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. Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
PITTSBURGH TISSUE ENGINEERING INITIATIVE INC
Employer identification number
25-1789285
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 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 monetary support
Yes
No
Yes
No
Yes
No
(A)
CARNEGIE MELLON UNIVERSITY
250969449
6
Yes
Yes
Yes
397,884
(B)
UNIVERSITY OF PITTSBURGH
250965591
6
Yes
Yes
Yes
583,275
(C)
UPMC HEALTH SYSTEM
251423657
7
Yes
Yes
Yes
8,216
(D)
DUQUESNE UNIVERSITY
251035663
6
Yes
Yes
Yes
33,105
Total
1,022,480
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990EZ.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2013
Schedule A (Form 990 or 990-EZ) 2013
Page 2
Part II
Support Schedule for Organizations Described in Sections 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) 2009
(b) 2010
(c) 2011
(d) 2012
(e) 2013
(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) 2009
(b) 2010
(c) 2011
(d) 2012
(e) 2013
(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. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)..
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 2013 (line 6, column (f) divided by line 11, column (f))
.........
14
15
Public support percentage for 2012 Schedule A, Part II, line 14
...............
15
16a
33 1/3% support test—2013.
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—2012.
If the organization did not check a 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—2013.
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—2012.
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) 2013
Schedule A (Form 990 or 990-EZ) 2013
Page 3
Part III
Support Schedule for Organizations Described in Section 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) 2009
(b) 2010
(c) 2011
(d) 2012
(e) 2013
(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) 2009
(b) 2010
(c) 2011
(d) 2012
(e) 2013
(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 2013 (line 8, column (f) divided by line 13, column (f))
.........
15
16
Public support percentage from 2012 Schedule A, Part III, line 15
...............
16
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2013 (line 10c, column (f) divided by line 13, column (f))
......
17
18
Investment income percentage from 2012 Schedule A, Part III, line 17
.............
18
19a
33 1/3% support tests—2013.
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—2012.
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) 2013
Schedule A (Form 990 or 990-EZ) 2013
Page 4
Part IV
Supplemental Information.
Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; and 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) 2013
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.
Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
PITTSBURGH TISSUE ENGINEERING INITIATIVE INC
Employer identification number
25-1789285
Return Reference
Explanation
FORM 990, PART IV, LINE 12A & PART XII, LINE 2B &3A:
THE BOARD OF DIRECTORS OF PTEI FORMALLY ADOPTED A WIND-DOWN PLAN FOR PTEI'S OPERATIONS DURING THE 17 MONTH PERIOD BEGINNING 7/1/2012 AND ENDING 11/30/2013. DUE TO THIS WIND-DOWN PLAN THERE ARE NO FINANCIAL STATEMENTS FOR THE PERIOD BEGINNING 7/1/2013 AND ENDING 11/30/2013. AN AUDIT WAS PERFORMED AND FINANCIAL STATEMENTS WERE ISSUED FOR THE ENTIRE 17 MONTH PERIOD.
FORM 990, PART VI, SECTION A, LINE 2
10 DIRECTORS AND TRUSTEES FOR THE ORGANIZATION ARE EMPLOYEES AND/OR OFFICERS FOR THE RELATED ORGANIZATIONS PROVIDED ON SCHEDULE R.
FORM 990, PART VI, SECTION B, LINE 11
THE FORM 990 IS REVIEWED BY THE CONTROLLER WITH THE EXECUTIVE DIRECTOR. THE EXECUTIVE DIRECTOR THEN REVIEWS THE 990 WITH THE GOVERNANCE AND COMPENSATION COMMITTEE. A FINAL COPY OF THE 990 IS THEN PROVIDED TO THE BOARD.
