2021-11-15T13:32:56-06:00 2020-12-31 135565207 KPMG LLP 60 SOUTH STREET TWO FINANCIAL CENTER BOSTON MA 02111 990 2020-01-01 050508742 CVS HEALTH CHARITY CLASSIC INC CVSH 4017651500 ONE CVS DRIVE WOONSOCKET RI 028956146 JEFFREY E CLARK ASSISTANT TREASURER 4017651500 2021-05-14 1 JEFFREY CLARK 999009999 STEPHANIE LONCZAK P01880207 6179881000 0 AAL1 IAL1 2020 2022-09-23 18:48:47Z EILEEN H BOONE ONE CVS DRIVE WOONSOCKET RI 028956146 3837531 0 X WWW.CVSHEALTHCHARITYCLASSIC.COM X 1999 RI SEE SCHEDULE O 5 3 0 500 0 0 4107958 2655534 0 0 0 0 -2985501 -535434 1122457 2120100 1002000 1502500 0 0 0 0 0 0 0 0 0 1002000 1502500 120457 617600 842606 1678584 243575 461953 599031 1216631 X SEE SCHEDULE O 0 0 1502500 1502500 THE CVS HEALTH CHARITY CLASSIC, INC. WAS ESTABLISHED TO RAISE MONEY VIA A WORLD CLASS GOLF VENUE FOR THE SUPPORT OF OTHER NON-PROFIT AGENCIES THROUGHOUT NEW ENGLAND. SINCE 1999, THE CVS HEALTH CHARITY CLASSIC, INC. HAS ALLOCATED OVER $26.3 MILLION IN CHARITABLE DONATIONS TO HUNDREDS OF ORGANIZATIONS. 1502500 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1 5 0 1 0 0 0 0 0 0 1 1 1 0 0 0 0 0 X 5 3 1 0 0 0 0 0 0 1 0 0 0 1 1 1 1 1 1 0 0 0 X JEFFREY E CLARK 4017705815 ONE CVS DRIVE WOONSOCKET RI 028956146 X EILEEN H BOONE PRESIDENT/DIRECTOR 0.50 41.50 X X 0 0 0 WAYNE CHARNESS DIRECTOR 0.50 0.00 X 0 0 0 SCOTT COWPER DIRECTOR 0.50 0.00 X 0 0 0 MARK G KOLLIGIAN DIRECTOR 0.50 0.00 X 0 0 0 FAITH WEINER DIRECTOR 0.50 40.50 X 0 0 0 CAROL A DENALE VICE PRESIDENT/ TREASURER 0.50 41.50 X 0 0 0 THOMAS S MOFFATT SECRETARY 0.50 41.50 X 0 0 0 JEFFREY E CLARK ASSISTANT SECRETARY 0.50 41.50 X 0 0 0 MELANIE K ST ANGELO ASSISTANT SECRETARY 0.50 41.50 X 0 0 0 0 0 0 0 0 0 0 OCTAGON INC PO BOX 74008253 CHICAGO IL 60674 ENTERTAINMENT 998353 1 1958054 682480 15000 2655534 1181997 1958054 1717431 -535434 -535434 2120100 0 0 -535434 1502500 1502500 1502500 1502500 0 0 496256 942684 294025 711658 52325 24242 842606 1678584 237905 461097 5670 856 243575 461953 X 599031 1201631 15000 599031 1216631 842606 1678584 617600 0 X 0 1 X 1 0 X 4157037 4048803 3787181 4107958 2655534 18756513 4157037 4048803 3787181 4107958 2655534 18756513 4648053 14108460 208 195 403 18756916 0.75220 0.78150 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 DUE TO AFFILIATES 856 856 X 3910381 72850 1717431 1790281 2120100 0 2120100 3292781 72850 1717431 1790281 1502500 0 1502500 PART X, LINE 2: THE ORGANIZATION RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. RECOGNIZED INCOME TAX POSITIONS ARE MEASURED AT THE LARGEST AMOUNT THAT IS GREATER