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CVS HEALTH CHARITY CLASSIC INC: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization
CVS HEALTH CHARITY CLASSIC INC (EIN 05-0508742)
Tax period
2016-01-01 to 2016-12-31
Filed
2017-11-14
IRS object ID
201743189349303669
Schema version
2016v3.1
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

FieldValueIRS element (for citing)
Return2017-11-14T10:49:14-06:00ReturnTs
Tax Period End2016-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1PricewaterhouseCoopers LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1101 SEAPORT BLVDAddressLine1Txt
CityBOSTONCityNm
State AbbreviationMAStateAbbreviationCd
ZIP02210ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2016-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN050508742EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1CVS HEALTH CHARITY CLASSIC INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
In Care Of% JEFFREY E CLARKInCareOfNm
Business Name ControlCVSHBusinessNameControlTxt
Phone4017651500PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1ONE CVS DRIVEAddressLine1Txt
CityWOONSOCKETCityNm
State AbbreviationRIStateAbbreviationCd
ZIP028956146ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonJEFFREY E CLARKPersonNm
Person TitleASSISTANT TREASURERPersonTitleTxt
Phone4017651500PhoneNum
Signature2017-11-08SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonPAUL J TANISPreparerPersonNm
PTINP01441612PTIN
Phone6175305000PhoneNum
Preparation2017-11-08PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address155.201.188.33IPv4AddressTxt
FieldValueIRS element (for citing)
Federal Original Submission Id04363820173185000003FederalOriginalSubmissionId
Federal Original Submission Id2017-11-14FederalOriginalSubmissionIdDt
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device Id1818DFECDE657413DFFFFFA65F228573FF62BF80AtSubmissionCreationDeviceId
At Submission Filing Device Id41937B3F5B69072E51D0E11B5CA7F460A5D35ADBAtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2016TaxYr
Build TS2017-02-10 21:41:12ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerEILEEN H BOONEPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1ONE CVS DRIVEAddressLine1Txt
CityWOONSOCKETCityNm
State AbbreviationRIStateAbbreviationCd
ZIP028956146ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$9,205,843GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.cvshealthcharityclassic.comWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1999FormationYr
Legal Domicile StateRILegalDomicileStateCd
Activity Or MissionSEE SCHEDULE OActivityOrMissionDesc
Voting Members Governing Body5VotingMembersGoverningBodyCnt
Voting Members Independent3VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers1434TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$4,212,533PYContributionsGrantsAmt
CY Contributions Grants$4,157,037CYContributionsGrantsAmt
PY Program Service Revenue$0PYProgramServiceRevenueAmt
CY Program Service Revenue$0CYProgramServiceRevenueAmt
PY Investment Income$191PYInvestmentIncomeAmt
CY Investment Income$208CYInvestmentIncomeAmt
PY Other Revenue-$2,993,236PYOtherRevenueAmt
CY Other Revenue-$3,147,527CYOtherRevenueAmt
PY Total Revenue$1,219,488PYTotalRevenueAmt
CY Total Revenue$1,009,718CYTotalRevenueAmt
PY Grants And Similar Paid$1,329,972PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$1,066,048CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$0PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$0CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$288,000PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$264,000CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$264,000CYTotalFundraisingExpenseAmt
PY Other Expenses$0PYOtherExpensesAmt
CY Other Expenses$0CYOtherExpensesAmt
PY Total Expenses$1,617,972PYTotalExpensesAmt
CY Total Expenses$1,330,048CYTotalExpensesAmt
PY Revenues Less Expenses-$398,484PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$320,330CYRevenuesLessExpensesAmt
Total Assets BOY$1,624,915TotalAssetsBOYAmt
Total Assets EOY$1,157,579TotalAssetsEOYAmt
Total Liabilities BOY$516,400TotalLiabilitiesBOYAmt
Total Liabilities EOY$194,882TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$1,108,515NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$962,697NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionSEE SCHEDULE OMissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$1,066,048ExpenseAmt
Grant$1,066,048GrantAmt
DescThe 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 $21.91 million in charitable donations to hundreds of organizations.Desc
Total Program Service Expenses$1,066,048TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsfalseTempOrPermanentEndowmentsInd
Report Land Building EquipmentfalseReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesfalseReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (true)IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtfalseConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingYes (true)ProfessionalFundraisingInd
Fundraising ActivitiesYes (true)FundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsYes (true)GrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredfalseScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContriYes (true)DeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntYes (true)RelatedOrganizationCtrlEntInd
Transaction With Control EntfalseTransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document19IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee0EmployeeCnt
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsYes (true)QuidProQuoContributionsInd
Quid Pro Quo Contri DisclYes (true)QuidProQuoContriDisclInd
Form8282 Property Disposed OfYes (true)Form8282PropertyDisposedOfInd
Form8282 Filed11Form8282FiledCnt
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members5GoverningBodyVotingMembersCnt
Independent Voting Member3IndependentVotingMemberCnt
Family Or Business RlnYes (true)FamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersfalseMembersOrStockholdersInd
Election Of Board MembersfalseElectionOfBoardMembersInd
Decisions Subject To ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesfalseMinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOfalseCompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonJEFFREY E CLARKPersonNm
Phone4017651500PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1ONE CVS DRIVEAddressLine1Txt
CityWOONSOCKETCityNm
State AbbreviationRIStateAbbreviationCd
ZIP028956146ZIPCd
FieldValueIRS element (for citing)
Info In Schedule O Part VIIYes (X)InfoInScheduleOPartVIIInd
No Listed Persons CompensatedYes (X)NoListedPersonsCompensatedInd

