EMPLOYEE COMMUNITY FOUNDATION OPTUM WASHINGTON: Form 990, tax year 2018
View the entire original 990 at ProPublica ↗
- Organization
- EMPLOYEE COMMUNITY FOUNDATION OPTUM WASHINGTON (EIN 94-3214711)
- Tax period
- 2018-01-01 to 2018-12-31
- Filed
- 2019-09-27
- IRS object ID
- 201922709349300837
- Schema version
- 2018v3.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2019-09-27T10:56:30-05:00 | ReturnTs |
| Tax Period End | 2018-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 910189318 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MOSS ADAMS LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2707 COLBY AVENUE SUITE 801 | AddressLine1Txt |
| City | EVERETT | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 98201 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2018-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 943214711 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE EVERETT CLINIC FOUNDATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | EVER | BusinessNameControlTxt |
| Phone | 4252590966 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3901 HOYT AVENUE | AddressLine1Txt |
| City | EVERETT | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 98201 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DR RON GREEN | PersonNm |
| Person Title | PRESIDENT | PersonTitleTxt |
| Phone | 4252590966 | PhoneNum |
| Signature | 2019-09-25 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | ROBERT GRANNUM | PreparerPersonNm |
| PTIN | P00355876 | PTIN |
| Phone | 4252597227 | PhoneNum |
| Preparation | 2019-09-25 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 12.129.4.210 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2019-09-25 | IPDt |
| IP Tm | 14:58:01 | IPTm |
| IP Timezone | PD | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | C07EA3D2EFE7589B691C7C6F5A7C1991A329BAB3 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2018 | TaxYr |
| Build TS | 2020-01-14 16:20:31Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | DR RONALD GREEN | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3901 HOYT AVENUE | AddressLine1Txt |
| City | EVERETT | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 98201 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $359,414 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.EVERETTCLINIC.COM/FOUNDATION | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1994 | FormationYr |
| Legal Domicile State | WA | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE ONGOING PHILANTHROPIC SUPPORT TO CHARITABLE ORGANIZATIONS IN SNOHOMISH COUNTY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 9 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 1 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 15 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $350,392 | PYContributionsGrantsAmt |
| CY Contributions Grants | $359,055 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $0 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $0 | CYProgramServiceRevenueAmt |
| PY Investment Income | $198 | PYInvestmentIncomeAmt |
| CY Investment Income | $359 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $350,590 | PYTotalRevenueAmt |
| CY Total Revenue | $359,414 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $341,514 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $352,640 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $0 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $0 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $15,213 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $13,134 | PYOtherExpensesAmt |
| CY Other Expenses | $27,093 | CYOtherExpensesAmt |
| PY Total Expenses | $354,648 | PYTotalExpensesAmt |