THAN 50% LIKELY OF BEING REALIZED UPON SETTLEMENT. CHANGES IN RECOGNITION IN MEASUREMENT ARE REFLECTED IN THE PERIOD IN WHICH THE CHANGE IN JUDGEMENT OCCURS. THE ORGANIZATION HAS NOT RECOGNIZED ANY LIABILITY FOR UNRECOGNIZED TAX BENEFITS. PART XI, LINE 2D - OTHER ADJUSTMENTS: RECLASSIFY FUNDRAISING EXPENSES 1,717,431. PART XII, LINE 2D - OTHER ADJUSTMENTS: RECLASSIFY FUNDRAISING EXPENSES 1,717,431. GOLF/ AUCTION 3140051 1958054 1181997 197475 139276 1380680 3140051 1958054 1181997 197475 139276 1380680 1717431 -535434 1 AMERICAN HEART ASSOCIATION ONE STATE STREET SUITE 200 PROVIDENCE RI 02908 135613797 501(C)(3) 35000 FMV HEALTHCARE AMERICAN RED CROSS 209 FARMINGTON AVENUE FARMINGTON CT 06110 530196605 501(C)(3) 35000 FMV COMMUNITY SERVICES AMOS HOUSE 460 PINE STREET PROVIDENCE RI 02907 050387218 501(C)(3) 10000 FMV COMMUNITY SERVICES ARTHRITIS FOUNDATION NEW ENGLAND REGION INC 2348 POST RD SUITE 104 WARWICK RI 02886 581341679 501(C)(3) 35000 FMV HEALTHCARE AUDOBON 12 SANDERSON RD SMITHFIELD RI 02917 050265675 501(C)(3) 7500 FMV ARTS & CULTURE AUTISM PROJECT 1516 ATWOOD AVENUE JOHNSTON RI 02919 050512037 501(C)(3) 35000 FMV HEALTHCARE BAYSIDE YMCA 70 WEST STREET BARRINGTON RI 02806 050258878 501(C)(3) 35000 FMV YOUTH DEVELOPMENT BOKS BUILD OUR KIDS SUCCESS 25 DRYDOCK AVENUE BOSTON MA 02110 043073548 501(C)(3) 20000 FMV EDUCATION BOSTON RED FOX FOUNDATION 4 JERSEY WAY BOSTON MA 02215 331007984 501(C)(3) 15000 FMV COMMUNITY SERVICES BOYS & GIRLS CLUB OF PAWTUCKET ONE MOELLER PLACE PAWTUCKET RI 02860 050258924 501(C)(3) 7500 FMV YOUTH DEVELOPMENT BOYS & GIRLS CLUBS OF NORTHERN RI 1 JAMES J MCKEE WAY CUMBERLAND RI 02864 050280121 501(C)(3) 25000 FMV YOUTH DEVELOPMENT BOYS & GIRLS CLUBS OF PROVIDENCE 550 WICKENDEN STREET PROVIDENCE RI 02903 050258929 501(C)(3) 35000 FMV YOUTH DEVELOPMENT BRAIN INJURY ASSOCIATION OF RI 1017 WATERMAN AVENUE EAST PROVIDENCE RI 02914 222528586 501(C)(3) 35000 FMV HEALTHCARE CHILD & FAMILY SERVICE OF NEWPORT COUNTY 31 JOHN CLARKE ROAD MIDDLETOWN RI 02842 237058381 501(C)(3) 7500 FMV COMMUNITY SERVICES CHILDREN'S FRIEND & SERVICE 153 SUMMER STREET PROVIDENCE RI 02903 050258819 501(C)(3) 35000 FMV COMMUNITY SERVICES CHILDREN'S WISH GROUP OF RI INC 2346 POST ROAD SUITE 30 WARWICK RI 02886 264662878 501(C)(3) 35000 FMV COMMUNITY SERVICES CITY YEAR PROVIDENCE 275 WESTMINSTER ST SUITE 500 PROVIDENCE RI 02903 222882549 501(C)(3) 35000 FMV COMMUNITY SERVICES COMMUNITY PREP 135 PRAIRIE AVENUE PROVIDENCE RI 02905 222485332 501(C)(3) 7500 FMV EDUCATION COMMUNITY SCHOLARSHIP FUND OF BARRINGTON 