Form990 Part VII Section A Form990PartVIISectionAGrp (9 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
Eileen H Boone
President/Director0.541.5Yes (X)Yes (X)$0$0$0
WAYNE CHARNESS
DIRECTOR0.50.0Yes (X)$0$0$0
MARK G KOLLIGIAN
DIRECTOR0.50.0Yes (X)$0$0$0
Scott Cowper
Director (AS OF 5/9/2016)0.50.0Yes (X)$0$0$0
Faith Weiner
Director (AS OF 5/9/2016)0.540.0Yes (X)$0$0$0
CAROL A DENALE
VICE PRESIDENT/TREASURER0.540.5Yes (X)$0$0$0
THOMAS S MOFFATT
SECRETARY0.541.5Yes (X)$0$0$0
MELANIE K LUKER
ASSISTANT SECRETARY0.540.5Yes (X)$0$0$0
JEFFREY E CLARK
ASSISTANT TREASURER0.541.5Yes (X)$0$0$0
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$0TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KfalseTotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
PETER JACOBSEN SPORTS LLC
9400 SW Barnes Road Suite 550PORTLANDOR97225Management$1,119,596
RHODE ISLAND COUNTRY CLUB
150 NAYATT ROAD PO BOX 74BARRINGTONRI02806Rental services$413,114
CAA SPORTS LLC
2000 AVENUE OF THE STARSLOS ANGELESCA90067CONSULTING SERVICES$387,090
LADY A'D PRODUCTIONS INC
2300 Charlotte Avenue 103NASHVILLETN37203Entertainment$350,000
CLASSIC TENTS
4505 S COUNTRY CLUB ROADTUCSONAZ85714RENTAL SERVICES$850,551
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K13CntrctRcvdGreaterThan100KCnt
Fundraising$3,437,654FundraisingAmt
Related Organizations$719,383RelatedOrganizationsAmt
All Other Contributions$0AllOtherContributionsAmt
Noncash Contributions$69,908NoncashContributionsAmt
Total Contributions$4,157,037TotalContributionsAmt
Total Program Service Revenue$0TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$208TotalRevenueColumnAmt
Exclusion$208ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$0RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$5,048,598FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event$3,437,654ContriRptFundraisingEventAmt
Fundraising Direct Expenses$8,196,125FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column-$3,147,527TotalRevenueColumnAmt
Exclusion-$3,147,527ExclusionAmt
FieldValueIRS element (for citing)
Gaming Gross Income$0GamingGrossIncomeAmt
Gaming Direct Expenses$0GamingDirectExpensesAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Gross Sales Of Inventory$0GrossSalesOfInventoryAmt
Cost Of Goods Sold$0CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Other Revenue Total$0OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,009,718TotalRevenueColumnAmt
Exclusion-$3,147,319ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$1,066,048TotalAmt
Program Services$1,066,048ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$264,000TotalAmt
Fundraising$264,000FundraisingAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$1,330,048TotalAmt
Program Services$1,066,048ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$264,000FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$1,251,932BOYAmt
EOY$879,432EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$307,152BOYAmt
EOY$267,550EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$65,531BOYAmt
EOY$10,358EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$300BOYAmt
EOY$239EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$1,624,915BOYAmt
EOY$1,157,579EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$516,400BOYAmt
EOY$194,882EOYAmt