FORM 990, PART VI, SECTION B, LINE 12C
DISCLOSURE: IN CONNECTION WITH ANY ACTUAL OR POSSIBLE CONFLICT OF INTEREST, AN INTERESTED PERSON MUST DISCLOSE THE EXISTENCE AND NATURE OF HIS OR HER FINANCIAL INTEREST TO THE DIRECTORS AND ANY RELEVANT COMMITTEE MEMBERS. FOR THIS PURPOSE, AN INTERESTED PERSON SHALL INCLUDE ANY DIRECTOR, OFFICER, OR MEMBER OF A COMMITTEE OF THE CORPORATION OR AN ENTITY AFFILIATED WITH THE CORPORATION WHO HAS A DIRECT OR INDIRECT FINANCIAL INTEREST IN A PROPOSED TRANSACTION. A FINANCIAL INTEREST SHALL INCLUDE: (A) AN OWNERSHIP OR INVESTMENT INTEREST IN ANY ENTITY WITH WHICH THE CORPORATION HAS A PROPOSED TRANSACTION OR ARRANGEMENT; (B) A COMPENSATION ARRANGEMENT WITH THE CORPORATION OR WITH ANY ENTITY OR INDIVIDUAL WITH WHICH THE CORPORATION HAS A PROPOSED TRANSACTION OR ARRANGEMENT, SUBJECT TO THE EXCEPTION BELOW; AND (C) A POTENTIAL OWNERSHIP OR INVESTMENT INTEREST IN, OR COMPENSATION ARRANGEMENT WITH, ANY ENTITY OR INDIVIDUAL WITH WHICH THE CORPORATION IS NEGOTIATING A TRANSACTION OR ARRANGEMENT. A DIRECTOR OR MEMBER OF A COMMITTEE SHALL NOT BE DEEMED TO HAVE A POSSIBLE CONFLICT OF INTEREST (A) BY REASON OF SERVING, OR HAVING SERVED, ON THE BOARD OF DIRECTORS OF ANY CORPORATION AFFILIATED WITH THE CORPORATION OR (B) BY REASON OF BEING A DIRECTOR OR EMPLOYEE OF, OR HAVING ANOTHER AFFILIATION WITH, ANY ORGANIZATION THAT IS SUPPORTED BY THE OPERATIONS OF THE CORPORATION AND NAMED AS SUCH IN THE ARTICLES OF INCORPORATION OF THE CORPORATION, PROVIDED THAT THE PROPOSED TRANSACTION DOES NOT INCLUDE FUNDING OF RESEARCH TO BE UNDERTAKEN BY THE DIRECTOR OR COMMITTEE MEMBER PERSONALLY OR SUPERVISED BY THE DIRECTOR OR COMMITTEE MEMBER PERSONALLY. RECUSAL AND INVESTIGATION: AFTER DISCLOSURE OF THE FINANCIAL INTEREST AND ANY APPROPRIATE EXPLANATION BY THE INTERESTED PERSON, THE INTERESTED PERSON SHALL LEAVE THE BOARD OR COMMITTEE MEETING WHILE THE FINANCIAL INTEREST IS DISCUSSED AND VOTED UPON. THE REMAINING DIRECTORS OR COMMITTEE MEMBERS SHALL DECIDE IF A CONFLICT OF INTEREST EXISTS. IF A CONFLICT OF INTEREST EXISTS, THE FOLLOWING PROCEDURES SHALL BE FOLLOWED: (A) THE CHAIR SHALL, IF APPROPRIATE, APPOINT A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT; (B) AFTER EXERCISING DUE DILIGENCE, THE DIRECTORS OR COMMITTEE SHALL DETERMINE WHETHER THE CORPORATION COULD OBTAIN A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT WITH REASONABLE EFFORTS FROM A PERSON OR ENTITY THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST; AND (C) IF A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT IS NOT REASONABLY ATTAINABLE, THE DIRECTORS OR COMMITTEE SHALL DETERMINE BY A MAJORITY VOTE OF THE DISINTERESTED DIRECTORS WHETHER THE TRANSACTION OR ARRANGEMENT IS IN THE CORPORATION'S BEST INTERESTS AND FOR ITS OWN BENEFIT AND WHETHER THE TRANSACTION IS FAIR AND REASONABLE TO THE CORPORATION AND SHALL DECIDE AS TO WHETHER TO ENTER INTO THE TRANSACTION OR ARRANGEMENT IN CONFORMITY WITH SUCH DETERMINATION. ANY RECOMMENDATION OF RESEARCH FUNDING BY THE APPROPRIATE COMMITTEE SHALL BE DEEMED TO SATISFY THE REQUIREMENT FOR INVESTIGATION. FAILURE TO DISCLOSE: IF A DIRECTOR OR COMMITTEE MEMBER HAS REASONABLE CAUSE TO BELIEVE THAT AN INTERESTED PERSON HAS FAILED TO DISCLOSE ACTUAL OR POSSIBLE CONFLICTS OF INTEREST, HE SHALL INFORM THE INTERESTED PERSON OF THE BASIS OF SUCH BELIEF AND AFFORD THE INTERESTED PERSON AN OPPORTUNITY