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
BROADMEAD INC
Employer identification number
52-1056690
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.") .
152,168
66,629
996,605
356,437
440,587
2,012,426
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......
16,915,334
18,078,187
18,296,902
18,552,111
18,391,616
90,234,150
3
Gross receipts from activities that are not an unrelated trade or business under section 513..
173,754
445,035
478,065
1,096,854
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.
17,067,502
18,144,816
19,467,261
19,353,583
19,310,268
93,343,430
7a
Amounts included on lines 1, 2, and 3 received from disqualified persons...
2,595
150
4,025
6,770
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.
307,044
138,647
445,691
c
Add lines 7a and 7b..
309,639
138,797
4,025
452,461
8
Public Support (Subtract line 7c from line 6.)
92,890,969
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...
17,067,502
18,144,816
19,467,261
19,353,583
19,310,268
93,343,430
10a
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
958,817
922,078
822,661
833,656
850,587
4,387,799
b
Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c
Add lines 10a and 10b.
958,817
922,078
822,661
833,656
850,587
4,387,799
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.)
5,700
4,700
3,800
14,200
13
Total support (Add lines 9, 10c, 11 and 12.).
18,026,319
19,066,894
20,295,622
20,191,939
20,164,655
97,745,429
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
95.030 %
16
Public support percentage from 2009 Schedule A, Part III, line 15
...............
16
95.060 %
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2010 (line 10c column (f) divided by line 13 column (f))
......
17
4.490 %
18
Investment income percentage from 2009 Schedule A, Part III, line 17
.............
18
4.590 %
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, PART II, LINE 12, EXPLANATION OF OTHER INCOME: APPLICATION FEES
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
BROADMEAD INC
Employer identification number
52-1056690
Identifier
Return Reference
Explanation
FORM 990, PART VI, SECTION A, LINE 6
THE SOLE MEMBER OF THE CORPORATION IS FRIENDS CARE, INC.
FORM 990, PART VI, SECTION A, LINE 7A
ALL TRUSTEES SHALL BE APPOINTED AND THE CLASS OF EACH TRUSTEE SHALL BE DETERMINED BY THE MEMBER, PROVIDED, HOWEVER, THAT AT ALL TIMES AT LEAST A MAJORITY OF THE TRUSTEES MUST BE MEMBERS OF THE RELIGIOUS SOCIETY OF FRIENDS.
FORM 990, PART VI, SECTION A, LINE 7B
THE BOARD OF TRUSTEES, APPOINTED BY THE MEMBER, SHALL HAVE FULL AUTHORITY TO MANAGE AND CONTROL THE BUSINESS AND AFFAIRS OF THE CORPORATION.
FORM 990, PART VI, SECTION B, LINE 11
THE 990 WILL BE REVIEWED INITIALLY BY THE CFO/TREASURER AND THE ENTIRE BOARD FOR ACCURACY AND COMPLETENESS. AFTER REVIEW, COMMENTS WILL BE PROVIDED TO THE EXTERNAL PREPARER TO MAKE ADJUSTMENTS. ONCE ADJUSTMENTS HAVE BEEN MADE, A FINALIZED COPY WILL BE PROVIDED TO THE BOARD OF DIRECTORS TO REVIEW BEFORE THE FORM 990 IS FILED WITH THE IRS.
FORM 990, PART VI, SECTION B, LINE 12
AS PART OF BROADMEAD'S QUAKER RELIGIOUS TENETS, THE ORGANIZATION DOES NOT USE CHECKLISTS OR REQUIRE SIGNATURES ON CERTAIN DOCUMENTS. THERE IS A VERBAL ACKNOWLEDGEMENT OF BOTH INDEPENDENCE AND CONFLICT OF INTEREST ISSUES ANNUALLY, WHICH IS REPORTED TO THE RISK MANAGEMENT COMMITTEE. TRUSTEES ARE REQUIRED TO REPORT CONFLICTS OF INTEREST OR INDEPENDENCE ISSUES THAT ARISE DURING THE YEAR.