Grants Payable GrantsPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$516,400BOYAmt
EOY$194,882EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$1,084,731BOYAmt
EOY$914,847EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$23,784BOYAmt
EOY$47,850EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$1,108,515BOYAmt
EOY$962,697EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$1,624,915BOYAmt
EOY$1,157,579EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$320,330ReconcilationRevenueExpnssAmt
Donated Services And Use Fclts$126,662DonatedServicesAndUseFcltsAmt
Other Changes In Net Assets$47,850OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Public Organization170Yes (X)PublicOrganization170Ind

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$2,529,711CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$2,685,179CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$2,419,220CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$4,212,533CurrentTaxYearMinus1YearAmt
Current Tax Year$4,157,037CurrentTaxYearAmt
Total$16,003,680TotalAmt

Tax Rev Levied Orgnztnl Bnft170 TaxRevLeviedOrgnztnlBnft170Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Govt Furn Srvc Fclts Vl170 GovtFurnSrvcFcltsVl170Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$2,529,711CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$2,685,179CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$2,419,220CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$4,212,533CurrentTaxYearMinus1YearAmt
Current Tax Year$4,157,037CurrentTaxYearAmt
Total$16,003,680TotalAmt
FieldValueIRS element (for citing)
Substantial Contributors Tot$3,473,576SubstantialContributorsTotAmt
Public Support Total170$12,530,104PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$512CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$438CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$228CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$191CurrentTaxYearMinus1YearAmt
Current Tax Year$208CurrentTaxYearAmt
Total$1,577TotalAmt

Unrelated Business Net Incm170 UnrelatedBusinessNetIncm170Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Income170 OtherIncome170Grp

FieldValueIRS element (for citing)
Total$0TotalAmt
FieldValueIRS element (for citing)
Total Support$16,005,257TotalSupportAmt
Gross Receipts Rltd Activities$12,423,416GrossReceiptsRltdActivitiesAmt
Public Support CY1700.78287PublicSupportCY170Pct
Public Support PY1700.74743PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170Yes (X)ThirtyThrPctSuprtTestsCY170Ind

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmountsArtPublicExhibitionAmountsGrp
Held Works ArtHeldWorksArtGrp
CY Minus3 Yr Endwmt FundCYMinus3YrEndwmtFundGrp
CY Minus4 Yr Endwmt FundCYMinus4YrEndwmtFundGrp
LandLandGrp
BuildingsBuildingsGrp
Leasehold ImprovementsLeaseholdImprovementsGrp
EquipmentEquipmentGrp
Other Land BuildingsOtherLandBuildingsGrp
Total Rev Etc Audited Fincl Stmt$9,380,355TotalRevEtcAuditedFinclStmtAmt
Donated Services And Use Fclts$126,662DonatedServicesAndUseFcltsAmt
Other Revenue$8,196,125OtherRevenueAmt
Revenue Not Reported$8,322,787RevenueNotReportedAmt
Revenue Subtotal$1,057,568RevenueSubtotalAmt
Other Revenues Not Included-$47,850OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt-$47,850RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$1,009,718TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$9,526,173TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included$8,196,125OtherExpensesIncludedAmt
Expenses Not Reported$8,196,125ExpensesNotReportedAmt
Expenses Subtotal$1,330,048ExpensesSubtotalAmt
Total Expenses Per Form990$1,330,048TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE D, PART XI, LINE 2D$8,196,125 RECLASSIFY FUNDRAISING EXPENSES.
SCHEDULE D, PART XI, LINE 4B$(47,850) SPONSORSHIPS
SCHEDULE D, PART XII, LINE 2D$8,196,125 RECLASSIFY FUNDRAISING EXPENSES.
SCHEDULE D, PART X, LINE 2FIN 48 FOOTNOTE 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 judgment occurs. The organization has not recognized any liability for unrecognized tax benefits.