| CY Total Expenses | $379,733 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$4,058 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$20,319 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $241,696 | TotalAssetsBOYAmt |
| Total Assets EOY | $221,377 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $0 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $0 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $241,696 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $221,377 | NetAssetsOrFundBalancesEOYAmt |
| Mission | THE GOAL OF THE FOUNDATION IS TO PROVIDE ONGOING PHILANTHROPIC SUPPORT TO CHARITABLE ORGANIZATIONS IN SNOHOMISH COUNTY. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $352,640 | ExpenseAmt |
| Grant | $352,640 | GrantAmt |
| Desc | PROVIDE DONATIONS AND GRANTS TO OTHER EXEMPT ORGANIZATIONS. | Desc |
| Total Program Service Expenses | $352,640 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | 0 | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | Yes (1) | GrantsToIndividualsInd |
| Schedule J Required | 0 | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 0 | EmployeeCnt |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 9 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 1 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | 0 | WhistleblowerPolicyInd |
| Document Retention Policy | 0 | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | BETSY SUYDAM | PersonNm |
| Phone | 4253395465 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3901 HOYT AVE | AddressLine1Txt |
| City | EVERETT | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 98201 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| No Listed Persons Compensated | Yes (X) | NoListedPersonsCompensatedInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (10 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt |
|---|---|---|---|---|---|---|---|
| DR RONALD GREEN | |||||||
| PRESIDENT | 0.75 | 40.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| KATHY NELSON | |||||||
| DIRECTOR (THROUGH 04/30) | 0.25 | 40.00 | Yes (X) | $0 | $0 | $0 | |
| CONNIE WITTREN | |||||||
| DIRECTOR | 0.25 | Yes (X) | $0 | $0 | $0 | ||
| AMANDA STANFIELD | |||||||
| DIRECTOR | 0.25 | 40.00 | Yes (X) | $0 | $0 | $0 | |
| DR SRILATHA SHOROFF | |||||||
| DIRECTOR | 0.25 | 20.00 | Yes (X) | $0 | $0 | $0 | |
| DR CHRISTOPHER HEMPEL | |||||||
| DIRECTOR | 0.25 | 40.00 | Yes (X) | $0 | $0 | $0 | |
| ASHLEY PEREZ | |||||||
| DIRECTOR | 0.25 | 40.00 | Yes (X) | $0 | $0 | $0 | |
| DEANNA SCOTT | |||||||
| DIRECTOR | 0.25 | 40.00 | Yes (X) | $0 | $0 | $0 | |
| SHANNON SKARTVED | |||||||
| DIRECTOR | 0.25 | 40.00 | Yes (X) | $0 | $0 | $0 | |
| SIMONE HAMBLEN | |||||||
| DIRECTOR | 0.25 | 32.00 | Yes (X) | $0 | $0 | $0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $0 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | 0 | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $201,650 | RelatedOrganizationsAmt |
| All Other Contributions | $157,405 | AllOtherContributionsAmt |
| Total Contributions | $359,055 | TotalContributionsAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $359 | TotalRevenueColumnAmt |
| Exclusion | $359 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $359,414 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $359 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $341,932 | TotalAmt |
| Program Services | $341,932 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,708 | TotalAmt |
| Program Services | $10,708 | ProgramServicesAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,130 | TotalAmt |
| Management And General | $11,130 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $570 | TotalAmt |
| Fundraising | $570 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $103 | TotalAmt |
| Management And General | $103 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $647 | TotalAmt |
