2017-11-14T10:49:14-06:00 2016-12-31 PricewaterhouseCoopers LLP 101 SEAPORT BLVD BOSTON MA 02210 990 2016-01-01 050508742 CVS HEALTH CHARITY CLASSIC INC % JEFFREY E CLARK CVSH 4017651500 ONE CVS DRIVE WOONSOCKET RI 028956146 JEFFREY E CLARK ASSISTANT TREASURER 4017651500 2017-11-08 true PAUL J TANIS P01441612 6175305000 2017-11-08 155.201.188.33 04363820173185000003 2017-11-14 P 1818DFECDE657413DFFFFFA65F228573FF62BF80 41937B3F5B69072E51D0E11B5CA7F460A5D35ADB 2016 2017-02-10 21:41:12Z EILEEN H BOONE ONE CVS DRIVE WOONSOCKET RI 028956146 9205843 false X www.cvshealthcharityclassic.com X 1999 RI SEE SCHEDULE O 5 3 0 1434 0 0 4212533 4157037 0 0 191 208 -2993236 -3147527 1219488 1009718 1329972 1066048 0 0 0 0 288000 264000 264000 0 0 1617972 1330048 -398484 -320330 1624915 1157579 516400 194882 1108515 962697 X SEE SCHEDULE O false false 1066048 1066048 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 $21.91 million in charitable donations to hundreds of organizations. 1066048 true true false false false false false false false false false false false false false false true false false false false false false true true false false true false false false false false false false false false false true false false false false true true false false false true 19 0 true 0 false false false false false true true true 11 false false false X 5 3 true false false false false false false true false false false true true true true true true false false false X JEFFREY E CLARK 4017651500 ONE CVS DRIVE WOONSOCKET RI 028956146 X X Eileen H Boone President/Director 0.5 41.5 X X 0 0 0 WAYNE CHARNESS DIRECTOR 0.5 0.0 X 0 0 0 MARK G KOLLIGIAN DIRECTOR 0.5 0.0 X 0 0 0 Scott Cowper Director (AS OF 5/9/2016) 0.5 0.0 X 0 0 0 Faith Weiner Director (AS OF 5/9/2016) 0.5 40.0 X 0 0 0 CAROL A DENALE VICE PRESIDENT/TREASURER 0.5 40.5 X 0 0 0 THOMAS S MOFFATT SECRETARY 0.5 41.5 X 0 0 0 MELANIE K LUKER ASSISTANT SECRETARY 0.5 40.5 X 0 0 0 JEFFREY E CLARK ASSISTANT TREASURER 0.5 41.5 X 0 0 0 0 0 0 0 false false false PETER JACOBSEN SPORTS LLC 9400 SW Barnes Road Suite 550 PORTLAND OR 97225 Management 1119596 RHODE ISLAND COUNTRY CLUB 150 NAYATT ROAD PO BOX 74 BARRINGTON RI 02806 Rental services 413114 CAA SPORTS LLC 2000 AVENUE OF THE STARS LOS ANGELES CA 90067 CONSULTING SERVICES 387090 LADY A'D PRODUCTIONS INC 2300 Charlotte Avenue 103 NASHVILLE TN 37203 Entertainment 350000 CLASSIC TENTS 4505 S COUNTRY CLUB ROAD TUCSON AZ 85714 RENTAL SERVICES 850551 13 3437654 719383 0 69908 4157037 0 208 208 0 0 0 0 0 0 5048598 3437654 8196125 -3147527 -3147527 0 0 0 0 0 0 0 1009718 -3147319 1066048 1066048 0 0 0 0 0 0 0 0 0 0 0 0 0 264000 264000 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1330048 1066048 0 264000 1251932 879432 0 0 0 0 307152 267550 0 0 0 0 0 0 65531 10358 0 0 0 0 0 0 0 0 0 0 0 0 300 239 1624915 1157579 516400 194882 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 516400 194882 X 1084731 914847 23784 47850 0 0 1108515 962697 1624915 1157579 X -320330 126662 47850 X false true X true false X 2529711 2685179 2419220 4212533 4157037 16003680 0 0 2529711 2685179 2419220 4212533 4157037 16003680 3473576 12530104 512 438 228 191 208 1577 0 0 16005257 12423416 0.78287 0.74743 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 9380355 126662 8196125 8322787 1057568 -47850 -47850 1009718 9526173 8196125 8196125 1330048 1330048 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 2 FIN 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. X true Peter Jacobsen SportsLLC 