TO EXPLAIN THE ALLEGED FAILURE TO DISCLOSE. IF, AFTER HEARING THE RESPONSE OF THE MEMBER AND MAKING SUCH FURTHER INVESTIGATION AS MAY BE WARRANTED IN THE CIRCUMSTANCES, THE DIRECTORS OR COMMITTEE DETERMINE THAT THE INTERESTED PERSON HAS IN FACT FAILED TO DISCLOSE AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, THE DIRECTORS SHALL TAKE APPROPRIATE STEPS TO PROTECT THE CORPORATION. RECORD OF ACTIONS: THE MINUTES OF THE BOARD AND ALL RELEVANT COMMITTEES SHALL CONTAIN THE FOLLOWING (A) THE NAMES OF PERSONS WHO DISCLOSED OR OTHERWISE WERE FOUND TO HAVE A FINANCIAL INTEREST IN CONNECTION WITH AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, THE NATURE OF THE FINANCIAL INTEREST, ANY ACTION TAKEN TO DETERMINE WHETHER A CONFLICT OF INTEREST WAS PRESENT, AND THE DIRECTORS OR COMMITTEE'S DECISION AS TO WHETHER A CONFLICT OF INTEREST IN FACT EXISTED; AND (B) THE NAMES OF THE PERSONS WHO WERE PRESENT FOR DISCUSSIONS AND VOTES RELATING TO THE TRANSACTION OR ARRANGEMENT, THE CONTENT OF THE DISCUSSION, INCLUDING ANY ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT, AND A RECORD OF ANY VOTES TAKEN IN CONNECTION THEREWITH. COMPENSATION: SPECIAL PROCEDURES SHALL BE IN EFFECT WITH RESPECT TO COMPENSATION ISSUES. A VOTING MEMBER OF THE BOARD OR ANY COMMITTEE WHOSE JURISDICTION INCLUDES COMPENSATION MATTERS AND WHO RECEIVES COMPENSATION, DIRECTLY OR INDIRECTLY, FROM THE CORPORATION FOR SERVICES IS PRECLUDED FROM VOTING ON MATTERS PERTAINING TO THAT MEMBER'S COMPENSATION. ANNUAL STATEMENTS: EACH INTERESTED PERSON SHALL ANNUALLY SIGN A STATEMENT THAT AFFIRMS THAT SUCH PERSON (A) HAS RECEIVED A COPY OF THE CONFLICTS OF INTEREST POLICY, (B) HAS READ AND UNDERSTANDS THE POLICY, (C) HAS AGREED TO COMPLY WITH THE POLICY, AND (D) UNDERSTANDS THAT THE CORPORATION IS A CHARITABLE ORGANIZATION AND THAT IN ORDER TO MAINTAIN ITS FEDERAL TAX EXEMPTION IT MUST ENGAGE PRIMARILY IN ACTIVITIES THAT ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES. THIS POLICY SHALL BE REVIEWED ANNUALLY FOR THE INFORMATION AND GUIDANCE OF MEMBERS OF THE BOARD, AND ANY NEW MEMBER SHALL BE ADVISED OF THE POLICY UPON ENTERING ON THE DUTIES OF HIS OFFICE. IN ADDITION, THE CORPORATION SHALL CONDUCT PERIODIC REVIEWS OF ITS ACTIVITIES, INCLUDING ANY TRANSACTIONS OR ARRANGEMENTS WITH INTERESTED PERSONS, TO ENSURE THAT ITS ACTIVITIES IN THE AGGREGATE PROMOTE AND FURTHER THE CORPORATION'S EXEMPT CHARITABLE, SCIENTIFIC, AND EDUCATIONAL PURPOSES.
FORM 990, PART VI, SECTION B, LINE 15
AN ANNUAL REVIEW IS CONDUCTED WITH THE EMPLOYEE AND DIRECT SUPERVISOR. THE REVIEW IS SIGNED AND COMPILED FOR THE EXECUTIVE DIRECTOR. THE EXECUTIVE DIRECTOR AND CONTROLLER DISCUSS EACH REVIEW AND MAKE A RECOMMENDATION TO THE GOVERNANCE AND COMPENSATION COMMITTEE. DURING THE GOVERNANCE AND COMPENSATION COMMITTEE MEETING, THE RECOMMENDATIONS ARE REVIEWED BY EMPLOYEE AND THEIR COMPENSATION IS DETERMINED. THE COMMITTEE RECOMMENDS THE COMPENSATION TO THE BOARD FOR APPROVAL.
FORM 990, PART VI, SECTION C, LINE 19
THIS INFORMATION IS MADE AVAILABLE UPON REQUEST.
FORM 990, PART VII, SECTION A
EACH BOARD MEMBER WAS CONTACTED VIA E-MAIL REQUESTING SALARY INFORMATION. FOR THE CURRENT FISCAL YEAR, THE DIRECTORS DID NOT PROVIDE REPORTABLE COMPENSATION FROM RELATED ORGANIZATIONS.
FORM 990, PART XI, LINE 9:
WRITE-OFF OF DONATED RESEARCH EQUIPMENT -31,541.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.