| Management And General | $647 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | SUPPLIES | Desc |
| Total | $14,643 | TotalAmt |
| Fundraising | $14,643 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $379,733 | TotalAmt |
| Program Services | $352,640 | ProgramServicesAmt |
| Management And General | $11,880 | ManagementAndGeneralAmt |
| Fundraising | $15,213 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $205,620 | BOYAmt |
| EOY | $168,142 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,049 | BOYAmt |
| EOY | $19,408 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,027 | BOYAmt |
| EOY | $33,827 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $241,696 | BOYAmt |
| EOY | $221,377 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Org Does Not Follow SFAS117 | Yes (X) | OrgDoesNotFollowSFAS117Ind |
Cap Stk Tr Prin Current Funds CapStkTrPrinCurrentFundsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Pd In Cap Srpls Land Bldg Eqp Fund PdInCapSrplsLandBldgEqpFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rtn Earn Endowment Incm Oth Fnds RtnEarnEndowmentIncmOthFndsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $241,696 | BOYAmt |
| EOY | $221,377 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $241,696 | BOYAmt |
| EOY | $221,377 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $241,696 | BOYAmt |
| EOY | $221,377 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$20,319 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | 0 | FSAuditedInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $430,847 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $351,000 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $563,413 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $350,392 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $359,055 | CurrentTaxYearAmt |
| Total | $2,054,707 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $430,847 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $351,000 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $563,413 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $350,392 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $359,055 | CurrentTaxYearAmt |
| Total | $2,054,707 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantial Contributors Tot | $1,084,960 | SubstantialContributorsTotAmt |
| Public Support Total170 | $969,747 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $21 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $26 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $86 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $198 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $359 | CurrentTaxYearAmt |
| Total | $690 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $2,055,397 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $51,293 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.47180 | PublicSupportCY170Pct |
| Public Support PY170 | 0.47520 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Schedule B IRS990ScheduleB
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (25 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|
| BIG BROTHERS & BIG SISTERS OF SNOHOMISH COUNTY | |||||||
| 1420 HEWITT AVE | EVERETT | WA | 98201 | 910565561 | 501(C)(3) | $5,200 | BOWLING FOR KIDS SAKE |
| CAMP FIRE SNOHOMISH COUNTY | |||||||
| 4312 RUCKER AVE | EVERETT | WA | 98203 | 910608531 | 501(C)(3) | $7,400 | IT'S ALL ABOUT OUR KIDS PROGRAM & I BELIEVE FUND |
| CHILD STRIVE | |||||||
| 14 E CASINO RD | EVERETT | WA | 98208 | 916053563 | 501(C)(3) | $9,000 | HOMELESS FAMILY SUPPORT FOR CHILDREN |
| CHRISTMAS HOUSE | |||||||
| PO BOX 717 | EVERETT | WA | 98206 | 911177244 | 501(C)(3) | $5,500 | CHRISTMAS TOYS FOR CHILDREN |
| CITRINE HEALTH | |||||||
| 2940 W MARINE VIEW DR | EVERETT | WA | 98201 | 911717603 | 501(C)(3) | $7,500 | UNDERGARMENTS FOR WOMEN |
