Department of the Treasury Internal Revenue Service
Public Charity Status and Public Support
Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.
Attach to Form 990 or Form 990-EZ. See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
Young Mens Christian Association of Sewickley Valley
Employer identification number
25-0979384
Part I
Reason for Public Charity Status
(All organizations must complete this part.) See instructions
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
10
11
e
By checking this box, I certify that the organization is not controlled directly or indirectly by one or more disqualified persons other than foundation managers and other than one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2).
f
If the organization received a written determination from the IRS that it is a Type I, Type II or Type III supporting organization, check this box
..................................................
g
Since August 17, 2006, has the organization accepted any gift or contribution from any of the following persons?
(i) a person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
and (iii) below, the governing body of the the supported organization?
................
11g(i)
(ii)
a family member of a person described in (i) above?
......................
11g(ii)
(iii)
a 35% controlled entity of a person described in (i) or (ii) above?
................
11g(iii)
h
Provide the following information about the supported organization(s).
(i) Name of supported organization
(ii) EIN
(iii) Type of organization (described on lines 1- 9 above or IRC section (see instructions))
(iv) Is the organization in col. (i) listed in your governing document?
(v) Did you notify the organization in col. (i) of your support?
(vi) Is the organization in col. (i) organized in the U.S.?
(vii) Amount of support?
Yes
No
Yes
No
Yes
No
Total
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 2
Part II
Support Schedule for Organizations Described in IRC 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi) (Complete only if you checked the box on line 5, 7, or 8 of Part I or if the
organization failed to qualify under Part III. If the organization fails to
qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year(or fiscal year beginning in)
(a) 2006
(b) 2007
(c) 2008
(d) 2009
(e) 2010
(f) Total
1
Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....
2
Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......
3
The value of services or facilities furnished by a governmental unit to the organization without charge..
4
Total. Add lines 1 through 3..
5
The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included
on line 1 that exceeds 2% of the amount shown on line 11, column (f)..
6
Public Support. Subtract line 5 from line 4.
Section B. Total Support
Calendar year(or fiscal year beginning in)
(a) 2006
(b) 2007
(c) 2008
(d) 2009
(e) 2010
(f) Total
7
Amounts from line 4..
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
9
Net income from unrelated business activities, whether or not the business is regularly carried on..
10
Other income. (Explain in Part IV.) Do not include gain or loss from the sale of capital assets..
11
Total support (Add lines 7 through 10).
12
Gross receipts from related activities, etc. (See instructions.)
..................
12
13
First Five Years
If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here..........................................
Section C. Computation of Public Support Percentage
14
Public Support Percentage for 2010 (line 6 column (f) divided by line 11 column (f))
.........
14
15
Public Support Percentage for 2009 Schedule A, Part II, line 14
...............
15
16a
33 1/3% support test—2010.
If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization
......................
b
33 1/3% support test—2009.
If the organization did not check the box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization
.....................
17a
10%-facts-and-circumstances test—2010.
If the organization did not check a box on line 13, 16a, or 16b and line 14
is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here. Explain
in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly supported
organization
..................................................
b
10%-facts-and-circumstances test—2009.
If the organization did not check a box on line 13, 16a, 16b, or 17a and line
15 is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here.
Explain in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly supported organization
..............................................
18
Private Foundation
If the organization did not check a box on line 13, 16a, 16b, 17a or 17b, check this box and see
instructions
...................................................
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 3
Part III
Support Schedule for Organizations Described in IRC 509(a)(2) (Complete only if you checked the box on line 9 of Part I or if the organization
failed to qualify under Part II. If the organization fails to qualify under
the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year(or fiscal year beginning in)
(a) 2006
(b) 2007
(c) 2008
(d) 2009
(e) 2010
(f) Total
1
Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
325,482
405,869
1,890,529
493,316
505,772
3,620,968
2
Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......
3,403,397
3,616,299
3,697,247
3,680,180
3,692,577
18,089,700
3
Gross receipts from activities that are not an unrelated trade or business under section 513..
44,064
45,885
46,682
17,683
11,505
165,819
4
Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5
The value of services or facilities furnished by a governmental unit to the organization without charge..
6
Total. Add lines 1 through 5.
3,772,943
4,068,053
5,634,458
4,191,179
4,209,854
21,876,487
7a
Amounts included on lines 1, 2, and 3 received from disqualified persons...
5,250
80,500
1,320,695
131,150
183,726
1,721,321
b
Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
0
c
Add lines 7a and 7b..