Schedule G IRS990ScheduleG

FieldValueIRS element (for citing)
Special Fundraising EventsYes (X)SpecialFundraisingEventsInd
Agrmt Prof Fundraising ActyYes (true)AgrmtProfFundraisingActyInd

Fundraiser Activity Info FundraiserActivityInfoGrp

FieldValueIRS element (for citing)
PersonPeter Jacobsen SportsLLCPersonNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line19400 SW Barnes Rd 550AddressLine1Txt
CityPortlandCityNm
State AbbreviationORStateAbbreviationCd
ZIP97225ZIPCd
FieldValueIRS element (for citing)
ActivityMarketingActivityTxt
Fundraiser Control Of FundsfalseFundraiserControlOfFundsInd
Gross Receipts$8,486,252GrossReceiptsAmt
Retained By Contractor$264,000RetainedByContractorAmt
Net To Organization$8,222,252NetToOrganizationAmt
FieldValueIRS element (for citing)
Total Gross Receipts$8,486,252TotalGrossReceiptsAmt
Total Retained By Contractors$264,000TotalRetainedByContractorsAmt
Total Net To Organization$8,222,252TotalNetToOrganizationAmt

Fundraising Event Information FundraisingEventInformationGrp

FieldValueIRS element (for citing)
Event1GOLF/AUCTIONEvent1Nm
Gross Receipts Event1$8,486,252GrossReceiptsEvent1Amt
Charitable Contri Event1$3,437,654CharitableContriEvent1Amt
Gross Revenue Event1$5,048,598GrossRevenueEvent1Amt
Cash Prizes Event1$1,732,000CashPrizesEvent1Amt
Rent Facility Costs Event1$1,529,673RentFacilityCostsEvent1Amt
Food And Beverage Event1$680,967FoodAndBeverageEvent1Amt
Entertainment Event1$890,692EntertainmentEvent1Amt
Other Direct Expenses Event1$3,362,793OtherDirectExpensesEvent1Amt
Other Events Total0OtherEventsTotalCnt
Gross Receipts Total$8,486,252GrossReceiptsTotalAmt
Charitable Contributions Tot$3,437,654CharitableContributionsTotAmt
Gross Revenue Total Events$5,048,598GrossRevenueTotalEventsAmt
Cash Prizes Total Events$1,732,000CashPrizesTotalEventsAmt
Rent Fclty Costs Total Events$1,529,673RentFcltyCostsTotalEventsAmt
Food And Beverage Total Events$680,967FoodAndBeverageTotalEventsAmt
Entertainment Total Events$890,692EntertainmentTotalEventsAmt
Oth Direct Expnss Total Events$3,362,793OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events$8,196,125DirectExpenseSummaryEventsAmt
Net Income Summary-$3,147,527NetIncomeSummaryAmt

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (true)GrantRecordsMaintainedInd