| CLOTHES FOR KIDS | |||||||
| 16725 52ND AVE W | LYNNWOOD | WA | 98037 | 911345075 | 501(C)(3) | $15,000 | GREATEST NEEDS AND SCHOOL WARDROBE PROGRAM |
| COCOON HOUSE | |||||||
| 2929 PINE ST | EVERETT | WA | 98201 | 911497667 | 501(C)(3) | $9,000 | BREAK CYCLE OF HOMELESSNESS THROUGH OUTREACH, HOUSING, PREVENTION |
| COMPASS HEALTH | |||||||
| PO BOX 3810 MS 49 | EVERETT | WA | 98213 | 911180810 | 501(C)(3) | $8,000 | EMERGENCY HOTEL VOUCHER PROGRAM |
| EVERETT COMMUNITY COLLEGE | |||||||
| 2000 TOWER ST | EVERETT | WA | 982011390 | 911280495 | 501(C)(3) | $15,000 | SCHOLARSHIP PROGRAM |
| HAND IN HAND | |||||||
| 14 E CASINO RD STE E | EVERETT | WA | 98208 | 010962762 | 501(C)(3) | $10,000 | SAFE PLACE |
| HOMAGE SENIOR SERVICES | |||||||
| 11627 AIRPORT RD STE B | EVERETT | WA | 98204 | 910910680 | 501(C)(3) | $15,000 | MEALS ON WHEELS |
| HOPEWORKS SOCIAL ENTERPRISES | |||||||
| 5830 EVERGREEN WAY | EVERETT | WA | 98203 | 800684608 | 501(C)(3) | $15,000 | PROVIDE EMPLOYMENT FOR HOMELESS & LOW-INCOME INDIVIDUALS |
| IMAGINE CHILDREN'S MUSEUM | |||||||
| 1502 WALL ST | EVERETT | WA | 98201 | 943153591 | 501(C)(3) | $6,000 | READ ALOUD PROGRAM |
| INTERFAITH ASSOCIATION OF NW WA | |||||||
| PO BOX 12824 | EVERETT | WA | 98206 | 911340220 | 501(C)(3) | $10,000 | FAMILY SHELTER |
| MONROE GOSPEL WOMEN'S MISSION | |||||||
| 450 S LEWIS ST | MONROE | WA | 98272 | 651234935 | 501(C)(3) | $7,000 | PROVIDED ASSISTANCE TO HOMELESS WOMEN |
| PROVIDENCE HOSPICE & HOME CARE OF SNOHOMISH CNTY | |||||||
| 2731 WETMORE SUITE 500 | EVERETT | WA | 98201 | 911054828 | 501(C)(3) | $12,000 | CAROUSEL PROGRAM |
| SAFE HARBOR FREE CLINIC | |||||||
| 10101 27TH ST NW | STANWOOD | WA | 98292 | 263825107 | 501(C)(3) | $10,000 | HEALTHCARE FOR UNINSURED/UNDERINSURED |
| SHERWOOD COMMUNITY SERVICES | |||||||
| 402 91ST AVE NE | LAKE STEVENS | WA | 98258 | 910762805 | 501(C)(3) | $10,000 | ASSISTIVE TECHNOLOGY SERVICES |
| VICTIM SUPPORT SERVICES | |||||||
| PO BOX 1949 | EVERETT | WA | 98206 | 910993005 | 501(C)(3) | $9,750 | VICTIM ADVOCACY & OUTREACH SERVICES |
| VILLAGE COMMUNITY SERVICES | |||||||
| 3210 SMOKEY POINT DR SUITE 200 | ARLINGTON | WA | 98223 | 911459748 | 501(C)(3) | $10,000 | SUPPORT FOR PEOPLE WITH DISABILITIES |
| VOLUNTEERS OF AMERICA WESTERN WA | |||||||
| PO BOX 839 | EVERETT | WA | 98206 | 910577128 | 501(C)(3) | $20,000 | PRESCRIPTION MEDICATION PATIENT |
| WARM BEACH HEALTH CARE CENTER INC | |||||||
| 20420 MARINE DRIVE | STANWOOD | WA | 98292 | 910968467 | 501(C)(3) | $6,000 | PROVIDES HOUSING AND SUPPORTIVE SERVICES FOR SENIORS |
| WITHINREACH | |||||||
| 155 NE 100TH ST SUITE 500 | SEATTLE | WA | 98125 | 911443685 | 501(C)(3) | $6,000 | PROVIDE ASSISTANCE TO ACCESS HEALTH & SOCIAL SERVICE IN WA |
| YMCA OF SNOHOMISH CO | |||||||
| 2720 ROCKFELLER AVE | EVERETT | WA | 98201 | 910482890 | 501(C)(3) | $25,000 | CAPITAL PROJECT |
| YWCA SEATTLEKINGSNOHOMISH | |||||||
| 1118 5TH AVE | SEATTLE | WA | 98101 | 910482710 | 501(C)(3) | $6,000 | PATHWAYS/HOMEWARD BOUND PROGRAM |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 25 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Type | LEND A HAND - EMPLOYEE EMERGENCY ASSISTANCE | GrantTypeTxt |
| Recipient | 22 | RecipientCnt |
| Cash Grant | $10,708 | CashGrantAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | ASSISTANCE TO ORGANIZATIONS - ANY AGENCY REQUESTING FUNDS IS ASKED TO COMPLETE A GRANT APPLICATION FORM. TO BE CONSIDERED, THE REQUESTING ORGANIZATION MUST BE CLASSIFIED BY THE INTERNAL REVENUE SERVICE (IRS) AS A 501(C)(3) ENTITY. GRANT REQUESTS MUST SPECIFY BENEFITS TO SNOHOMISH COUNTY RESIDENTS. FUNDS ARE ALLOCATED ON A QUARTERLY BASIS BY THE EVERETT CLINIC FOUNDATION BOARD. LEND A HAND ASSISTANCE - EMPLOYEES ARE REQUIRED TO FILL OUT AN APPLICATION WHICH IS SUBMITTED AND FORWARDED TO REPRESENTATIVES OF HR, FOUNDATION BOARD AND FOUNDATION COMMITTEE BEFORE APPROVAL IS GRANTED. EMPLOYEES MUST PROVIDE EXPLANATION OF HOW FUNDS NEEDED ARE DUE TO A CRISIS OR CATASTROPHIC SITUATION. IF CRITERIA IS NOT MET, FUNDS ARE NOT AWARDED. FUNDS MUST BE PAID TO THE COMPANY DIRECTLY THE EMPLOYEE IS NEEDING ASSISTANCE WITH (UTILITIES, MORTGAGE/RENT, ETC.) AND NOT PAID DIRECTLY TO THE EMPLOYEE. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 7A | PER THE BYLAWS OF THE EVERETT CLINIC FOUNDATION, THE EVERETT CLINIC HAS THE AUTHORITY TO ELECT BOARD MEMBERS. |