5,250
80,500
1,320,695
131,150
183,726
1,721,321
8
Public Support (Subtract line 7c from line 6.)
20,155,166
Section B. Total Support
Calendar year (or fiscal year beginning in)
(a) 2006
(b) 2007
(c) 2008
(d) 2009
(e) 2010
(f) Total
9
Amounts from line 6...
3,772,943
4,068,053
5,634,458
4,191,179
4,209,854
21,876,487
10a
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
328,626
338,181
180,792
126,823
134,301
1,108,723
b
Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c
Add lines 10a and 10b.
328,626
338,181
180,792
126,823
134,301
1,108,723
11
Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
12
Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)
13
Total support (Add lines 9, 10c, 11 and 12.).
4,101,569
4,406,234
5,815,250
4,318,002
4,344,155
22,985,210
14
First Five Years
If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here.............................................
Section C. Computation of Public Support Percentage
15
Public Support Percentage for 2010 (line 8 column (f) divided by line 13 column (f))
.........
15
87.690 %
16
Public support percentage from 2009 Schedule A, Part III, line 15
...............
16
88.070 %
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2010 (line 10c column (f) divided by line 13 column (f))
......
17
4.820 %
18
Investment income percentage from 2009 Schedule A, Part III, line 17
.............
18
5.000 %
19a
33 1/3% support tests—2010.
If the organization did not check the box on line 14, and line 15 is more than 33 1/3% and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization
..........
b
33 1/3% support tests—2009.
If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization
....
20
Private Foundation
If the organization did not check a box on line 14, 19a or 19b, check this box and see instructions
.....
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 4
Part IV
Supplemental Information.
Supplemental Information. Complete this part to provide the explanation required by Part II, line 10; Part II, line 17a or 17b; or Part III, line 12. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
Explanation
Schedule A (Form 990 or 990-EZ) 2010
Additional Data
Software ID:
Software Version:
-
TIN:
SCHEDULE O (Form 990 or 990-EZ)
Department of the Treasury Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ
Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
Attach to Form 990 or 990-EZ.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
Young Mens Christian Association of Sewickley Valley
Employer identification number
25-0979384
Identifier
Return Reference
Explanation
Form 990, Part VI, Section A, line 6
Members are described in the Line 7a note below.
Form 990, Part VI, Section A, line 7a
YMCA members who were 18 years old and who numbered 9,252 at December 31, 2010, were eligible to vote in the annual election of the Board of Directors at the YMCA's annual meeting. Voting in this annual election is the only governance role of the YMCA members.
Form 990, Part VI, Section B, line 11
Prior to submission of the IRS Form 990 to the Internal Revenue Service, the Sewickley Valley YMCA Finance Committee meets with an independent auditor to receive a formal presentation of the financial audit, the completed IRS Form 990, and the management letter for the previous fiscal year. Following the presentation, and after all questions have been answered, the Finance Committee formally votes to accept or reject the audit and the completed IRS Form 990. Following a favorable vote, the audit, management letter, and completed IRS Form 990 are submitted to the full Board of Directors for a period of review. Following full Board review, the IRS Form 990 is signed and submitted to the IRS.
Form 990, Part VI, Section B, line 12c
The following Conflict of Interest Policy and Procedure was adopted and implemented by the Sewickley Valley YMCA Board of Directors in September, 2008: Sewickley Valley YMCA Conflict of Interest Policy and Procedures I. PURPOSE OF THE CONFLICT OF INTEREST POLICY The purpose of the Conflict of Interest Policy of the Sewickley Valley YMCA is to protect the YMCA when it is contemplating entering into a contract, transaction or arrangement that has the potential for benefiting the private interest of a "Significant Person" as defined below. This policy is intended to supplement, but not replace, any applicable state and federal laws governing conflict of interest applicable to nonprofit and charitable organizations. II. STATEMENT OF POLICY The YMCA will not engage in any contract, transaction or arrangement involving a Conflict of Interest without establishing appropriate safeguards to protect the interests of the YMCA. To that end: A. Each Significant Person must promptly, fully and timely comply with the disclosure requirements set forth in this policy, or as otherwise adopted by the Board in accordance with this policy. B. All transactions, contracts or arrangements involving a conflict of interest must be reviewed by the Board or by a designated body of disinterested persons. C. The Board, or designated body, must determine by a majority vote of disinterested persons, that appropriate safeguards are in place to protect the interests of the YMCA and are consistent with the purposes of this Policy. D. Where appropriate, the Board or designated body shall seek advice of legal counsel. This Policy applies to (a) Significant Persons, and (b) any contract, transaction or arrangements involving the Y. III. DEFINITIONS APPLICABLE TO THE POLICY Significant Person - Any director, officer, key employee or committee member with board delegated powers is a Significant Person. Note: This reflects an intentional shift (from "Interested Person') to focus on a broader class of individuals; it is intended to apply to all decision makers, not just those Significant by the Intermediate Sanctions regulations. Conflict of Interest - A "Conflict of Interest" exists whenever a Significant Person has a significant personal interest in a proposed contract, transaction or arrangement to which the Y may be a party, Note: Attention should also