FORM 990, PART VI, SECTION B, LINE 15
THE PROCESS USED TO DETERMINE THE CEO'S COMPENSATION IS TO USE AN INDEPENDENT CONSULTANT TO REVIEW COMPENSATION FOR SIMILAR EXECUTIVES. THIS INFORMATION IS PROVIDED TO THE EXECUTIVE EVALUATION AND COMPENSATION COMMITTEE, WHICH CONSISTS OF BOARD MEMBERS, AND THEY DETERMINE WHETHER THE CEO'S COMPENSATION IS APPROPRIATE AND RECOMMEND ANY INCREASE FOR THE NEXT FISCAL YEAR. IF A KEY EMPLOYEE IS HIRED FOR A NEW POSITION, A CONSULTANT IS USED TO DETERMINE AN APPROPRIATE SALARY RANGE. THE COMPENSATION FOR KEY EMPLOYEES IS REVIEWED ANNUALLY BY THE CEO. IF A NEW KEY EMPLOYEE IS HIRED INTO AN ALREADY ESTABLISHED POSITION, THEIR COMPENSATION IS BASED ON THE COMPENSATION OF THE EMPLOYEE WHO PREVIOUSLY HELD THE POSITION IN ADDITION TO THE EXPERIENCE OF THE NEW HIRE.
FORM 990, PART VI, SECTION C, LINE 19
BROADMEAD'S FORM 1023, 990, GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE CURRENTLY AVAILABLE IN THE OFFICE OF THE CFO/TREASURER.
WITHIN THEIR RESPECTIVE ROLES, BARBARA CARROLL, PATRICIA GORDON, RICHARD COMPTON AND THOMAS MONDLOCH DEVOTE TIME TO BROADMEAD AND TO A RELATED ORGANIZATION, BROADMEAD MEDICAL SERVICES. IT IS ESTIMATED THAT EACH WEEK, THESE EMPLOYEES DEVOTE THEIR TIME AS FOLLOWS: BARBARA CARROLL- 24 HOURS BROADMEAD, 16 HOURS BROADMEAD MEDICAL SERVICES PATRICIA GORDON- 40 HOURS BROADMEAD, 5 HOURS BROADMEAD MEDICAL SERVICES RICHARD COMPTON- 40 HOURS BROADMEAD, 5 HOURS BROADMEAD MEDICAL SERVICES THOMAS MONDLOCH- 32 HOURS BROADMEAD, 8 HOURS BROADMEAD MEDICAL SERVICES
BOARD OF TRUSTEE'S HOURS
FORM 990, PART VII, COLUMN B
FOR ALL MEMBERS OF THE BOARD OF TRUSTEES OF THE ORGANIZATION, TIME IS DEVOTED BOTH TO BROADMEAD AND A RELATED ORGANIZATION, BROADMEAD MEDICAL SERVICES. FREDERIC HINZE, BETTIE FARRAR, LAWRENCE REID, AND ROBERT FETTER DEVOTE 5 OF THEIR 6 HOURS TO BROADMEAD, WHILE THE REMAINING MEMBERS DEVOTE 2 HOURS TO THEIR 3 HOURS TO BROADMEAD.
CHANGES IN NET ASSETS OR FUND BALANCES:
FORM 990, PART XI, LINE 5:
NET UNREALIZED GAINS ON INVESTMENTS: 3,489,905.
AUDIT OVERSIGHT:
FORM 990, PAGE 12, PART XI, LINE 2C
THE FINANCE COMMITTEE REVIEWS THE AUDIT IN DRAFT FORM AND MAKES RECOMMENDATIONS OF ANY CHANGES. THEY ALSO MEET WITH THE AUDITORS, WITHOUT THE PRESENCE OF STAFF, TO DISCUSS HOW THE ENGAGEMENT WAS HANDLED AND TO DETERMINE WHETHER THERE ARE ANY OTHER MATTERS THAT THE AUDITORS WANT TO COMMUNICATE TO THE COMMITTEE. IF APPROPRIATE, THE FINANCE COMMITTEE RECOMMENDS THAT THE AUDIT BE ACCEPTED BY THE BOARD OF TRUSTEES. THE AUDITORS ALSO GIVE A PRESENTATION TO THE BOARD OF TRUSTEES ON THE AUDIT.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.