Attach to Form 990 or 990-EZ.| Identifier | Return Reference | Explanation |
|---|---|---|
| FORM 990, PART VI, SECTION A, LINE 2 | DARRYL VANDERVORT AND TIM BROOS ARE BOTH EMPLOYEES OF KSB HOSPITAL. DARRYL IS THE CEO, AND TIM IS THE CHIEF INFORMATION OFFICER. RICK CURIA SERVES ON THE BOARD OF DIRECTORS OF KSB HOSPITAL. TWO BOARD MEMBERS SHARE A FAMILIAL RELATIONSHIP. DARRYL VANDERVORT AND SHAWN ORTGIESEN ARE BOTH MEMBERS OF THE LEE COUNTY INDUSTRIAL DEVELOPMENT ASSOCIATION. AN ORGANIZATION THAT DIXON AREA CHAMBER PROVIDES MANAGEMENT SERVICES TO. | |
| FORM 990, PART VI, SECTION A, LINE 6 | PER THE ORGANIZATIONS BY LAWS THE ORGANIZATION HAS MEMBERS WHO ARE INDIVIDUALS OR BUSINESSES IN GOOD STANDING WITHIN THE COMMUNITY WHO PAY DUES BASED ON AN INVESTITURE SCHEDULE. | |
| FORM 990, PART VI, SECTION A, LINE 7A | MEMBERS OF THE BOARD ARE NOMINATED BY A NOMINATION COMMITTEE CREATED BY THE BOARD. FULL MEMBERS OF THE CHAMBER ARE THEN ALLOWED TO VOTE FOR THE NEW MEMBERS. | |
| FORM 990, PART VI, SECTION B, LINE 11 | TO MAINTAIN ITS STATUS AS A SECTION 501(C)(6) NOT-FOR-PROFIT BUSINESS ASSOCIATION, THE DIXON AREA CHAMBER OF COMMERCE AND INDUSTRY (THE "CHAMBER") IS ANNUALLY REQUIRED TO FILE FORM 990 -RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX WITH THE INTERNAL REVENUE SERVICE. PRIOR TO FILING FORM 990, THE PRESIDENT OF THE CHAMBER WILL DISTRIBUTE FORM 990, AS PREPARED BY ITS ACCOUNTANT, TO EACH MEMBER OF THE EXECUTIVE COMMITTEE OF BOARD OF DIRECTORS (THE "EXECUTIVE COMMITTEE"). AFTER RECEIVING A COPY OF FORM 990, THE EXECUTIVE COMMITTEE SHALL DISCUSS THE PREPARED FORM 990, AND EACH MEMBER WILL BE GIVEN AN OPPORTUNITY TO ASK QUESTIONS OR RAISE CONCERNS. FORM 990 SHALL ONLY BE FILED AFTER A MAJORITY VOTE OF THE EXECUTIVE COMMITTEE AUTHORIZES THE FILING OF THE SAME. IN ADDITION, FORM 990 SHALL BE AVAILABLE FOR REVIEW AND INSPECTION BY THE OTHER MEMBERS OF THE BOARD OF DIRECTORS. | |
| FORM 990, PART VI, SECTION B, LINE 12C | EACH MEMBER OF THE BOARD IS REQUIRED TO SIGN A STATEMENT AT THE BEGINNING OF THEIR TERM ACKNOWLEDGING UNDERSTANDING OF THE CONFLICT OF INTEREST POLICY, AND ITS GOALS. IF THE BOARD BECOMES AWARE, OR HAS REASONABLE CAUSE TO SUSPECT A MEMBER HAS VIOLATED THE COFLICT OF INTERST POLICY IT SHALL INFORM THE MEMBER OF THE BASIS OF SUCH BELIEF AND ALLOW THE MEMBER TO EXPLAIN THE POSSIBLE VIOLATION. IF THE BOARD SO WARRANTS FURTHER INVESTIGATION, AND OR DISCIPLINARY AND CORRECTIVE ACTION MAY RESULT. | |
| FORM 990, PART VI, SECTION B, LINE 15 | AFTER REVIEW OF COMPARABILITY DATA COMPENSATION ADJUSTMENTS ARE APPROVED BY THE BOARD AS PART OF THE BUDGET PROCESS AND DOCUMENTED IN THE MINUTES. | |
| FORM 990, PART VI, SECTION C, LINE 19 | BECAUSE OF ITS STATUS AS A 501(C)(6) BUSINESS ASSOCIATION, THE DIXON AREA CHAMBER OF COMMERCE AND INDUSTRY (THE "CHAMBER")IS REQUIRED TO MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS (COLLECTIVELY REFERRED TO HEREIN AS "PUBLIC DOCUMENTS")AVAILABLE TO THE PUBLIC. THE CHAMBER COMPLIES WITH THIS REQUIREMENT BY MAINTAINING THE PUBLIC DOCUMENTS AT ITS CORPORATE OFFICE, LOCATED AT 101 WEST SECOND STREET, SUITE 301, DIXON, ILLINOIS 61021. DURING NORMAL BUSINESS HOURS, THE PUBLIC DOCUMENTS ARE AVAILABLE AT THE AFOREMENTIONED ADDRESS FOR INSPECTION, PROVIDED THAT SUCH INSPECTION SHALL NOT UNREASONABLY INTERFERE WITH THE CHAMBER'S OPERATION OF ITS BUSINESS. THE CHAMBER SHALL TAKE ALL REASONABLE STEPS NECESSARY TO COOPERATE WITH ANYONE WISHING TO INSPECT THE PUBLIC DOCUMENTS. | |
| CHANGES IN NET ASSETS OR FUND BALANCES: | FORM 990, PART XI, LINE 5: | ADJUSTMENT TO MATCH FINANCIAL STATEMENTS -1. TOTAL TO FORM 990, PART XI, LINE 5: -1. |
| FORM 990 PART XII, LINE 2C | THE ORGANIZATION HAS AN EXECUTIVE COMMITTEE THAT APPOINTS THE INDEPENDANT AUDITOR. |
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