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
DISABILITY NETWORKLAKESHORE
Employer identification number
38-3038466
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.") ....
539,231
637,049
654,662
594,807
569,210
2,994,959
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..
539,231
637,049
654,662
594,807
569,210
2,994,959
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.
2,994,959
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..
539,231
637,049
654,662
594,807
569,210
2,994,959
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
6,206
6,001
1,965
2,219
878
17,269
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..
3,589
7,978
10,374
21,941
11
Total support (Add lines 7 through 10).
3,034,169
12
Gross receipts from related activities, etc. (See instructions.)
..................
12
260,534
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
98.710 %
15
Public Support Percentage for 2009 Schedule A, Part II, line 14
...............
15
98.410 %
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.") .
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
Gross receipts from activities that are not an unrelated trade or business under section 513..
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.
7a
Amounts included on lines 1, 2, and 3 received from disqualified persons...
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.
c
Add lines 7a and 7b..
8
Public Support (Subtract line 7c from line 6.)
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...
10a
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b
Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c
Add lines 10a and 10b.
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.).
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
16
Public support percentage from 2009 Schedule A, Part III, line 15
...............
16
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2010 (line 10c column (f) divided by line 13 column (f))
......
17
18
Investment income percentage from 2009 Schedule A, Part III, line 17
.............
18
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
DISABILITY NETWORKLAKESHORE
Employer identification number
38-3038466
Identifier
Return Reference
Explanation
EXPLANATION ON VOLUNTEERS AND TYPES OF SERVICES OR BENEFITS
FORM 990, PAGE 1, PART I, LINE 6
VOLUNTEERS WERE EXTENSIVELY USED IN A VARIETY OF ROLES SUCH AS: PROVIDING GENERAL OFFICE AND ADMINISTRATIVE SUPPORT, CLERICAL AND RECEPTION SERVICES; BOARD OF DIRECTORS; VARIOUS FRIENDS OF TRANSIT PROJECTS; EMPLOYMENT SERVICES SUCH AS MOCK INTERVIEWING AND RESUME REVIEW. PROVIDED LIFE SKILLS AND EMPLOYMENT-RELATED MENTORING SPECIFIC TO YOUTH IN SIGNIFICANT LONG-TERM RELATIONSHIPS WITH ADULTS WHO HAVE DISABILITY EXPERIENCE.
FIRST ACHIEVEMENT DESCRIPTION
FORM 990, PAGE 2, PART III, LINE 4A
