948 3274356 4522813 3800424 3391203 18653744 186029136 198812181 208646241 212363946 216502760 1022354264 0.98070 0.98020 0.00100 0.00100 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1 1 0 1 0 0 1 31977 1 0 31977 0 X X X 1 80.00 0 0 0 1 0 100.00 0 1 1 1 0 34313920 2487529 4868779 5138430 36531798 34764985 2848409 3247117 6546591 34313920 37485223 2919416 1425808 7065462 34764985 31346898 1919339 5843950 1624964 37485223 26463411 3159195 3043881 1319589 31346898 0.85900 0.12050 0.02050 0 1 1 5710434 5710434 83079958 46359829 36720129 1809976 1311513 498463 12260709 10327428 1933281 9655456 6829981 2825475 47687782 AFFILIATE RECEIVABLES 3926580 MISCELLANEOUS RECEIVABLES 489533 INTERUNIT RECEIVABLE 207268 INVESTMENT ESCROW ACCOUNT 369226 INTANGIBLE ASSETS 4034904 INVESTMENT IN PROPERTY 905000 9932511 ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS- MEDICAID 3976771 REFUNDABLE FEES 19998 CRATS PAYABLE 884054 LIABILITY FOR PENSION BENEFITS 919257 INTEREST RATE SWAP, NET 6348 5806428 X 237900384 153966 20173227 20327193 217573191 0 217573191 235893204 20173227 20173227 215719977 0 215719977 PART II, LINE 9: THE FINANCIAL STATEMENTS FOR MOSAIC AND ITS AFFILIATES DO NOT CONTAIN ANY INFORMATION REGARDING THE CONSERVATION EASEMENT. PART IV, LINE 1B: MOSAIC IS THE REPRESENTATIVE-PAYEE FOR THE PERSONAL FUNDS OF A NUMBER OF INDIVIDUALS IN SERVICE. MOSAIC DOES NOT OWN THE ACCOUNTS. THE ACCOUNTING FOR SUCH ACTIVITIES OCCURS AT THE AGENCY LEVEL AND AN AGGREGATE ACCOUNTING OF SUCH SERVICES IS NOT POSSIBLE. MOSAIC ALSO DOES NOT TRACK THE BALANCES OF THE ACCOUNTS WHICH ARE OWNED BY RESIDENTS OF ITS FACILITIES. $1 IS ENTERED ON PART IV, LINE 1C AND F BECAUSE THE ACTUAL TOTAL IS NOT KNOWN. PART V, LINE 4: THE ENDOWMENT FUNDS ARE INTENDED FOR SUPPORT OF MOSAIC'S LONG TERM COMMITMENT TO ITS MISSION AND FOR CAPITAL IMPROVEMENTS AND GENERAL OPERATIONS. THE ENDOWMENT FUNDS ARE HELD BY THE MOSAIC FOUNDATION. PART X, LINE 2: ALL CONSOLIDATED AFFILIATED ENTITIES, EXCEPT FOR MOSAIC HOUSING CORP V, INC. BETHPHAGE RESIDENTIAL SERVICES, AND EASE-E MEDICAL, INC. ARE NOT-FOR-PROFIT CORPORATIONS AS DESCRIBED IN SECTION 501(C)(3) OR 501(C)(2) OF THE INTERNAL REVENUE CODE AND ARE EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE INTERNAL REVENUE SERVICE HAS ESTABLISHED STANDARDS TO BE MET TO MAINTAIN MOSAIC'S TAX EXEMPT STATUS. IN GENERAL, SUCH STANDARDS REQUIRE MOSAIC TO MEET A COMMUNITY BENEFITS STANDARD AND COMPLY WITH VARIOUS LAWS AND REGULATIONS. MOSAIC IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR THE YEARS ENDED PRIOR TO JUNE 30, 2011. MOSAIC RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. SUCH TAX POSITIONS, WHICH ARE MORE THAN 50% LIKELY OF BEING REALIZED, ARE MEASURED AT THEIR HIGHEST VALUE. CHANGES IN RECOGNITION OR MEASUREMENT ARE REFLECTED IN THE PERIOD IN WHICH THE CHANGE IN JUDGMENT OCCURS. DURING 2014 AND 2013, MANAGEMENT DETERMINED THAT THERE ARE NO INCOME TAX POSITIONS REQUIRING RECOGNITION IN THE CONSOLIDATED FINANCIAL STATEMENTS OTHER THAN DESCRIBED PREVIOUSLY. PART XI, LINE 2D - OTHER ADJUSTMENTS: ELIMINATION OF INTERNAL MANAGEMENT FEES 20,173,227. PART XII, LINE 2D - OTHER ADJUSTMENTS: ELIMINATION OF INTERNAL MANAGEMENT FEES 20,173,227. 1 0 0 0 0 0 0 0 0 0 EUROPE SUPPORT DEVELOPMENT OF SERVICES FOR PEOPLE WITH INTELLECTUAL AND DEVELOPMENTAL DISABILITIES. RESIDENTIAL & VOCATIONAL SUPPORT FOR CHILDREN WITH DISABILITIES WHO FORMERLY LIVED IN STATE-RUN INSTITUTIONS. 80000 WIRE TRANSFER SUB-SAHARAN AFRICA SUPPORT DEVELOPMENT OF SERVICES FOR PEOPLE WITH INTELLECTUAL AND DEVELOPMENTAL DISABILITIES. CENTER-BASED AND IN-HOME SUPPORT FOR CHILDREN WITH DISABILITIES AND THEIR CAREGIVERS. 19271 WIRE TRANSFER EUROPE SUPPORT DEVELOPMENT OF SERVICES FOR PEOPLE WITH INTELLECTUAL AND DEVELOPMENTAL DISABILITIES. 82242 WIRE TRANSFER 3 0 0 0 1 0 0 0 1 CURRENT YEAR PAYMENTS - THE GRANT PROVIDED IS TO A RELATED ORGANIZATION TO FURTHER ITS TAX EXEMPT FUNCTION. THE BOARDS OF EACH ORGANIZATION REVIEW AND APPROVE THE GRANTS MADE EACH YEAR. MOSAIC HOUSING CORPORATION I 4980 S 118 ST OMAHA NE 68137 363756911 501(C)(3) 36421 THE GRANT PROVIDED IS TO A RELATED ORGANIZATION TO FURTHER ITS TAX EXEMPT FUNCTION. THE BOARDS OF EACH ORGANIZATION REVIEW AND APPROVE THE GRANTS MADE EACH YEAR. MOSAIC HOUSING CORPORATION XIII 4980 S 118 ST OMAHA NE 68137 421626679 501(C)(3) 9500 THE GRANT PROVIDED IS TO A RELATED ORGANIZATION TO FURTHER ITS TAX EXEMPT FUNCTION. THE BOARDS OF EACH ORGANIZATION REVIEW AND APPROVE THE GRANTS MADE EACH YEAR. MOSAIC HOUSING CORPORATION XXII 4980 S 118 ST OMAHA NE 68137 273483415 501(C)(3) 7589 THE GRANT PROVIDED IS TO A RELATED ORGANIZATION TO FURTHER ITS TAX EXEMPT FUNCTION. THE BOARDS OF EACH ORGANIZATION REVIEW AND APPROVE THE GRANTS MADE EACH YEAR. MOSAIC ILLINOIS HOUSING OF ROCKFORD 1 4980 S 118 ST OMAHA NE 68137 204841856 501(C)(3) 48228 THE GRANT PROVIDED IS TO A RELATED ORGANIZATION TO FURTHER ITS TAX EXEMPT FUNCTION. THE BOARDS OF EACH ORGANIZATION REVIEW AND