| FORM 990, PART VI, SECTION B, LINE 11B | THIS FORM 990 AND SCHEDULE B WAS PREPARED BY THE FINANCE DEPARTMENT PERSONNEL OF THE EVERETT CLINIC FOUNDATION IN COLLABORATION WITH ITS OUTSIDE ACCOUNTING FIRM. PRIOR TO FILING, A COPY OF THIS FORM 990 AND SCHEDULE B WAS REVIEWED BY THE FOUNDATION'S TAX MANAGER AND PRESIDENT. A COPY OF THIS FORM 990 AND SCHEDULE B WAS ALSO PROVIDED TO ALL BOARD MEMBERS FOR THEIR REVIEW BEFORE FILING WITH THE IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE EVERETT CLINIC FOUNDATION HAS A PROCEDURE IN PLACE THAT IS FOLLOWED IN INSTANCES WHERE A CONFLICT OF INTEREST ARISES. BOARD MEMBERS ARE REQUIRED TO CONDUCT HIM/HERSELF SOLELY IN THE INTERESTS OF THE FOUNDATION WITHOUT CONSIDERATION OF PERSONAL ADVANTAGE OR GAIN IN THE INTERESTS OF ANY COMPANY, AGENCY, ORGANIZATION OR ASSOCIATION. HE OR SHE IS REQUIRED TO DISCLOSE ANY MATERIAL PERSONAL, FINANCIAL, OR OTHER BENEFICIAL INTEREST IN ANY ENTITY ASKING FOR FUNDS FROM TEC FOUNDATION. IN THE EVENT THERE IS AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, THE BOARD MEMBER MUST DISCLOSE THE EXISTENCE OF THE FINANCIAL INTEREST. ANY DIRECTOR MAY RECUSE HIM/HERSELF AT ANY TIME FROM INVOLVEMENT IN ANY DECISION OR DISCUSSION IN WHICH THE DIRECTOR BELIEVES HE OR SHE HAS OR MAY HAVE A CONFLICT OF INTEREST. AFTER DISCLOSURE OF A POSSIBLE CONFLICT OF INTEREST AND ALL MATERIAL FACTS, THE REMAINING BOARD MEMBERS SHALL DECIDE IF A CONFLICT OF INTEREST EXISTS. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE EVERETT CLINIC FOUNDATION GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART VI, LINE 1B, INDEPENDENT BOARD MEMBERS | ALL BOARD MEMBERS, WITH THE EXCEPTION OF ONE, ARE EMPLOYEES OF THE EVERETT CLINIC A RELATED ENTITY AND THUS ARE NOT CONSIDERED TO BE INDEPENDENT. AS THE EVERETT CLINIC IS A TAXABLE ENTITY, IS NOT OWNED OR CONTROLLED BY THE FOUNDATION, DOES NOT PROVIDE MANAGEMENT SERVICES FOR A FEE TO THE FOUNDATION AND THE BOARD MEMBERS OF THE FOUNDATION ARE ON A VOLUNTEER BASIS, THE VOLUNTEER EXCEPTION APPLIES. AS SUCH RELATED PARTY COMPENSATION IS NOT REQUIRED TO BE REPORTED ON FORM 990, PART VII, SECTION A. |
Schedule R IRS990ScheduleR
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DAVITA MEDICAL MANAGEMENT LLC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2000 16TH ST | AddressLine1Txt |
| City | DENVER | CityNm |
| State Abbreviation | CO | StateAbbreviationCd |
| ZIP | 80202 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 954509662 | EIN |
| Primary Activities | MEDICAL SERVICES | PrimaryActivitiesTxt |
| Legal Domicile State | CO | LegalDomicileStateCd |
| Direct Controlling NA | N/A | DirectControllingNACd |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE EVERETT CLINIC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3901 HOYT AVENUE | AddressLine1Txt |
| City | EVERETT | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 98201 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 910214500 | EIN |
| Primary Activities | MEDICAL SERVICES | PrimaryActivitiesTxt |
| Legal Domicile State | WA | LegalDomicileStateCd |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Entity Type | C | EntityTypeTxt |
| Controlled Organization | 0 | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |