Wisconsin Sleep Inc.

“Due to management services agreement established between University of Wisconsin Medical Foundation, Inc. (UWMF) and Wisconsin Sleep, Inc. We have answered yes to Question #3 on Part VI Section A. UWMF is the management company within this agreement. UWMF provides payroll services (through a paymaster agreement), human resources, patient billing and collections, accounts payable services, I/T services, monthly financial statement preparation, tax return preparation support, financial audit support, compliance auditing, medical records storage/transcription, infection control/employee health, maintenance/mechanical support, nursing and nursing support, quality assurance and improvement, housekeeping, removal of hazardous waste, courier, mail and receiving, security and telecommunications. In addition, an administrative person is charged with carrying out the decision/direction of Wisconsin Sleep Inc's Board of Directors and any clinical duties performed for UWMF. Karil Walther served as Director of Wisconsin Sleep and was compensated by the management company (UWMF); she did not receive compensation for services provided to Wisconsin Sleep.”

“The Organization has two equal members: University of Wisconsin Medical Foundation and Unitypoint Health-Meriter.”

“Each member elects three individuals to the Board of Directors (2 employee directors and 1 public director).”

“The Organization does not have any committees beyond the governing body.”

“Form 990 is completed by the organization's external accounting firm. Key finance employees review the Form 990 to determine complete and accurate. The return is provided to the members of the board of directors before filing. The return is submitted for filing with the Internal Revenue Service.”

“Members of the Board of Directors must review and sign the conflict of interest policy on a yearly basis. Should a conflict arise, the interested party shall not participate in any discussions or vote related to this determination, except to the extent necessary to fully explain the financial interest and the manner in which the proposed transaction or arrangement to be discussed or acted upon by the Board may or will bear upon or relate to the financial interest. A member of the Board may direct that the interested person leave the meeting for all or part of the discussion of whether the financial interest creates a conflict of interest.”

“Governing documents, conflicts of interest policy, and financial statements are made available to the public upon request for the same period of disclosure as set forth in IRC Section 6104(d).”

“Purchased Services: Program service expenses 156,847. Management and general expenses 834,648. Fundraising expenses 0. Total expenses 991,495.”