Recipient Table RecipientTable (48 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdRecipient EINRecipientEINIRC SectionIRCSectionDescCash GrantCashGrantAmtValuation Method UsedValuationMethodUsedDescPurpose Of GrantPurposeOfGrantTxtNon Cash AssistanceNonCashAssistanceAmtNon Cash AssistanceNonCashAssistanceDesc
American Heart Association
One State Street Suite 200ProvidenceRI02908135613797501(C)(3)$25,000FMVHealth & Human Services
Arthritis Foundation New England Region
2348 Post Rd Suite 104WarwickRI02886042113261501(C)(3)$30,000FMVHealth Care
Autism Project
1516 Atwood AveJohnstonRI02919050512037501(C)(3)$25,000FMVHealth and Advocacy
Barrington Education Foundation
283 County RdBarringtonRI02806050474061501(C)(3)$10,000FMVEducation
Bayside YMCA
70 West StBarringtonRI02806050258878501(C)(3)$7,500FMVRecreation & Education
Boston Red Fox Foundation
4 Yawkey StreetBostonMA02215331007984501(C)(3)$10,000FMVYouth Development
Boys & Girls Clubs of Providence
550 Wickenden StProvodenceRI02903050258929501(C)(3)$25,000FMVYouth Development
Boys & Girls Clubs of Woonsocket
72 Kendrick AvenueWoonsocketRI02895061663293501(C)(3)$10,000FMVYouth Development
Brain Injury Association of Rhode Island
935 Park Ave Ste 8CranstonRI02910222528586501(C)(3)$25,000FMVHealth & Human Services
Children's Wish Group of RI Inc
2346 Post Rd Suite 102WarwickRI02886264662878501(C)(3)$30,000FMVYouth Development
City Year Providence
275 Westminster St Suite 500ProvidenceRI02903222882549501(C)(3)$55,000FMVYouth Development
Crossroads Rhode Island
160 Broad StreetProvidenceRI02903050259094501(C)(3)$23,500FMVHealth & Human Services
Economic Progress Institute
600 Mount Pleasant Ave Bldg 9ProvidenceRI02908320295517501(C)(3)$10,000FMVHealth & Social Services
Emma Pendleton Bradley Hospital
1011 Veterans Memorial ParkwayEast ProvidenceRI02915050258806501(C)(3)$25,000FMVHealth and Youth Education
Gloria Gemma Breast Cancer Resource Foundation
249 Roosevelt Avenue Suite 201PawtucketRI02860134283582501(C)(3)$10,000FMVHealth Care
Golf Foundation of RI (Button Hole)
1 ButtonHole Drive Suite OneProvidenceRI02909050497481501(C)(3)$20,000FMVEducation
Highlander Charter School
42 Lexington AveProvidenceRI02907050517389501(C)(3)$10,000FMVEducation$4,998AED
JDRF
2350 Post Road Ste 201WarwickRI02886121907729501(C)(3)$10,000FMVHealth & Human Services
Learning Center for Deaf Inc
848 Central STFraminghamMA01701237064431501(C)(3)$25,000FMVEducation
March of Dimes
260 West Exchange Suite 004ProvidenceRI02903131846366501(C)(3)$25,000FMVHealth & Human Services
Meeting Street
1000 Eddy streetProvidenceRI02905050269232501(C)(3)$25,000FMVEducation
Our Sister's School
145 Brownell AveNew BedfordMA02740260367118501(C)(3)$25,000FMVEducation
PeaceLove Foundation
171 Main StreetPawtucketRI02860272224246501(C)(3)$25,000FMVArts & Culture
Rhode Island Community Food Bank
200 Niantic AvenueProvidenceRI02907050395601501(C)(3)$6,800FMVCommunity Services
Save The Bay
100 Save The Bay DriveProvidenceRI02905050343046501(C)(3)$25,000FMVEducation
Serve Rhode Island
655 Broad St Po Box 72822ProvidenceRI02907050479705501(C)(3)$40,000FMVHealth and Human Services
Sojourner House
386 Smith StreetProvidenceRI02907050370419501(C)(3)$25,000FMVCommunity Services
Special Olympics Rhode Island
370 George Washington HwySmithfieldRI02917050377867501(C)(3)$25,000FMVYouth Development
Spurwink RI
One Spurwink PlaceCranstonRI02910010370716501(C)(3)$15,000FMVHealth & Human services
Tap In
PO Box 252BarringtonRI02806222481382501(C)(3)$10,000FMVCommunity Services
Tides Family Services
215 Washington StreetWest WarwickRI02893222478229501(C)(3)$25,000FMVHealth & Human Services
Youth Pride Inc
743 Westminster StreetProvidenceRI02903050478645501(C)(3)$15,000FMVHealth & Human Services
Community Scholarship Fund of Barrington
PO Box 300BarringtonRI02806300798085501(C)(3)$10,000FMVEducation
Girl Scouts of Southeastern New England
500 Greenwich AveWarwickRI02886050300724501(C)(3)$5,500FMVYouth Development
Stadium Theatre Foundation
28 Monument SquareWoonsocketRI02895050486986501(C)(3)$10,000FMVArts & Culture
American Lung Association of the Northeast
260 West Exchange Street Suite 102ProvidenceRI02903060646594501(C)(3)$10,000FMVHEALTH AND HUMAN SERVICES
College Visions
131 Washington Street Suite 205ProvidenceRI02903272344723501(C)(3)$10,000Education
Gaits of Harmony Therapeautic Riding Inc
PO Box 21West KingstonRI02892464780609501(c)(3)$5,000fmvHealth & Human Services$1,666AED
Old Colony Habitat for Humanity
PO Box 100AttleboroMA02703272344723501(C)(3)$10,000Community Services
Alzheimer's Foundation of America
322 Eighth Avenue 7th FloorNew YorkNY10001911792864501(C)(3)$10,000Health Care
American National Red Cross
209 Farmington AvenueFarmingtonCT06110530196605501(C)(3)$25,000Disaster Relief
Build Our Kids Success (BOKS)
1895 JW Foster BlvdCantonMA02021043073548501(C)(3)$25,000Youth Development
Girls on the Run
PO Box 72787ProvidenceRI02907453061488501(C)(3)$10,000Youth Development
Hockomock Area YMCA
300 Elmwood StNorth AttleboroMA02760042131749501(C)(3)$15,000Youth Development
Rhode Island Public Radio
One Union StationProvidenceRI02903050498502501(C)(3)$10,000Community Services
San Miguel School
525 Branch AvenueProvidenceRI02904223232973501(C)(3)$20,000Education
Woonsocket Education Department
108 High StreetWoonsocketRI02895050494840501(C)(3)$10,000Education
Morgan Pressel Foundation
PO Box 480157Delray BeachFL33448272854677501(C)(3)$25,000Health and Recreation
FieldValueIRS element (for citing)
Total501c3 Org48Total501c3OrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceDESCRIPTION OF ORGANIZATIONAL PROCEDURESFormAndLineReferenceDesc
ExplanationFORM 990, SCHEDULE I DESCRIPTION OF ORGANIZATION'S PROCEDURES FOR MONITORING THE USE OF GRANTS 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 CLASSIC REVIEWS THE IMPACT OF THE PROPOSED GRANT ON THE RESIDENTS OF RHODE ISLAND.ExplanationTxt