9400 SW Barnes Rd 550 Portland OR 97225 Marketing false 8486252 264000 8222252 8486252 264000 8222252 GOLF/AUCTION 8486252 3437654 5048598 1732000 1529673 680967 890692 3362793 0 8486252 3437654 5048598 1732000 1529673 680967 890692 3362793 8196125 -3147527 true American Heart Association One State Street Suite 200 Providence RI 02908 135613797 501(C)(3) 25000 FMV Health & Human Services Arthritis Foundation New England Region 2348 Post Rd Suite 104 Warwick RI 02886 042113261 501(C)(3) 30000 FMV Health Care Autism Project 1516 Atwood Ave Johnston RI 02919 050512037 501(C)(3) 25000 FMV Health and Advocacy Barrington Education Foundation 283 County Rd Barrington RI 02806 050474061 501(C)(3) 10000 FMV Education Bayside YMCA 70 West St Barrington RI 02806 050258878 501(C)(3) 7500 FMV Recreation & Education Boston Red Fox Foundation 4 Yawkey Street Boston MA 02215 331007984 501(C)(3) 10000 FMV Youth Development Boys & Girls Clubs of Providence 550 Wickenden St Provodence RI 02903 050258929 501(C)(3) 25000 FMV Youth Development Boys & Girls Clubs of Woonsocket 72 Kendrick Avenue Woonsocket RI 02895 061663293 501(C)(3) 10000 FMV Youth Development Brain Injury Association of Rhode Island 935 Park Ave Ste 8 Cranston RI 02910 222528586 501(C)(3) 25000 FMV Health & Human Services Children's Wish Group of RI Inc 2346 Post Rd Suite 102 Warwick RI 02886 264662878 501(C)(3) 30000 FMV Youth Development City Year Providence 275 Westminster St Suite 500 Providence RI 02903 222882549 501(C)(3) 55000 FMV Youth Development Crossroads Rhode Island 160 Broad Street Providence RI 02903 050259094 501(C)(3) 23500 FMV Health & Human Services Economic Progress Institute 600 Mount Pleasant Ave Bldg 9 Providence RI 02908 320295517 501(C)(3) 10000 FMV Health & Social Services Emma Pendleton Bradley Hospital 1011 Veterans Memorial Parkway East Providence RI 02915 050258806 501(C)(3) 25000 FMV Health and Youth Education Gloria Gemma Breast Cancer Resource Foundation 249 Roosevelt Avenue Suite 201 Pawtucket RI 02860 134283582 501(C)(3) 10000 FMV Health Care Golf Foundation of RI (Button Hole) 1 ButtonHole Drive Suite One Providence RI 02909 050497481 501(C)(3) 20000 FMV Education Highlander Charter School 42 Lexington Ave Providence RI 02907 050517389 501(C)(3) 10000 4998 FMV AED Education JDRF 2350 Post Road Ste 201 Warwick RI 02886 121907729 501(C)(3) 10000 FMV Health & Human Services Learning Center for Deaf Inc 848 Central ST Framingham MA 01701 237064431 501(C)(3) 25000 FMV Education March of Dimes 260 West Exchange Suite 004 Providence RI 02903 131846366 501(C)(3) 25000 FMV Health & Human Services Meeting Street 1000 Eddy street Providence RI 02905 050269232 501(C)(3) 25000 FMV Education Our Sister's School 145 Brownell Ave New Bedford MA 02740 260367118 501(C)(3) 25000 FMV Education PeaceLove Foundation 171 Main Street Pawtucket RI 02860 272224246 501(C)(3) 25000 FMV Arts & Culture Rhode Island Community Food Bank 200 Niantic Avenue Providence RI 02907 050395601 501(C)(3) 6800 FMV Community Services Save The Bay 100 Save The Bay Drive Providence RI 02905 050343046 501(C)(3) 25000 FMV Education Serve Rhode Island 655 Broad St Po Box 72822 Providence RI 02907 050479705 501(C)(3) 40000 FMV Health and Human Services Sojourner House 386 Smith Street Providence RI 02907 050370419 501(C)(3) 25000 FMV Community Services Special Olympics Rhode Island 370 George Washington Hwy Smithfield RI 02917 050377867 501(C)(3) 25000 FMV Youth Development Spurwink RI One Spurwink Place Cranston RI 02910 