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
MOSAIC COMMUNITY SERVICES INC
Employer identification number
52-1338141
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.") ....
315,065
447,750
1,384,970
1,008,921
3,702,041
6,858,747
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..
315,065
447,750
1,384,970
1,008,921
3,702,041
6,858,747
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)..
381,461
6
Public Support. Subtract line 5 from line 4.
6,477,286
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..
315,065
447,750
1,384,970
1,008,921
3,702,041
6,858,747
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
185,828
170,811
117,419
68,054
124,127
666,239
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..
279,270
410,761
444,252
235,572
275,572
1,645,427
11
Total support (Add lines 7 through 10).
9,170,413
12
Gross receipts from related activities, etc. (See instructions.)
..................
12
109,435,596
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
70.630 %
15
Public Support Percentage for 2009 Schedule A, Part II, line 14
...............
15
58.660 %
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
MOSAIC COMMUNITY SERVICES INC
Employer identification number
52-1338141
Identifier
Return Reference
Explanation
NEW PROGRAM SERVICES
FORM 990, PART III, LINE 2
ON JULY 1, 2010, THE NORTH BALTIMORE CENTER, INC. MERGED INTO MOSAIC COMMUNITY SERVICES, INC. UNDER A STATUTORY MERGER. THE NORTH BALTIMORE CENTER, INC. WAS A RELATED ORGANIZATION AND WHOLLY OWNED SUBSIDIARY OF THE SHEPPARD AND ENOCH PRATT FOUNDATION, INC. PROVIDING COMMUNITY OUTPATIENT SERVICES. AS A RESULT OF THE MERGER, MOSAIC ABSORBED THE OPERATION OF SEVERAL NEW REHABILITATIVE PROGRAMS INCLUDING THE CHESAPEAKE CONNECTIONS CAPITATED CONTRACT, MOBILE TREATMENT, MEDIATION, CASE MANAGEMENT AND OFFSITE COUNSELING SERVICES. THE MERGER WAS ENTERED INTO FOR THE PURPOSES OF FURTHER DEVELOPING EXISTING SERVICES AND ADDITIONAL SERVICES FOR THE RESIDENTS OF BALTIMORE CITY, BALTIMORE COUNTY, AND CARROLL COUNTY, MARYLAND.
CHANGES IN PROGRAM SERVICES
FORM 990, PART III, LINE 3
ON JULY 1, 2010, THE ORGANIZATION MERGED THE NORTH BALTIMORE CENTER, INC. INTO MOSAIC COMMUNITY SERVICES, INC. UNDER A STATUTORY MERGER. AS A RESULT OF THE MERGER, MOSAIC ABSORBED THE OPERATION OF SEVERAL NEW REHABILITATIVE PROGRAMS INCLUDING THE CHESAPEAKE CONNECTIONS CAPITATED CONTRACT, MOBILE TREATMENT, MEDIATION, CASE MANAGEMENT AND OFFSITE COUNSELING SERVICES.
FORM 990, PART VI, SECTION A, LINE 4
ON JULY 1, 2010, THE ORGANIZATION MERGED THE NORTH BALTIMORE CENTER, INC. INTO MOSAIC COMMUNITY SERVICES, INC. UNDER A STATUTORY MERGER. ARTICLES OF MERGER BETWEEN NORTH BALTIMORE CENTER, INC.(THE MERGING CORPORATION) AND MOSAIC COMMUNITY SERVICES, INC (THE SURVIVING CORPORATION) HAVE BEEN INCLUDED WITH THE ORGANIZATIONAL DOCUMENTS OF MOSAIC COMMUNITY SERVICES, INC. THE SIGNIFICANT CHANGES OUTLINED IN THE ARTICLES OF MERGER ARE SUMMARIZED BELOW: 1. THE MERGING CORPORATION OWNS INTERESTS IN LAND LOCATED IN BALTIMORE CITY, MARYLAND. 