144 WESTMINSTER STREET PROVIDENCE RI 02903 300798085 501(C)(3) 15000 FMV EDUCATION CONNNECTING CHILDREN & FAMILIES 46 HOPE ST WOONSOCKET RI 02895 050475365 501(C)(3) 15000 FMV COMMUNITY SERVICES CROSSROADS RHODE ISLAND 160 BROAD STREET PROVIDENCE RI 02903 050259094 501(C)(3) 35000 FMV COMMUNITY SERVICES EAST LAKE FOUNDATION 2606 ALSTON DRIVE SE ATLANTA GA 30317 582204306 501(C)(3) 10000 FMV COMMUNITY SERVICES ECONOMIC PROGRESS INSTITUTE 600 MOUNT PLEASANT AVE BLDG 9 PROVIDENCE RI 02908 320295517 501(C)(3) 10000 FMV COMMUNITY SERVICES EMMA PENDLETON BRADLEY HOSPITAL 1011 VETERANS MEMORIAL PARKWAY EAST PROVIDENCE RI 02915 050258806 501(C)(3) 35000 FMV HEALTHCARE FAMILY SERVICE OF RI BE SAFE PROGRAM 134 THURBERS AVE PROVIDENCE RI 02905 050258858 501(C)(3) 7500 FMV COMMUNITY SERVICES GIRLS INC (NATIONAL) 120 WALL ST NEW YORK NY 10005 131915124 501(C)(3) 25000 FMV COMMUNITY SERVICES GOLF FIGHTS CANCER INC 300 ARNOLD PALMER BOULEVARD NORTON MA 02766 341987772 501(C)(3) 7500 FMV HEALTHCARE GOLF FOUNDATION OF RI BUTTON HOLE ONE BUTTON HOLE DRIVE PROVIDENCE RI 02909 050497481 501(C)(3) 35000 FMV COMMUNITY SERVICES HOCKOMOCK AREA YMCA 300 ELMWOOD STREET NORTH ATTLEBORO MA 02760 042131749 501(C)(3) 35000 FMV YOUTH DEVELOPMENT HOLE IN THE WALL GANG CAMP 555 LONG WHARF DRIVE NEW HAVEN CT 06511 061157655 501(C)(3) 25000 FMV YOUTH DEVELOPMENT JOE ANDRUZZI FOUNDATION 49 PLAIN STREET SUITE 500 NORTH ATTLEBORO MA 02760 262017043 501(C)(3) 25000 FMV COMMUNITY SERVICES JOHNNYCAKE CENTER 1231 KINGSTOWN RD PEACEDALE RI 02879 050374356 501(C)(3) 15000 FMV HEALTH & HUMAN SERVICES LEARNING CENTER FOR THE DEAF INC 848 CENTRAL STREET FRAMINGHAM MA 01701 237064431 501(C)(3) 35000 FMV HEALTHCARES LOAVES AND FISHES 1520 BROAD STREET PROVIDENCE RI 02905 814433645 501(C)(3) 25000 FMV COMMUNITY SERVICES MARCH OF DIMES 220 WEST EXCHANGE STREET PROVIDENCE RI 02903 131846366 501(C)(3) 35000 FMV HEALTH & HUMAN SERVICES MEETING STREET 1000 EDDY STREET PROVIDENCE RI 02905 050269232 501(C)(3) 35000 FMV EDUCATION NEIGHBORWORKS HOME SAFE PROGRAM 719 FRONT ST WOONSOCKET RI 02895 222907602 501(C)(3) 7500 FMV COMMUNITY SERVICES NORTHERN RI FOOD PANTRY PO BOX 7833 CUMBERLAND RI 02864 455042619 501(C)(3) 15000 FMV COMMUNITY SERVICES OUR SISTERS SCHOOL 145 BROWNELL AVE NEW BEDFORD MA 02740 260367118 501(C)(3) 35000 FMV EDUCATION PARENT SUPPORT NETWORK OF RI PEER SUPPORT GROUPS 535 CENTERVILLE RD STE 202 WARWICK RI 02886 050473340 501(C)(3) 7500 FMV COMMUNITY SERVICES PEACELOVE FOUNDATION 999 MAIN STREET 708 PAWTUCKET RI 02860 272224246 501(C)(3) 15000 