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
UCHCFC Munson Road Corp
Employer identification number
20-1800328
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)
No
(ii)
a family member of a person described in (i) above?
......................
11g(ii)
No
(iii)
a 35% controlled entity of a person described in (i) or (ii) above?
................
11g(iii)
No
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
(1)
UNIVERSITY OF CONNECTICUT HEALTH CENTER FINANCE CORPORATION
061213246
02
Yes
0
Total
0
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.") .
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
UCHCFC Munson Road Corp
Employer identification number
20-1800328
Identifier
Return Reference
Explanation
ORGANIZATION'S MISSION
PART I, LINE I; PART III, LINE I
The UConn Health Center Finance Corporation Munson Road Corporation was formed pursuant to Section 10a-254 of the Connecticut General Statutes by the UConn Health Center Finance Corporation to fulfill its mission of service by entering into new financing agreements enabling the purchase of additional building capacity at the Health Center.
MEMBERS OR STOCKHOLDERS
PART VI, SECTION A, LINES 6, 7A, AND 7B
The sole member of the UConn Health Center Finance Corporation Munson Road Corporation is the University of Connecticut Health Center Finance Corporation, its parent. The subsidiary corporation is administered by a board of directors elected on an annual basis by the sole member's board of directors.
MEETING DOCUMENTATION
PART VI, SECTION A, LINE 8B
All meetings, consisting solely of board of directors meetings, are documented. The activities of the corporation have not required additional committees be formed by the board of directors.
FORM 990 REVIEW PROCESS
PART VI, SECTION B, LINE 11B
The information needed to compile the 990 return is gathered by the UCHC finance department and used to fill out the work papers provided by KPMG LLP, Independent Tax Consultant. Once KPMG LLP completes the draft 990, the draft is reviewed by UCHC Finance. UCHC then issues a letter to the board of directors of the Munson Road Corporation summarizing the disclosures in Form 990 and makes the Form 990 available at the next board meeting prior to filing the return with the IRS.
CONFLICT OF INTEREST POLICY
PART VI, SECTION B, LINE 12C
UCHCFC Munson Road is covered under the policies for the University of Connecticut. The University of Connecticut has a policy in place under the "University Guide to the State Code of Ethics" which states: GIFTS: In general, employees are prohibited from accepting gifts, discounts or gratuities of any kind from donors: (1) doing business with or seeking to do business with the University; (2) directly regulated by the University; (3) known to be a registered lobbyist or a lobbyist's representative, or; (4) pre-qualified under Conn. Gen. Stat. 4a-100. A list of registered lobbyists can be found on the web site of the Office of State Ethics. Certain items are excluded from the definition of "gift," including: items offered to the public at large (for example, trinkets provided at an open house), items valued at under $10, food and beverage up to $50 in a calendar year from each donor and training for a product purchased by the University provided such training is offered to all customers of that vendor. "Gifts to the state" are also permitted unless earmarked for travel or conference expenses. If an employee is offered a benefit from someone other than the prohibited donors listed above, and the benefit is offered because of the employee's position at the University, the total value of benefits received from one source in a year must not exceed $100. Additionally, supervisors may only accept gifts valued at no more than $100 from a subordinate; a subordinate may only accept gifts valued at no more than $100 from his/her supervisor. Questions regarding specific facts and circumstances surrounding various gift-giving scenarios should be directed to the University's Ethics Liaison or the Office of State Ethics. OUTSIDE EMPLOYMENT: No employee may accept outside employment that will impair his or her independence of judgment with regard to his/her state duties or would encourage the disclosure of confidential information gained in state service. Additionally, although an employee may use his/her expertise, he/she may not use his/her state position to obtain outside employment. An employee is not allowed to use his/her business address, telephone number, title or status in any way to promote, advertise or solicit personal business. Employees interested in pursuing outside employment may seek and receive written approval from their Department Head and, if uncertain about the application of the Code, the Office of State Ethics. For faculty and professional staff, the University of Connecticut Laws and By-Laws specifically address consulting, private professional practice, teaching, and other outside employment situations. (See policy at http://www.policy.uconn.edu/Bylaws070109.pdf). Members of the AAUP bargaining unit must adhere to the University's policy on assigning textbooks which they have authored. (See policy at: http://policy.uconn.edu/pages/findPolicy.cfm?PolicyID=252). Union members are referred to contract articles, if such exist, relating to outside employment in their respective collective bargaining agreements. If you are thinking about an opportunity for outside employment, you may also consult with the University's ethics liaison for guidance. FINANCIAL BENEFIT: Employees may not use their official position or confidential information gained in their service for personal financial benefit, or the financial benefit of a family member or a business with which they, or a family member, are associated. Employees are prohibited from using state time, personnel or materials, including telephones, computers, e-mail systems, fax machines, copy machines, state vehicles and any other supplies, for personal, non-state related purposes. It is understood, however, that incidental use of state property for personal use is permissible so long as you reimburse the state for any identifiable charges. CONTRACTS WITH THE STATE: Employees, their immediate family members, and/or a business with which an employee or his/her family member is associated may not enter into a contract with the state valued at $100 or more, unless the contract has been awarded through an open and public process. The Office of State Ethics has ruled that immediate family members may not be hired as an independent contractor unless there has been an open and public process. APPEARANCE FEES: No employee may personally accept any fee or honorarium given in return for a speech or appearance made or article written in the employee's official capacity. You may, however, direct that the fee or honorarium be deposited in a University account to be used for future University-related business activities. Necessary expenses to participate in a particular event may be acceptable under certain circumstances and, if received from a non-governmental entity, may also require the filing of a disclosure form with the Office of State Ethics. "Necessary expenses" are limited to: necessary travel expenses, lodging for the nights before, of and after the appearance, speech, or event; meals and any related conference or seminar registration fees. The paramount issue to be considered is whether the activity in question is performed in an employee's "official capacity." As a general rule, if a university employee is asked to participate in an event, speak, appear, or write an article and the employee's official position or authority was a significant factor in the decision to extend the invitation, then it will be deemed to be in his/her official capacity. If, however, a state employee has developed an expertise in a particular field and he/she is asked to participate in an event, speak, appear, or write an article as a result of his/her knowledge and expertise, then the employee is not prohibited from accepting a fee or honorarium. Note that these situations are very fact specific and employees are encouraged to contact the University's Ethics Liaison for guidance. Members of the board of directors who are also members of the University confirm their compliance with the Conflict of Interest policy annually. Members of the board of directors are also subject to the "Code of Ethics for Public Officials" as found in Chapter 10 of the Connecticut General Statutes.
COMPENSATION POLICY
PART VI, SECTION B, LINES 15A AND 15B
The Munson Road Corporation does not compensate any of its officers, directors or employees. Two of the organization's officers receive compensation from related parties under the guidelines of the University of Connecticut.
PUBLIC DISCLOSURE
PART VI, SECTION C, LINE 19
ALL REQUIRED DOCUMENTS ARE AVAILABLE FOR PUBLIC INSPECTION.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.