010370716 501(C)(3) 15000 FMV Health & Human services Tap In PO Box 252 Barrington RI 02806 222481382 501(C)(3) 10000 FMV Community Services Tides Family Services 215 Washington Street West Warwick RI 02893 222478229 501(C)(3) 25000 FMV Health & Human Services Youth Pride Inc 743 Westminster Street Providence RI 02903 050478645 501(C)(3) 15000 FMV Health & Human Services Community Scholarship Fund of Barrington PO Box 300 Barrington RI 02806 300798085 501(C)(3) 10000 FMV Education Girl Scouts of Southeastern New England 500 Greenwich Ave Warwick RI 02886 050300724 501(C)(3) 5500 FMV Youth Development Stadium Theatre Foundation 28 Monument Square Woonsocket RI 02895 050486986 501(C)(3) 10000 FMV Arts & Culture American Lung Association of the Northeast 260 West Exchange Street Suite 102 Providence RI 02903 060646594 501(C)(3) 10000 FMV HEALTH AND HUMAN SERVICES College Visions 131 Washington Street Suite 205 Providence RI 02903 272344723 501(C)(3) 10000 Education Gaits of Harmony Therapeautic Riding Inc PO Box 21 West Kingston RI 02892 464780609 501(c)(3) 5000 1666 fmv AED Health & Human Services Old Colony Habitat for Humanity PO Box 100 Attleboro MA 02703 272344723 501(C)(3) 10000 Community Services Alzheimer's Foundation of America 322 Eighth Avenue 7th Floor New York NY 10001 911792864 501(C)(3) 10000 Health Care American National Red Cross 209 Farmington Avenue Farmington CT 06110 530196605 501(C)(3) 25000 Disaster Relief Build Our Kids Success (BOKS) 1895 JW Foster Blvd Canton MA 02021 043073548 501(C)(3) 25000 Youth Development Girls on the Run PO Box 72787 Providence RI 02907 453061488 501(C)(3) 10000 Youth Development Hockomock Area YMCA 300 Elmwood St North Attleboro MA 02760 042131749 501(C)(3) 15000 Youth Development Rhode Island Public Radio One Union Station Providence RI 02903 050498502 501(C)(3) 10000 Community Services San Miguel School 525 Branch Avenue Providence RI 02904 223232973 501(C)(3) 20000 Education Woonsocket Education Department 108 High Street Woonsocket RI 02895 050494840 501(C)(3) 10000 Education Morgan Pressel Foundation PO Box 480157 Delray Beach FL 33448 272854677 501(C)(3) 25000 Health and Recreation 48 DESCRIPTION OF ORGANIZATIONAL PROCEDURES FORM 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. X 495 Fair Market Value X 5 2706 Fair Market Value X 288 2877 Retail Value X Soda & Water 1750 1593 Retail Value X Bottles of Wine 203 5699 Retail Value X Fenway 1st Pitch 2 10000 Fair Market Value X EMC Dinner 2 800 Fair Market Value X gift cert/goody bags 1074 45738 fair market value false true true Schedule M, Line 32 b: The 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. ORGANIZATION'S MISSION STATEMENT 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. Description of Relationships Form 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 Authority Form 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 990 Form 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 interest 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. 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 Documents Form 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 ASSETS FORM 990, PART XI, LINE 9 $47,850 SPONSORSHIPS. CVS FOUNDATION One CVS Drive Woonsocket RI 02895 223206973 Grant Making RI 501(c)(3) PF CVS PHARMACY true CVS HEALTH EMPLOYEE RELIEF FUND One CVS Drive Woonsocket RI 02895 274380115 Grant Making RI 501(C)(3) 7 CVS PHARMACY true OMNICARE FOUNDATION ONE CVS DRIVE WOONSOCKET RI 02895 311389112 GRANT MAKING OH 501(c)(3) PF OMNICARE INC true Accendo Insurance Company One CVS Drive Woonsocket RI 02895 061566092 Insurance UT N/A C Corp true Alabama CVS Pharmacy LLC One CVS Drive Woonsocket RI 02895 203648395 Retail AL N/A C Corp true Caremark Ulysses Holding Corp One CVS Drive Woonsocket RI 02895 112580136 Holding Compa NY N/A C Corp true Connecticut CVS Pharmacy LLC One CVS Drive Woonsocket RI 02895 203648725 Retail CT N/A C Corp true CVS Arclight Inc One CVS Drive Woonsocket RI 02895 050514363 Retail DE N/A C Corp true CVS Caremark Indemnity Ltd One CVS Drive Woonsocket RI 02895 050500188 Retail RI N/A C Corp true CVS Foreign Inc One CVS Drive Woonsocket RI 02895 050497953 Non Retail NY N/A C Corp true CVS International LLC One CVS Drive Woonsocket RI 02895 455509568 Holding Compa DE N/A C Corp true CVS Pharmacy Inc One CVS Drive Woonsocket RI 02895 050340626 Pharmacy Serv RI N/A C Corp true CVS Rx Services Inc One CVS Drive Woonsocket RI 02895 050501917 Pharmacy Serv NY N/A C Corp true CVS WWRE Inc One CVS Drive Woonsocket RI 02895 050511636 Retail NY N/A C Corp true Delaware CVS Pharmacy LLC One CVS Drive Woonsocket RI 02895 260223262 Retail DE N/A C Corp true ETB INC One CVS Drive Woonsocket RI 02895 742118879 Retail TX N/A C Corp true Eckerd Corporation of Florida Inc One CVS Drive Woonsocket RI 02895 593102662 Non Retail FL N/A C Corp true Iowa CVS Pharmacy LLC One CVS Drive Woonsocket RI 02895 204281257 Retail IA N/A C Corp true JEC Funding Inc One CVS Drive Woonsocket RI 02895 133388181 Non Retail DE N/A C Corp true Kentucky CVS Pharmacy LLC One CVS Drive Woonsocket RI 02895 204452072 Retail KY N/A C Corp true Maryland CVS Pharmacy LLC One CVS Drive Woonsocket RI 02895 651262539 Retail MD N/A C Corp true Massachusetts CVS Pharmacy Inc One CVS Drive Woonsocket RI 02895 300790391 Retail MA N/A C Corp true Melville Realty Company Inc One CVS Drive Woonsocket RI 02895 046050302 Lease Guarant NY N/A C Corp true New Jersey CVS Pharmacy LLC One CVS Drive Woonsocket RI 02895 203618568 Retail NJ N/A C Corp true North Carolina CVS Pharmacy LLC One CVS Drive Woonsocket RI 02895 203649570 Retail NC N/A C Corp true Oklahoma CVS Pharmacy LLC One CVS Drive Woonsocket RI 02895 204837341 Retail OK N/A C Corp true Pennsylvania Life Insurance Company One CVS Drive Woonsocket RI 02895 231305366 Insurance PA N/A C Corp true PharmaCare Captive RE Ltd One CVS Drive Woonsocket RI 02895 202840526 Insurance AZ N/A C Corp true Retrac Inc One CVS Drive Woonsocket RI 02895 310963857 Retail OH N/A C Corp true Rhode Island CVS Pharmacy LLC One CVS Drive Woonsocket RI 02895 204451847 Retail RI N/A C Corp true Richmond Heights Acquisition Corp One CVS Drive Woonsocket RI 02895 611428940 Retail OH N/A C Corp true SilverScript Insurance Company One CVS Drive Woonsocket RI 02895 202833904 Insurance TN N/A C Corp true Tennessee CVS Pharmacy LLC One CVS Drive Woonsocket RI 02895 203738440 Retail TN N/A C Corp true UAC Holding Inc One CVS Drive Woonsocket RI 02895 271298765 Retail DE N/A C Corp true Virginia CVS Pharmacy LLC One CVS Drive Woonsocket RI 02895 203649917 Retail VA N/A C Corp true OMNICARE INC ONE CVS Drive WOONSOCKET RI 02895 311001351 PHARMACY SERV OH NA C CORP true CVS HEALTH CORPORATION ONE CVS Drive WOONSOCKET RI 02895 050494040 HOLDING COMPA RI NA C CORP false Coram Alternate Site Services Inc ONE CVS DRIVE WOONSOCKET RI 02895 760215922 HOME INFUSION RI NA C CORP true false false true false true false false false false false false false true true false false false false false