FMV COMMUNITY SERVICES POWHERFUL FOUNDATION 134 W 26TH ST RM 1150 NEW YORK NY 10001 452440475 501(C)(3) 50000 FMV COMMUNITY SERVICES PROGRESS LATINO EMERGENCY FUNDS PROGRAM 626 BROAD ST CENTRAL FALLS RI 02863 050380608 501(C)(3) 7500 FMV COMMUNITY SERVICES QUELL PO BOX 1924 N FALMOUTH MA 02556 475127883 501(C)(3) 25000 FMV COMMUNITY SERVICES RHODE ISLAND COMMUNITY FOOD BANK 200 NIANTIC AVENUE PROVIDENCE RI 02907 050395601 501(C)(3) 25000 FMV COMMUNITY SERVICES RHODE ISLANDERS SPONSORING EDUCATION 1155 WESTMINSTER STREET PROVIDENCE RI 02909 061470525 501(C)(3) 7500 FMV EDUCATION RI FREE CLINIC 655 BROAD ST STE 301 PROVIDENCE RI 02907 050501276 501(C)(3) 50000 FMV HEALTH & HUMAN SERVICES RONALD MCDONALD HOUSE OF PROVIDENCE 45 GAY STREET PROVIDENCE RI 02905 050434218 501(C)(3) 10000 FMV COMMUNITY SERVICES SAN MIGUEL EDUCATION CENTER 525 BRANCH AVENUE PROVIDENCE RI 02904 223232973 501(C)(3) 35000 FMV EDUCATION SAVE THE BAY 100 SAVE THE BAY DRIVE PROVIDENCE RI 02905 050343046 501(C)(3) 35000 FMV COMMUNITY SERVICES SOJOURNER HOUSE 386 SMITH STREET PROVIDENCE RI 02907 050370419 501(C)(3) 35000 FMV COMMUNITY SERVICES SPECIAL OLYMPICS RHODE ISLAND 370 GEORGE WASHINGTON HWY SMITHFIELD RI 02917 050377867 501(C)(3) 35000 FMV COMMUNITY SERVICES SPURWINK RI ONE SPURWINK PLACE CRANSTON RI 02910 010370716 501(C)(3) 35000 FMV COMMUNITY SERVICES TIDES FAMILY SERVICES 215 WASHINGTON STREET WEST WARWICK RI 02893 222478229 501(C)(3) 35000 FMV COMMUNITY SERVICES TRI COUNTY FOOD BANK 1126 HARTFORD AVE JOHNSTON RI 02919 050309695 501(C)(3) 15000 FMV COMMUNITY SERVICES 55 PART I, LINE 2: DESCRIPTION OF ORGANIZATIONAL PROCEDURES THE PARTICIPATING ORGANIZATIONS ARE ASKED TO COMPLETE A GRANT APPLICANT QUESTIONNAIRE IN WHICH THEY ARE REQUIRED TO PROVIDE INFORMATION REGARDING PROGRAMS, FINANCES, TAX STATUS INFORMATION & COPIES OF TAX RETURNS. THE CVS HEALTH CHARITY CLASSIC REVIEWS ALL DOCUMENTS SUBMITTED BY GRANT APPLICANTS AND INDEPENDENTLY VERIFIES TAX-EXEMPT STATUS. IN ADDITION, THE CVS HEALTH CHARITY CLASSIC REVIEWS THE IMPACT OF THE PROPOSED GRANT ON THE RESIDENTS OF RHODE ISLAND. FORM 990, PART I, LINE 1 AND PART III, LINE 1 THE PURPOSE OF THE ORGANIZATION IS TO ORGANIZE AND CONDUCT FUNDRAISING EVENTS IN ORDER TO RAISE MONEY TO MAKE CHARITABLE CONTRIBUTIONS TO ORGANIZATIONS THAT ARE EXEMPT FROM TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND WHOSE TAX EXEMPT PURPOSES RELATES DIRECTLY OR INDIRECTLY TO THE HEALTH EDUCATION AND/OR GENERAL WELFARE OF THE GENERAL PUBLIC. FORM 990, PART VI, SECTION A, LINE 2 EILEEN HOWARD