Schedule M IRS990ScheduleM

FieldValueIRS element (for citing)
Works Of ArtWorksOfArtGrp
Art Historical TreasuresArtHistoricalTreasuresGrp
Art Fractional InterestArtFractionalInterestGrp
Books And PublicationsBooksAndPublicationsGrp

Clothing And Household Goods ClothingAndHouseholdGoodsGrp

FieldValueIRS element (for citing)
Non Cash CheckboxYes (X)NonCashCheckboxInd
Noncash Contributions Rpt F990$495NoncashContributionsRptF990Amt
Method Of Determining RevenuesFair Market ValueMethodOfDeterminingRevenuesTxt
FieldValueIRS element (for citing)
Cars And Other VehiclesCarsAndOtherVehiclesGrp
Boats And PlanesBoatsAndPlanesGrp
Intellectual PropertyIntellectualPropertyGrp
Securities Publicly TradedSecuritiesPubliclyTradedGrp
Securities Closely Held StockSecuritiesCloselyHeldStockGrp
Secur Prtnrshp Trust IntrstsSecurPrtnrshpTrustIntrstsGrp
Securities MiscellaneousSecuritiesMiscellaneousGrp
Qualified Contrib Hist StructQualifiedContribHistStructGrp
Qualified Contrib OtherQualifiedContribOtherGrp
Real Estate ResidentialRealEstateResidentialGrp
Real Estate CommercialRealEstateCommercialGrp
Real Estate OtherRealEstateOtherGrp

Collectibles CollectiblesGrp

FieldValueIRS element (for citing)
Non Cash CheckboxYes (X)NonCashCheckboxInd
Contribution5ContributionCnt
Noncash Contributions Rpt F990$2,706NoncashContributionsRptF990Amt
Method Of Determining RevenuesFair Market ValueMethodOfDeterminingRevenuesTxt
FieldValueIRS element (for citing)
Food InventoryFoodInventoryGrp

Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp

FieldValueIRS element (for citing)
Non Cash CheckboxYes (X)NonCashCheckboxInd
Contribution288ContributionCnt
Noncash Contributions Rpt F990$2,877NoncashContributionsRptF990Amt
Method Of Determining RevenuesRetail ValueMethodOfDeterminingRevenuesTxt
FieldValueIRS element (for citing)
TaxidermyTaxidermyGrp
Historical ArtifactsHistoricalArtifactsGrp
Scientific SpecimensScientificSpecimensGrp
Archaeological ArtifactsArchaeologicalArtifactsGrp

Other Non Cash Contri Table OtherNonCashContriTableGrp (5 entries)

Non Cash CheckboxNonCashCheckboxIndDescDescContributionContributionCntNoncash Contributions Rpt F990NoncashContributionsRptF990AmtMethod Of Determining RevenuesMethodOfDeterminingRevenuesTxt
Yes (X)Soda & Water1750$1,593Retail Value
Yes (X)Bottles of Wine203$5,699Retail Value
Yes (X)Fenway 1st Pitch2$10,000Fair Market Value
Yes (X)EMC Dinner2$800Fair Market Value
Yes (X)gift cert/goody bags1074$45,738fair market value
FieldValueIRS element (for citing)
Any Property That Must Be HeldfalseAnyPropertyThatMustBeHeldInd
Review Process Unusual NC GiftsYes (true)ReviewProcessUnusualNCGiftsInd
Third Parties UsedYes (true)ThirdPartiesUsedInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSchedule M, Line 32 b:FormAndLineReferenceDesc
ExplanationThe Organization entered into agreements with a third party organization, Peter Jacobsen Sports, LLC, to market the CVS Health Charity CLASSIC Golf tournament on behalf of the organization.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (7 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
ORGANIZATION'S MISSION STATEMENTFORM 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.
Description of RelationshipsForm 990, Part VI, SECTION A, Line 2 Eileen H. Boone, a director on the CVS Health Charity Classic's Board, is also an officer of CVS Pharmacy, Inc. Jeffrey E. Clark, Faith Weiner and Melanie K. Luker are employees of CVS Pharmacy, Inc. Carol A. Denale and Thomas S. Moffatt are officers of CVS HEALTH Corporation.
Committee AuthorityForm 990, Part VI, Section A, Line 8 There are no committees with authority to act on behalf of the governing body.
Process for review of Form 990Form 990, Part VI, Section B, Line 11B 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 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 and supporting schedules are reviewed by the Board of Directors.
Description of Process to monitor transactions for conflict of interestFORM 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. THE REMAINING BOARD OR COMMITTEE MEMBERS SHALL DECIDE IF 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.
Public Access to Organization's DocumentsForm 990, Part VI, Section C, Line 10 Governing documents, financial statements, and the organization's conflict of interest policy are available to the public upon request.
RECONCILIATION OF NET ASSETSFORM 990, PART XI, LINE 9 $47,850 SPONSORSHIPS.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (3 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
CVS FOUNDATION
One CVS DriveWoonsocketRI02895223206973Grant MakingRI501(c)(3)PFCVS PHARMACYYes (true)
CVS HEALTH EMPLOYEE RELIEF FUND
One CVS DriveWoonsocketRI02895274380115Grant MakingRI501(C)(3)7CVS PHARMACYYes (true)
OMNICARE FOUNDATION
ONE CVS DRIVEWOONSOCKETRI02895311389112GRANT MAKINGOH501(c)(3)PFOMNICARE INCYes (true)