SERVICES TO ASSURE ACCESS. PROVIDED 20 BUSINESSES, COMMUNITY ORGANIZATIONS, HOSPITALS, GOVERNMENTAL UNITS AND CHURCHES WITH COMPREHENSIVE DISABILITY AWARENESS, SENSITIVITY AND ETIQUETTE TRAINING, REPRESENTING 500 PLUS INDIVIDUALS EDUCATED. AS THE RESULT OF AN ACCESSIBILITY AUDIT AT HOPE COLLEGE, THE EVENTS AND CONFERENCE STAFF ANTICIPATED ACCESS NEEDS OF DANCING WHEELS PERFORMERS AND BUILT RAMPS ON BOTH SIDES OF THE STAGES. THIS WAS A PUBLIC EVENT THAT WAS ATTENDED BY OVER 200 COMMUNITY MEMBERS. TRAINED 3 BUSINESS ENGINEERS ON ACCESSIBILITY GUIDELINES, PROVIDED INSTRUCTION ON HOW TO PERFORM ACCESSIBILITY AUDITS. ORGANIZED THE ZEELAND LIVABILITY AND WALKABILITY COALITION IN THE CITY OF ZEELAND TO SUPPORT COMPLETE STREETS. PRESENTED COMPLETE STREETS PRESENTATION TO 5 MUNICIPALITIES. ASSISTIVE TECHNOLOGY: FACILITATED TWO ASSISTIVE TECHNOLOGY TRAINING WORKSHOPS FOR 37 PROFESSIONALS. EMPLOYMENT: 86 EMPLOYERS WERE EDUCATED ABOUT THE VALUE AND ABILITY OF PEOPLE WITH DISABILITIES IN THE WORKPLACE. 43 EMPLOYERS ACTIVELY ENGAGED IN OUR WORK, PROVIDED RESUME REVIEWS AND MULTIPLE FEEDBACK INTERVIEWS FOR 35 MRS CUSTOMERS. DEVELOPED NEW SIGNIFICANT PARTNERSHIP WITH A MAJOR EMPLOYER IN THE AREA, PROVIDING ACCESSIBILITY AUDITS, REVIEWING HR PRACTICES RELATED TO DISABILITY, AND ASSISTING WITH RECRUITMENT OF QUALIFIED APPLICANTS WITH DISABILITIES. HEALTH CARE / LONG TERM SUPPORTS: ATTENDED MEETINGS AND PLANNED FOR EFFECTIVE I & R REFERRALS BETWEEN SENIOR RESOURCES (AAA) AND 2 CENTERS FOR INDEPENDENT LIVING AS NEXT STEPS IN DEVELOPING A LOCAL AGING AND DISABILITY RESOURCE CENTER NETWORK. STAFF PROVIDED TRAINING ON THE MENTAL MODELS OF DISABILITY TO HOLLAND COMMUNITY HOSPITAL, WITH A FOCUS ON THE HEALTH CARE BARRIERS EXPERIENCED BY PEOPLE WITH DISABILITIES. COORDINATED DEVELOPMENT OF A SOAR COALITION FOR DEVELOPING FINANCING SUPPORT FOR SOAR WORK WITH HOMELESS INDIVIDUALS IN APPLYING FOR SSI/SSDI. HOUSING: PARTICIPATED IN MEETINGS OF THE OTTAWA COUNTY HOUSING COMMISSION. PARTNERED WITH WEST MICHIGAN FAIR HOUSING CENTER TO ADDRESS THE FAIR HOUSING NEEDS OF PERSONS WITH DISABILITIIES. NURSING FACILITY TRANSITION OUTREACH: REGUARLY MET WITH NURSING FACILITY STAFF FROM THE 16 NURSING FACILITIES IN OUR TWO COUNTY AREA TO EXPLAIN THE NURSING FACILITY TRANSITION PROGRAM AND EDUCATE SOCIAL WORKERS AND DISCHARGE PLANNERS ON SERVICES OFFERED. PRESENTED TO 22 SERVICE PROVIDERS AT THE BUILDING TIES NETWORKING GROUP IN ALLEGAN COUNTY ON NFG SERVICES. TRANSPORTATION: PUBLISHED 2 REPORTS. PUBLISHED AND CONDUCTED 3 PRESENTATIONS FOR THE ALLEGAN COUNTY TRANSPORTATION FIVE YEAR STRATEGIC PLAN FOR ALLEGAN SDNT STUDY. CREATED AND PRESENTED 2 FRIENDS OF TRANSIT COALITIONS IN ORDER TO ADVOCATE FOR EXPANDED PUBLIC TRANSPORTATION OPTIONS IN EASTERN OTTAWA COUNTY. DEVELOPED LAKESHORE FRIENDS OF TRANSIT WEBSITE. TRANSIT: LARGELY AS A RESULT OF OUR COMMUNITY/SYSTEMS ADVOCACY, COLLABORATION/NETWORKING SERVICES, PUBLIC TRANSIT PROVIDERS IN THE NORTHERN PART OF OUR SERVICES AREA HAVE EXPANDED THEIR SERVICES. TRANSIT COALITIONS HAVE BEEN CREATED IN TWO ADDITIONAL PORTIONS OF OUR EASTERN SERVICE AREA.
ORGANIZATION'S PROCESS USED TO REVIEW FORM 990
FORM 990, PAGE 6, PART VI, LINE 11B
A DRAFT COPY OF FORM 990 AND SUPPORTING SCHEDULES WAS SUBMITTED VIA EMAIL, TO THE EXECUTIVE DIRECTOR. CONFIRMATION OF RECEIPT AND APPROVAL WAS SENT VIA RETURN EMAIL RESPONSE. AFTER SAID APPROVAL, A COPY OF THE 990 WAS PROVIDED TO ALL BOARD MEMBERS.