be placed on the organizational costs associated with the "appearance" of impropriety created by a personal interest even if it does not constitute an actual conflict of interest. Significant Personal Interest - A Significant Personal Interest exists if the Significant Person, directly or indirectly, through business, investment, or family member, has a(n): A. Ownership or investment interest in any entity with which the YMCA has a contract, transaction or arrangement; B, Compensation arrangement with the YMCA; C. Compensation arrangement with any entity or individual with which the YMCA has a contract, a transaction or arrangement; D. Potential ownership or investment interest in, or compensation arrangement with, any entity or individual with which the YMCA is negotiating (or is proposing to negotiate) a contract, a transaction or arrangement; or E. Fiduciary position (e.g., member, officer, director, committee member), whether compensated or uncompensated, with another, unaffiliated organization (i) which directly competes with the YMCA in terms of service or for charitable contributions; or (ii) with which the YMCA has (or is proposing to enter into) a contract, transaction or arrangement. Compensation includes direct and indirect remuneration, consulting fees, board or advisory committee fees, honoraria, as well as gifts or favors that are not insubstantial. A Significant Interest is not necessarily a conflict of interest. Article IV, Section 4 describes the procedure that will be used to decide whether or not a conflict of interest exists. Family Member - With respect to a Significant Person, a "Family Member" means: A. The Person's spouse; B, A brother, sister, parent, grandparent, child, grandchild, great grandchild (by whole or half blood) of the Person or the Person's spouse, or C. The spouse of an individual listed in paragraph (b), However, a Family Member includes individuals listed in paragraphs (a) and (b) (other than a child) only if the individual lives in the Person's household, the Person manages the individual's financial affairs, or the Person is aware without special inquiry that the Family Member holds a particular Interest. IV. PROCEDURES FOR INDENTICATION FOR POTENTIAL CONFLICTS OF INTEREST Annual Ouestionnaire - Each Significant Person shall completely, accurately and timely submit the annual Conflict of Interest Questionnaire (the "Annual Questionnaire") as prepared and distributed by the Board [or Committee]. Duty to Disclose - A Significant Person must disclose the existence of any Interest and be given the opportunity to disclose all material facts to the persons the board has designated to consider the proposed contract, transaction or arrangement. Such information must be provided so that decisions are made with full knowledge and understanding of the Significant Person's interest. Continuing Disclosures - If, after completion of the Armual Questionnaire, any Significant Person becomes aware of anything that could give rise to a potential Conflict of Interest with respect to a proposed contract, transaction or arrangement involving the YMCA, the Significant Person shall promptly disclose that Interest to the Board or its designee. V. PROCEDURE FOR DETERMINING WHETHER A CONFLICT OF INTEREST EXISTS The Board [or Committee] shall determine by a majority vote of disinterested directors whether the disclosed Interest may result in a conflict of interest after meeting, discussing and voting on the matter. The Board [or Committee] shall: A. Review responses to the Annual Questionnaire and any continuing disclosures that are made during the year; B. Take such steps as are necessary to identify and review any so identified; C. Take such further investigation as it deems appropriate with regard to Interests disclosed or identified; and D. Determine whether any such Interest gives rise to a Conflict ofInterest. The Board [or Committee] may request additional information concerning the relevant Interest from all reasonable sources before reaching a determination. A Significant Person may make a presentation at the Board [or Committee] meeting, but after the presentation, he/she shall leave the meeting during the discussion of, and the vote of, the transaction or arrangement involving the possible conflict of interest. VI. PROCEDURE WHEN A CONFLICT OF INTEREST EXISTS Where a conflict of interest is determined to exist, the YMCA shall not enter into the proposed contract, transaction or arrangement unless the Board [or Committee thereof] has complied with the following: A. The chairperson of the board [or Committee] shall, if appropriate, appoint a disinterested person or committee to investigate alternatives to the proposed contract, transaction or arrangement. B. After exercising due diligence, the Board [or Committee] shall determine whether the YMCA can, with reasonable efforts, get a more advantageous contract, transaction or arrangement from a person or entity without a conflict of interest. C. If a more advantageous transaction or arrangement is not reasonably possible, the Board [or Committee] shall detennine by a majority vote of the disinterested directors whether the transaction or arrangement is in the Y's 'best interest", for its own benefit, and whether it is fair and reasonable. In conformity with the above determination, the Board shall make its decision as to whether to enter into the contract, transaction or arrangement. VII. PROCEDURE FOR VIOLATIONS OF THE POLICY A. If the Board [or Committee] has reasonable cause to believe a Significant Person has failed to comply with the disclosure requirements in this Policy, it shall infonn the Person of the basis for such belief and afford the Person an opportunity to explain the alleged failure to disclose. B. If, after hearing the Significant Person's response and after making further investigation as warranted by the circumstances, the Board [or Committee] detennines the Significant Person has failed to disclose an actual or possible conflict of interest, it shall take appropriate disciplinary and corrective action.