BOONE, A DIRECTOR ON THE CVS HEALTH CHARITY CLASSIC'S BOARD, IS ALSO AN OFFICER OF CVS PHARMACY, INC. JEFFERY E. CLARK, FAITH WEINER AND MELANIE K. ST ANGELO ARE EMPLOYEES OF CVS PHARMACY, INC. CAROL A. DENALE AND THOMAS S. MOFFATT ARE OFFICERS OF CVS HEALTH CORPORATION. FORM 990, PART VI, SECTION A, LINE 8B COMMITTEE AUTHORITY THERE ARE NO COMMITTEES WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11B PROCESS FOR REVIEW OF FORM 990 CVS HEALTH EMPLOYEES GATHER ALL DATA FOR THE RETURN AND PROVIDE THE INFORMATION TO AN OUTSIDE ACCOUNTING FIRM FOR PREPARATION. THE RETURN IS REVIEWED BY CVS HEALTH MANAGEMENT AND THE OUTSIDE ACCOUNTING FIRM THAT SIGNS AS PREPARER. THE MANAGEMENT OF THE CHARITY CLASSIC REVIEWS THE RETURN AND MAKES ANY ADJUSTMENTS DEEMED NECESSARY TO FILE A COMPLETE AND ACCURATE RETURN. BEFORE FILING WITH THE IRS, THE COMPLETE FORM 990 IS PROVIDED TO THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 12C EACH DIRECTOR, OFFICER, AND MEMBER OF A COMMITTEE WITH BOARD-DELEGATED POWERS IS AN INTERESTED PERSON AND MUST ANNUALLY AFFIRM THAT THEY HAVE RECEIVED A COPY OF THE CONFLICT OF INTEREST POLICY OF CVS HEALTH CORPORATION, AND HAVE AGREED TO COMPLY WITH THE POLICY. IN CONNECTION WITH ANY ACTUAL OR POSSIBLE CONFLICT OF INTEREST, AN INTERESTED PERSON HAS AN ONGOING DUTY TO DISCLOSE THE EXISTENCE OF THE FINANCIAL INTEREST AND SHALL BE GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS TO THE DIRECTORS AND MEMBERS OF COMMITTEES WITH BOARD-DELEGATED POWERS CONCERNING THE PROPOSED TRANSACTION OR ARRANGEMENT. AFTER DISCLOSURE OF THE FINANCIAL INTEREST AND ALL MATERIAL FACTS, AND AFTER ANY DISCUSSIONS WITH THE INTERESTED PERSON, HE OR SHE SHALL LEAVE THE BOARD OR COMMITTEE MEETING DURING THE DISCUSSION OF THE POTENTIAL CONFLICT OF INTEREST AND THE VOTE ON WHETHER A CONFLICT OF INTEREST EXISTS. IF A CONFLICT OF INTEREST IS FOUND TO EXIST, THE CHAIRMAN OF THE BOARD OR THE COMMITTEE SHALL, IF APPROPRIATE, APPOINT A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT. AFTER EXERCISING DUE DILIGENCE, THE BOARD OR COMMITTEE SHALL DETERMINE WHETHER THE CORPORATION CAN OBTAIN WITH REASONABLE EFFORTS A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT FROM A PERSON OR ENTITY THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST. FORM 990, PART VI, SECTION C, LINE 19 PUBLIC ACCESS TO ORGANIZATION'S DOCUMENTS GOVERNING DOCUMENTS, FINANCIAL STATEMENTS AND THE ORGANIZATION'S CONFLICT OF INTEREST POLICY ARE AVAILABLE TO THE PUBLIC UPON REQUEST. 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