ENFORCEMENT OF CONFLICTS POLICY
FORM 990, PAGE 6, PART VI, LINE 12C
THE ORGANIZATION STRIVES TO MAINTAIN THE HIGHEST ETHICAL STANDARDS IN ALL POLICIES, PROCEDURES AND PROGRAMS TO AVOID ANY CONFLICT OF INTEREST. EACH DIRECTOR AND EMPLOYEE SHALL ANNUALLY SIGN A STATEMENT WHICH AFFIRMS THAT SUCH PERSON: 1) HAS RECEIVED A COPY OF THE CONFLICT OF INTEREST POLICY; 2) HAS READ AND UNDERSTANDS THE POLICY; 3) HAS AGREED TO COMPLY WITH THE POLICY. IN CONNECTION WITH ANY DIRECT OR INDIRECT FINANCIAL INTEREST OR CONFLICT OF INTEREST, AN INTERESTED PERSON MUST DISCLOSE THE EXISTENCE OF HIS/HER FINANCIAL INTEREST OR AFFILIATION AND ALL MATERIAL FACTS TO THE BOARD. AFTER SUCH DISCLOSURE AND DISCUSSION WITH THE INTERESTED PERSON, HE OR SHE SHALL LEAVE THE BOARD MEETING WHILE THE DETERMINATION OF A CONFLICT OF INTEREST IS DISCUSSED AND VOTED UPON. THE REMAINING BOARD MEMBERS SHALL DETERMINE IF A CONFLICT OF INTEREST EXISTS.
COMPENSATION PROCESS FOR TOP OFFICIAL
FORM 990, PAGE 6, PART VI, LINE 15A
AN EXECUTIVE DIRECTOR'S SALARY AND PERFORMANCE REVIEW SHALL TAKE PLACE ANNUALLY. THE REVIEW CONSISTS OF A REVIEW BY INDEPENDENT PERSONS, COMPARABILITY DATA AND DISCUSSION OF THE RESULTS AT THE BOARD MEETING. THE ANNUAL SALARY AND PERFORMANCE REVIEW OF THE EXECUTIVE DORECTOR SHALL BE COMPLETED BY THE EXECUTIVE COMMITTEE AND SHALL INCLUDE REVIEW AND CONSIDERATION OF: 1) FEEDBACK GATHERED FROM THE BOARD, STAFF, AND/OR COMMUNITY PARTNERS 2) THE DIRECTOR'S GOALS FOR THE CURRENT YEAR AND ACHIEVEMENT OF THOSE GOALS 3) THE DIRECTOR'S GOALS FOR THE COMING YEAR. 4) RECENT SALARY DATA COMPARED BY ORGANIZATIONAL SIZE AND POSITION FOR WEST MICHIGAN AND MICHIGAN AS A WHOLE USING THE MICHIGAN NONPROFIT ASSOCIATION SALARY AND BENEFIT SURVEY. 5) BUDGET DATA FOR THE COMING YEAR
COMPENSATION PROCESS FOR OFFICERS
FORM 990, PAGE 6, PART VI, LINE 15B
ANNUAL EVALUATIONS ARE PERFORMED FOR EACH EMPLOYEE. COMPENSATION OF STAFF IS DETERMINED BY ANNUAL PERFORMANCE EVALUATIONS. GENERALLY SPEAKING, SALARY RANGES HAVE BEEN ESTABLISHED FOR EACH STAFF POSITION. THE PRIMARY TOOLS USED TO SET THE SALARY RANGES INCLUDE LOOKING AT POSITION DESCRIPTIONS AND COMPARABLE SALARY RANGES AS IDENTIFIED IN THE MICHIGAN NON-PROFIT ASSOCIATION SALARY AND BENEFIT SURVEY.
GOVERNING DOCUMENTS DISCLOSURE EXPLANATION
FORM 990, PAGE 6, PART VI, LINE 19
GOVERNING DOCUMENTS SUCH AS THE 1023 APPLICATION, ARTICLES OF INCORPORATION AND BY-LAWS ARE READILY AVAILABLE UPON REQUEST. THE ORGANIZATION'S ANNUAL REPORT IS AVAILABLE ON THEIR WEBSITE.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.