2. BOTH THE SURVIVING CORPORATION AND THE MERGING CORPORATION ARE MEMBERSHIP CORPORATIONS. PRIOR TO THE EFFECTIVE DATE, THE MEMBERS OF EACH CORPORATION ARE AS FOLLOWS: (A) SURVIVING CORPORATION - THE SOLE MEMBER OF THE SURVIVING CORPORATION IS SHEPPARD AND ENOCH PRATT FOUNDATION, INC. (B) MERGING CORPORATION - THE SOLE MEMBER OF THE MERGING CORPORATION, IS SHEPPARD AND ENOCH PRATT FOUNDATION, INC. AFTER THE EFFECTIVE DATE OF THE MERGER, SHEPPARD AND ENOCH PRATT FOUNDATION INC., WILL BE THE SOLE MEMBER OF THE SURVIVING CORPORATION. 3. UPON THE EFFECTIVE DATE, THE SURVIVING CORPORATION SHALL POSSESS ANY AND ALL PURPOSES AND POWERS OF THE MERGING CORPORATION; AND ALL LEASES, LICENSES, PROPERTY, RIGHTS, PRIVILEGES, AND POWERS OF WHATEVER NATURE AND DESCRIPTION OF THE MERGING CORPORATION SHARE BE TRANSFERRED TO, VESTED IN, AND DEVOLVED UPON THE SURVIVING CORPORATION, WITHOUT FURTHER ACT OR DEED, SUBJECT TO ALL OF THE DEBTS AND OBLIGATIONS OF THE MERGING CORPORTATION. 4. THE DIRECTORS OF THE MERGING CORPORATION ADOPTED A RESOLUTION DECLARING THAT THE TERMS AND CONDITIONS OF THE MERGER ARE ADVISABLE, AND DIRECTING THAT THE PROPOSED TRANSACTION BE SUBMITTED FOR CONSIDERATION BY THE MEMBER OF THE MERGING CORPORATION. 5. THE TRUSTEES OF SHEPPARD AND ENOCH PRATT FOUNDATION, INC ADOPTED A RESOLUTION DECLARING THAT THE TERMS AND CONDITIONS OF THE MERGER ARE ADVISABLE.
FORM 990, PART VI, SECTION A, LINE 6
THE ORGANIZATION IS A WHOLLY OWNED SUBSIDIARY OF THE SHEPPARD & ENOCH PRATT FOUNDATION, INC.
FORM 990, PART VI, SECTION A, LINE 7A
THE SHEPPARD & ENOCH PRATT FOUNDATION HOLDS RESERVED RIGHTS WHICH INCLUDE THE POWERS TO APPOINT AND REMOVE BOARD MEMBERS.
FORM 990, PART VI, SECTION A, LINE 7B
THE SHEPPARD & ENOCH PRATT FOUNDATION HOLDS RESERVED RIGHTS WHICH INCLUDE THE POWERS TO APPOINT AND REMOVE BOARD MEMBERS. THE FOUNDATION HOLDS THE RIGHT TO APPROVE CERTAIN SELECT TRANSACTIONS OF ITS SUBSIDIARIES INCLUDING THE SELECTION OF THE AUDITING FIRM AND INSURANCE PROVIDER.
FORM 990, PART VI, SECTION B, LINE 11
THE FORM 990 IS PRESENTED AND REVIEWED BY MOSAIC'S BOARD OF DIRECTORS PRIOR TO ITS FILING.
FORM 990, PART VI, SECTION B, LINE 12C
MOSAIC'S BOARD OF DIRECTORS SIGN CONFLICT OF INTEREST STATEMENTS EACH YEAR. THE STATEMENTS ARE REVIEWED AND REQUIRED ACTIONS ARE TAKEN IF NECESSARY TO RESOLVE ANY ISSUES.
FORM 990, PART VI, SECTION B, LINE 15
THE BOARD OF DIRECTORS REVIEWS AND APPROVES ANNUALLY THE EXECUTIVE DIRECTOR'S COMPENSATION. MOSAIC'S HUMAN RESOURCES DEPARTMENT IN CONJUNCTION WITH THE CEO DETERMINE COMPENSATION FOR KEY EMPLOYEES AND EMPLOYEES BASED UPON MARKET DATA, COMPENSATION SURVEYS, ETC.
FORM 990, PART VI, SECTION C, LINE 19
FINANCIAL STATEMENTS ARE AVAILABLE ON MOSAIC'S WEBSITE AND FORM 990S ARE AVAILABLE TO THE PUBLIC ON GUIDESTAR. GOVERNING DOCUMENTS ARE AVAILABLE TO THE PUBLIC AT THE STATE DEPARTMENT OF ASSESSMENTS AND TAXATION (SDAT WEBSITE). ADDITIONALLY, ALL DOCUMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST.
CHANGES IN NET ASSETS OR FUND BALANCES:
FORM 990, PART XI, LINE 5:
NET UNREALIZED GAINS ON INVESTMENTS: 153,076. TRANSFERS FROM AFFILIATES 322,502. CHANGES IN VALUE OF RESTRICTED ASSETS -50. ADDITION OF NORTH BALTIMORE CENTER NET ASSETS 349,724. TOTAL TO FORM 990, PART XI, LINE 5: 825,252.
FORM 990, PART XII, LINE 2C
THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.