APPROVE THE GRANTS MADE EACH YEAR. 4 PART I, LINE 2: GRANTS ARE PROVIDED TO RELATED ORGANIZATIONS TO FURTHER THEIR TAX EXEMPT FUNCTIONS. THE BOARDS OF EACH ORGANIZATION REVIEW AND APPROVE THE GRANTS MADE EACH YEAR. X 1 1 X X X X X X 1 0 0 0 0 0 0 0 0 LINDA TIMMONS CEO & PRESIDENT 421355 0 25000 0 5402 0 17500 0 19676 0 488933 0 0 0 CINDY SCHROEDER CFO & SVP 290361 0 15000 0 2111 0 17500 0 12296 0 337268 0 0 0 RAUL SALDIVAR CHIEF OPERATING OFFICER 305650 0 88336 0 1486 0 17500 0 17172 0 430144 0 0 0 KEITH SCHMODE SVP OF MISSION ADVANCEMENT 220646 0 75415 0 3895 0 17500 0 16896 0 334352 0 0 0 HOLLY MORRISON SVP OF OPERATIONS 205148 0 7500 0 820 0 13812 0 11600 0 238880 0 0 0 SCOTT HOFFMAN SVP OF FINANCE 166378 0 7500 0 1698 0 9757 0 19069 0 204402 0 0 0 DONNA WERNER SVP OF ORGANIZATIONAL DEVELOPMENT 159874 0 10000 0 820 0 11028 0 21996 0 203718 0 0 0 PAMELA BENNER SVP OF HUMAN RESOURCES 68027 0 0 0 92705 0 0 0 13556 0 174288 0 0 0 TAMMY WESTFALL REGIONAL VP 133907 0 1000 0 820 0 0 0 21996 0 157723 0 0 0 NANCY DAVIS REGIONAL VP 136109 0 1000 0 820 0 0 0 15512 0 153441 0 0 0 MARVA WEAVER REGIONAL VP 128518 0 500 0 820 0 0 0 21996 0 151834 0 0 0 MARLIN WILKERSON REGIONAL VP 134541 0 0 0 820 0 0 0 14996 0 150357 0 0 0 DAVID JACOX FORMER EXECUTIVE VP 353063 0 0 0 0 0 0 0 11736 0 364799 0 353063 0 PART I, LINE 1A EVERY EMPLOYEE CAN BE REIMBURSED UP TO $25 PER MONTH FOR HEALTH OR SOCIAL CLUB DUES OR INITIATION FEES. PART I, LINE 4A PAMELA BENNER RECEIVED SEVERANCE PAYMENTS OF $92,500. A HOSPITAL AUTHORITY NO 1 OF KEARNEY COUNTY NE 476006477 2003-01-28 2100000 PURCHASE OF RESIDENTIAL REAL ESTATE 0 0 0 B CITY OF GARDEN CITY KANSAS 486009982 2005-06-01 833000 REFUND ISSUES (11/01/01, 07/01/04 & 07/08/04) 0 0 0 C NEBRASKA INVESTMENT FINANCE AUTHORITY 470613449 2010-04-14 7000000 PURCHASE OF RESIDENTIAL REAL ESTATE 0 0 0 D HOSPITAL AUTHORITY NO 1 OF KEARNEY COUNTY NE 476006477 2010-03-31 3500000 REMODELING OF RESIDENTIAL REAL ESTATE 0 0 0 A 1328040 2105405 2105405 2004 0 0 1 1 B 478329 833000 431 832569 2005 1 0 1 1 C 1289297 7000333 7000333 2012 0 0 1 1 D 642108 3500187 3500187 2010 0 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 B 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 C 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 D 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 A 0 0 0 1 0 0 0 0 0 B 0 0 1 1 0 0 0 0 0 C 0 0 1 1 0 0 0 0 0 D 0 0 1 1 0 0 0 0 0 A 0 B 0 C 0 D 0 SCHEDULE K, PART II, PROCEEDS, LINE 3: THE TOTAL PROCEEDS DO NOT AGREE TO THE ISSUE PRICE IN PART I, COLUMN (E) DUE TO INVESTMENT EARNINGS. SCHEDULE K, PART IV, ARBITRAGE, LINE 2C: (A) ISSUER NAME: HOSPITAL AUTHORITY NO. 1 OF KEARNEY COUNTY, NE DATE THE REBATE COMPUTATION WAS PERFORMED: 12/31/2007 (A) ISSUER NAME: CITY OF GARDEN CITY, KANSAS DATE THE REBATE COMPUTATION WAS PERFORMED: 12/01/2005 (A) ISSUER NAME: NEBRASKA INVESTMENT FINANCE AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 03/31/2013 (A) ISSUER NAME: HOSPITAL AUTHORITY NO. 1 OF KEARNEY COUNTY, NE DATE THE REBATE COMPUTATION WAS PERFORMED: 02/28/2013 (A) ISSUER NAME: HOSPITAL AUTHORITY NO. 1 OF GAGE COUNTY, NE DATE THE REBATE COMPUTATION WAS PERFORMED: 02/28/2013 (A) ISSUER NAME: IOWA FINANCE AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 10/30/2012 NOTE REGARDING THE REBATE COMPUTATIONS: SINCE THE BOND PROCEEDS HAVE BEEN SPENT AND THE DEBT SERVICE FUNDS ARE OPERATED ON A BONA FIDE BASIS, NO FURTHER REBATE CALCULATIONS ARE NECESSARY. A HOSPITAL AUTHORITY NO 1 OF GAGE COUNTY NE 470785499 2010-03-12 1800000 REMODELING OF RESIDENTIAL REAL ESTATE 0 0 0 B IOWA FINANCE AUTHORITY 521699886 2012-04-30 3200000 ACQUISITION & REMODEL OF REAL ESTATE 0 0 0 A 326002 1800104 1800104 2010 0 0 1 1 B 355825 3200000 3200000 2012 0 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 B 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 A 0 0 1 1 0 0 0 0 0 B 0 0 1 1 1 1 WELLS FARGO BANK NA 15.000000000000 0 0 0 0 0 A 0 B 0 FORM 990, PART VI, SECTION A, LINE 7A THE EVANGELICAL LUTHERAN CHURCH IN AMERICA APPOINTS ONE MEMBER OF THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B MOSAIC BOARD OF DIRECTORS MAY MAKE ANY AMENDMENTS TO THE ARTICLES OF INCORPORATION WITHOUT OTHER APPROVAL WITH THE EXCEPTION OF SECTIONS 8 AND 10. AMENDMENTS TO SECTIONS 8 AND 10 OF THE ARTICLES OF INCORPORATION REQUIRE PRIOR WRITTEN CONSENT OF THE EVANGELICAL LUTHERAN CHURCH IN AMERICA. SECTION 8 OF THE ARTICLES OF INCORPRATION SPECIFIES WHERE ASSETS WOULD BE TRANSFERRED UPON THE LIQUIDATION OF MOSAIC, AND SECTION 10 COVERS MOSAIC'S AFFILIATION WITH THE EVANGELICAL LUTHERAN CHURCH IN AMERICA. FORM 990, PART VI, SECTION B, LINE 11 EACH DECEMBER, THE SENIOR VICE PRESIDENT FOR HUMAN RESOURCES AND CHIEF INTEGRITY OFFICER IDENTIFY THE DISQUALIFIED PERSONS BASED ON INFORMATION FILED IN EACH KEY EMPLOYEE'S ANNUAL CONFLICT OF INTEREST FORM. THE VP OF HR SOLUTIONS AND VP OF FINANCIAL OPERATIONS REVIEW THE SALARY AND BENEFIT INFORMATION REQUIRED FOR ALL DIRECTORS, OFFICERS, KEY EMPLOYEES AND DISQUALIFIED PERSONS AND PREPARE A SCHEDULE FOR REVIEW BY THE SVP OF HUMAN RESOURCES AND SENIOR VICE PRESIDENT AND CHIEF FINANCIAL OFFICER. A REVIEW OF ALL INTERNATIONAL, LOBBYING AND UNRELATED BUSINESS ACTIVITIES IS COMPLETED BY THE CHIEF FINANCIAL OFFICER AND VP OF FINANCIAL OPERATIONS WITH RELEVANT STAFF. FORM 990 IS PREPARED BY THE ORGANIZATION'S OUTSIDE ACCOUNTING FIRM. THE CHIEF FINANCIAL OFFICER, THE ORGANIZATION'S OUTSIDE ACCOUNTING FIRM, AND THE CHIEF EXECUTIVE OFFICER REVIEW THE RETURN. THE FINANCE AND AUDIT COMMITTEE AND THE BOARD OF DIRECTORS ARE PROVIDED A COPY OF THE RETURN PRIOR TO FILING FORM 990. FORM 990, PART VI, SECTION B, LINE 12C ON AN ANNUAL BASIS EACH BOARD DIRECTOR COMPLETES A CONFLICT OF INTEREST FORM AND SUBMITS IT TO THE CHAIRPERSON OF THE BOARD GOVERNANCE RISK AND INTEGRITY COMMITTEE. ANY FINANCIAL CONFLICTS OF INTEREST ARE REPORTED TO THE CHIEF FINANCIAL OFFICER FOR REPORTING ON THE FORM 990. ON AN ANNUAL BASIS ALL STAFF COMPLETE A CONFLICT OF INTEREST FORM IN CONJUNCTION WITH THEIR ANNUAL EVALUATION. ALL CONFLICTS OF INTEREST ARE REVIEWED BY HUMAN RESOURCES. ANY CONFLICTS OF INTEREST OF THE CHIEF EXECUTIVE OFFICER ARE REPORTED TO THE BOARD OF DIRECTORS. CONFLICTS OF INTEREST OF SENIOR STAFF ARE REVIEWED BY THE SENIOR VICE PRESIDENT FOR HUMAN RESOURCES AND CHIEF INTEGRITY OFFICER AND REPORTED TO THE CHIEF EXECUTIVE OFFICER AND CHIEF FINANCIAL OFFICER FOR REPORTING ON THE FORM 990. ANY NEW CONFLICTS OF INTEREST THAT ARISE DURING THE YEAR ARE REQUIRED TO BE REPORTED AT THAT TIME. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD OF DIRECTORS ESTABLISHED A COMPENSATION COMMITTEE. THE COMPENSATION COMMITTEE IS RESPONSIBLE FOR: CONTRACTING WITH AN INDEPENDENT CONSULTANT TO DOCUMENT COMPARABLE COMPENSATION LEVELS PAID TO EXECUTIVES WITH SIMILAR POSITIONS AND RESPONSIBILITIES IN SIMILAR ORGANIZATIONS, HELPING THE COMMITTEE APPLY MOSAIC'S COMPENSATION PHILOSOPHY TO THE MARKET SURVEY DATA TO IDENTIFY SUPPORTABLE COMPENSATION LEVELS AND COMPENSATION RANGES, AND OPINING IN ADVANCE THAT RESULTING COMPENSATION RANGES ARE REASONABLE COMPENSATION. THE COMPENSATION CONSULTANT WILL ALSO ADVISE AND OPINE ON BENEFIT DESIGN, BENEFIT OPTIONS, AND REASONABLENESS OF BENEFIT AMOUNTS AS ELEMENTS OF COMPENSATION. THE COMPENSATION COMMITTEE WILL ADOPT A COMPENSATION PHILOSOPHY FOR OFFICERS AND KEY EMPLOYEES GUIDED BY THE CONSULTANT'S INFORMATION AND USE THE COMPENSATION PHILOSOPHY TO APPROVE THE COMPENSATION OF THE CEO, APPROVE THE COMPENSATION RANGES FOR OTHER OFFICERS AND KEY EMPLOYEES, AND REPORT ITS ACTIONS TO THE FULL BOARD. THE CEO, WORKING WITHIN SALARY RANGES APPROVED BY THE COMPENSATION COMMITTEE, SETS THE COMPENSATION OF OTHER OFFICERS AND KEY EMPLOYEES. MINUTES, DOCUMENTATION OF INDEPENDENT CONSULTANT COMPARABILITY DATA AND RECOMMENDATIONS ARE MAINTAINED AS PART OF THE RECORD OF THE COMPENSATION COMMITTEE. FORM 990, PART VI, SECTION C, LINE 19 INDIVIDUALS MAY REQUEST MOSAIC'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS THROUGH AN EMAIL REQUEST FORM AVAILABLE ON MOSAIC'S PUBLIC WEBSITE (WWW.MOSAICINFO.ORG). FORM 990, PART IX, LINE 11G OTHER FEES: PROGRAM SERVICE EXPENSES 19,615,811. MANAGEMENT AND GENERAL EXPENSES 2,724,138. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 22,339,949. FORM 990, PART XI, LINE 9: POSTRETIREMENT BENEFIT RELATED CHANGES OTHER THAN NET PERIODIC COST 285,632. FORM 990, PART XII, LINE 2C: THE FINANCE AND AUDIT COMMITEE OVERSEES THE AUDIT & SELECTION OF THE INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. MOSAIC FOUNDATION 4980 S 118 ST OMAHA NE 68137 363837360 FUND RAISING AND INVESTMENT ASSET MANAGEMENT NE 501(C)(3) 9 MOSAIC 1 THE OAKS OF DUNN COUNTY 4980 S 118 ST OMAHA NE 68137 391913323 SENIOR LIVING SERVICES WI 501(C)(3) 9 MOSAIC 1 MOSAIC HOUSING CORPORATION I 4980 S 118 ST OMAHA NE 68137 363756911 LOW INCOME HOUSING NE 501(C)(3) 9 MOSAIC 1 MOSAIC HOUSING CORPORATION II 4980 S 118 ST OMAHA NE 68137 470773689 LOW INCOME HOUSING NE 501(C)(3) 9 MOSAIC 1 MOSAIC HOUSING CORPORATION III 4980 S 118 ST OMAHA NE 68137 470788396 LOW INCOME HOUSING NE 501(C)(3) 9 MOSAIC 1 MOSAIC HOUSING CORPORATION IV 4980 S 118 ST OMAHA NE 68137 911823422 LOW INCOME HOUSING NE 501(C)(3) 9 MOSAIC 1 MOSAIC HOUSING CORPORATION VII 4980 S 118 ST OMAHA NE 68137 470828015 LOW INCOME HOUSING NE 501(C)(3) 9 MOSAIC 1 MOSAIC HOUSING CORPORATION VIII 4980 S 118 ST OMAHA NE 68137 470828012 LOW INCOME HOUSING NE 501(C)(3) 9 MOSAIC 1 MOSAIC HOUSING CORPORATION IX 4980 S 118 ST OMAHA NE 68137 742838413 LOW INCOME HOUSING NE 501(C)(3) 9 MOSAIC 1 MOSAIC HOUSING CORPORATION X 4980 S 118 ST OMAHA NE 68137 742908789 LOW INCOME HOUSING NE 501(C)(3) 9 MOSAIC 1 MOSAIC HOUSING CORPORATION XI 4980 S 118 ST OMAHA NE 68137 311706640 LOW INCOME HOUSING NE 501(C)(3) 9 MOSAIC 1 MOSAIC HOUSING CORPORATION XII 4980 S 118 ST OMAHA NE 68137 481297244 LOW INCOME HOUSING NE 501(C)(3) 9 MOSAIC 1 MOSAIC HOUSING CORPORATION XIII 4980 S 118 ST OMAHA NE 68137 421626679 LOW INCOME HOUSING NE 501(C)(3) 9 MOSAIC 1 MOSAIC HOUSING CORPORATION XIV 4980 S 118 ST OMAHA NE 68137 204417891 LOW INCOME HOUSING NE 501(C)(3) 9 MOSAIC 1 MOSAIC HOUSING CORPORATION XV 4980 S 118 ST OMAHA NE 68137 205765691 LOW INCOME HOUSING NE 501(C)(3) 9 MOSAIC 1 MOSAIC HOUSING CORPORATION XVI 4980 S 118 ST OMAHA NE 68137 205765731 LOW INCOME HOUSING NE 501(C)(3) 9 MOSAIC 1 MOSAIC HOUSING CORPORATION XVII 4980 S 118 ST OMAHA NE 68137 261710013 LOW INCOME HOUSING NE 501(C)(3) 9 MOSAIC 1 MOSAIC HOUSING CORPORATION XVIII 4980 S 118 ST OMAHA NE 68137 261710184 LOW INCOME HOUSING NE 501(C)(3) 9 MOSAIC 1 MOSAIC HOUSING CORPORATION XIX 4980 S 118 ST OMAHA NE 68137 261710259 LOW INCOME HOUSING NE 501(C)(3) 9 MOSAIC 1 MOSAIC HOUSING CORPORATION XX 4980 S 118 ST OMAHA NE 68137 264555206 LOW INCOME HOUSING NE 501(C)(3) 9 MOSAIC 1 MOSAIC ILLINOIS HOUSING 1 4980 S 118 ST OMAHA NE 68137 202997161 LOW INCOME HOUSING NE 501(C)(3) 9 MOSAIC 1 MOSAIC ILLINOIS HOUSING 2 4980 S 118 ST OMAHA NE 68137 204417645 LOW INCOME HOUSING NE 501(C)(3) 9 MOSAIC 1 MOSAIC ILLINOIS HOUSING OF MACOMB 1 4980 S 118 ST OMAHA NE 68137 204841909 LOW INCOME HOUSING NE 501(C)(3) 9 MOSAIC 1 MOSAIC ILLINOIS HOUSING OF ROCKFORD 1 4980 S 118 ST OMAHA NE 68137 204841856 LOW INCOME HOUSING NE 501(C)(3) 9 MOSAIC 1 MOSAIC VEBA 4980 S 118 ST OMAHA NE 68137 363831874 EMPLOYEE WELFARE BENEFIT PLAN NE 501(C)(9) N/A MOSAIC 1 MOSAIC HOUSING CORPORATION XXII 4980 S 118 ST OMAHA NE 68137 273483415 LOW INCOME HOUSING NE 501(C)(3) 9 MOSAIC 1 MOSAIC HOUSING CORPORATION XXIII 4980 S 118 ST OMAHA NE 68137 710875364 LOW INCOME HOUSING NE 501(C)(3) 9 MOSAIC 1 BETHPHAGE RESIDENTIAL PARTNERSHIP 4980 S 118 ST OMAHA NE 68137 470805544 LOW INCOME HOUSING NE N/A MOSAIC RESIDENTIAL SERVICES OF NEBRASKA LLC 4980 S 118 ST OMAHA NE 68137 271695051 LOW INCOME HOUSING NE N/A EASE-E MEDICAL INC 380 SKYLAND DR SUITE A PENROSE CO 81240 470842353 SALE OF MEDICAL EQUIPMENT AND SUPPLIES NE N/A C 3841492 1116888 1.00000 1 MOSAIC HOUSING CORPORATION V 4980 S 118 ST OMAHA NE 68137 470805545 LOW INCOME HOUSING NE N/A C 1452239 1.00000 1 BICO 4980 S 118 ST OMAHA NE 68137 CAPTIVE INSURANCE BD N/A C 14622324 1.00000 1 1 1 1 1 0 0 0 0 0 0 0 1 1 1 1 1 1 1 1 EASE-E MEDICAL EQUIPMENT A 76224 FMV MOSAIC HOUSING CORPORATION XXII B 235447 FMV THE MOSAIC FOUNDATION L 1905700 FMV BICO L 725000 FMV EASE-E MEDICAL EQUIPMENT L 186504 FMV THE MOSAIC FOUNDATION C 6467552 FMV EASE-E MEDICAL EQUIPMENT D 3400769 FMV MOSAIC VEBA L 300000 FMV