Form 990, Part VI, Section B, line 15b
The following Executive Compensation Review Process was adopted and implemented by the Sewickley Valley YMCA Board of Directors in September, 2008: Sewickley Valley YMCA IRS Intermediate Sanctions Rebuttable Presumption Statement Year ____ Total Rewards Data Executive Director: (Date of Employment at the Sewickley Valley YMCA: Annual Compensation: Base Annual Salary: Annual Incentive: (Based on mean salary increase over past five years) Long Term Incentive: Total Cash: Basic & Supplemental Insurance Benefits: Medicare Insurance: Health Insurance: Dental Insurance: AD&D Insurance: Life Insurance: Short-Term Disability Insurance: Long-Term Disability Insurance: Workers' Compensation Insurance: Total Insurance Benefits: Basic & Supplemental Retirement Benefits: Social Security: Qualified Pension Fund: (12% of gross salary paid to the YMCA Retirement Fund) Total Retirement Benefits: Flexible Perquisites Plan: Percent of annual salary or dollar amount allocated for perquisites: Alternative Perquisites: Car/Car Allowance: Cellular Telephone: Professional Dues: Legal Services: Financial Counseling: YMCA Membership: Executive Physical Exam: Continuing Professional Education: $ Home Computer Laptop: Other: Total Alternative Perquisites: $ Total Rewards Comparison Source of Comparability: 2009 YMCA of the USA Salary Administration Guideline Recommendation Competitive Percentile Competitive Value Year 2008 D. Stevenson Annual Compensation Basic & Supplemental Insurance Benefits Basic & Supplemental Retirement Benefits Flexible Perquisites Plan Alternative Perquisites Plan Total Rewards Opportunity Office or file where comparability data kept: Decision-Making Body Compensation Approval Member Name Approved / Not Approved/ Date Approved Comparability Data Relied Upon by Authorized Body and How Data Was Obtained Names and Actions (if any) by Members of Authorized Body Having Conflict of Interest Date of Preparation of this Document (must be prepared by the latter of the next meeting of authorized body, or sixty days after authorized body approved compensation) Date of Approval of this Document by the Board of Directors (must be within reasonable time after preparations of document above) Board of Directors Approval: September 23,2008 Legal Review Completed: September 8,2008
Form 990, Part VI, Section C, line 19
The Sewickley Valley YMCA presents the following governing documents for public view on the YMCA website www.sewickleyymca.org and in a view notebook held in the Executive Directors' office: Sewickley Valley YMCA Mission, Theme and Brief History Sewickley Valley YMCA Form 990 - Return of Organization Exempt From Income Tax Governance Policies: Code of Ethics Conflict of Interest Policy Record Retention and Document Destruction Policy Whistleblower Policy, Executive Compensation Policy Staff and Volunteer Expenses and Allowances Policy Commonwealth of Pennsylvania - Department of State Bureau of Charitable Organizations - Certificate of Registration Sewickley Valley YMCA Audited Financial Statements Sewickley Valley YMCA Amended and Restated Articles of Incorporation Sewickley Valley YMCA By-Laws and Committee Commissions Sewickley Valley YMCA Property Deeds Sewickley Valley YMCA Income and Sales Tax Exemption Information Sewickley Valley YMCA Strategic Plan Sewickley Valley YMCA Annual Report
Changes in Net Assets or Fund Balances:
Form 990, Part XI, line 5:
Net unrealized gains on investments: 4,285.
No change in accounting method
Form 990, Part XI, Line 1
There has not been a change in accounting method.
The process has not changed from the prior year.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.