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (35 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdDirect Controlling NADirectControllingNACdEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationIndBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Txt
Accendo Insurance Company
One CVS DriveWoonsocketRI02895061566092InsuranceUTN/AC CorpYes (true)
Alabama CVS Pharmacy LLC
One CVS DriveWoonsocketRI02895203648395RetailALN/AC CorpYes (true)
Caremark Ulysses Holding Corp
One CVS DriveWoonsocketRI02895112580136Holding CompaNYN/AC CorpYes (true)
Connecticut CVS Pharmacy LLC
One CVS DriveWoonsocketRI02895203648725RetailCTN/AC CorpYes (true)
CVS Arclight Inc
One CVS DriveWoonsocketRI02895050514363RetailDEN/AC CorpYes (true)
CVS Caremark Indemnity Ltd
One CVS DriveWoonsocketRI02895050500188RetailRIN/AC CorpYes (true)
CVS Foreign Inc
One CVS DriveWoonsocketRI02895050497953Non RetailNYN/AC CorpYes (true)
CVS International LLC
One CVS DriveWoonsocketRI02895455509568Holding CompaDEN/AC CorpYes (true)
CVS Pharmacy Inc
One CVS DriveWoonsocketRI02895050340626Pharmacy ServRIN/AC CorpYes (true)
CVS Rx Services Inc
One CVS DriveWoonsocketRI02895050501917Pharmacy ServNYN/AC CorpYes (true)
CVS WWRE Inc
One CVS DriveWoonsocketRI02895050511636RetailNYN/AC CorpYes (true)
Delaware CVS Pharmacy LLC
One CVS DriveWoonsocketRI02895260223262RetailDEN/AC CorpYes (true)
ETB INC
One CVS DriveWoonsocketRI02895742118879RetailTXN/AC CorpYes (true)
Eckerd Corporation of Florida Inc
One CVS DriveWoonsocketRI02895593102662Non RetailFLN/AC CorpYes (true)
Iowa CVS Pharmacy LLC
One CVS DriveWoonsocketRI02895204281257RetailIAN/AC CorpYes (true)
JEC Funding Inc
One CVS DriveWoonsocketRI02895133388181Non RetailDEN/AC CorpYes (true)
Kentucky CVS Pharmacy LLC
One CVS DriveWoonsocketRI02895204452072RetailKYN/AC CorpYes (true)
Maryland CVS Pharmacy LLC
One CVS DriveWoonsocketRI02895651262539RetailMDN/AC CorpYes (true)
Massachusetts CVS Pharmacy Inc
One CVS DriveWoonsocketRI02895300790391RetailMAN/AC CorpYes (true)
Melville Realty Company Inc
One CVS DriveWoonsocketRI02895046050302Lease GuarantNYN/AC CorpYes (true)
New Jersey CVS Pharmacy LLC
One CVS DriveWoonsocketRI02895203618568RetailNJN/AC CorpYes (true)
North Carolina CVS Pharmacy LLC
One CVS DriveWoonsocketRI02895203649570RetailNCN/AC CorpYes (true)
Oklahoma CVS Pharmacy LLC
One CVS DriveWoonsocketRI02895204837341RetailOKN/AC CorpYes (true)
Pennsylvania Life Insurance Company
One CVS DriveWoonsocketRI02895231305366InsurancePAN/AC CorpYes (true)
PharmaCare Captive RE Ltd
One CVS DriveWoonsocketRI02895202840526InsuranceAZN/AC CorpYes (true)
Retrac Inc
One CVS DriveWoonsocketRI02895310963857RetailOHN/AC CorpYes (true)
Rhode Island CVS Pharmacy LLC
One CVS DriveWoonsocketRI02895204451847RetailRIN/AC CorpYes (true)
Richmond Heights Acquisition Corp
One CVS DriveWoonsocketRI02895611428940RetailOHN/AC CorpYes (true)
SilverScript Insurance Company
One CVS DriveWoonsocketRI02895202833904InsuranceTNN/AC CorpYes (true)
Tennessee CVS Pharmacy LLC
One CVS DriveWoonsocketRI02895203738440RetailTNN/AC CorpYes (true)
UAC Holding Inc
One CVS DriveWoonsocketRI02895271298765RetailDEN/AC CorpYes (true)
Virginia CVS Pharmacy LLC
One CVS DriveWoonsocketRI02895203649917RetailVAN/AC CorpYes (true)
OMNICARE INC
ONE CVS DriveWOONSOCKETRI02895311001351PHARMACY SERVOHC CORPYes (true)NA
CVS HEALTH CORPORATION
ONE CVS DriveWOONSOCKETRI02895050494040HOLDING COMPARIC CORPfalseNA
Coram Alternate Site Services Inc
ONE CVS DRIVEWOONSOCKETRI02895760215922HOME INFUSIONRIC CORPYes (true)NA
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (true)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgYes (true)LoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgfalseRentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgfalseRentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (true)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (true)SharingOfFacilitiesInd
Paid Employees SharingfalsePaidEmployeesSharingInd
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrgInd
Transfer To Other OrgfalseTransferToOtherOrgInd
Transfer From Other OrgfalseTransferFromOtherOrgInd