2017-07-31T14:47:24-05:00 2016-12-31 450250958 EIDE BAILLY LLP 4310 17TH AVE S PO BOX 2545 FARGO ND 581082545 990 2016-01-01 742358522 NCMC INC NCMC 9708106052 1801 16TH STREET GREELEY CO 80631 ROBERT E MURPHY TREASURER 9703506052 2017-07-31 1 LISA CHAFFEE CPA P00193453 7012398500 2017-07-31 198.135.125.137 2017-07-31 14:14:18 CD P 6C9B1A35775087DBDB8A6D25ECA509C7F6C27838 385FD7544B689D76E9DA9F221308BA92DD4DD75D 2016 2021-01-29 14:40:06Z JEFF CARLSON 1801 16TH STREET GREELEY CO 80631 231877821 0 X N/A X 1984 CO PROVISION OF HOSPITAL FACILITIES TO ORGANIZATIONS DESCRIBED IN SECTION 501(C)(3) OF THE IRS CODE, FOR THE DELIVERY OF HEALTH CARE SERVICES TO THE COMMUNITY. 10 10 0 12 533 0 633115 320535 47892794 42097774 10875646 2996279 301384 -9586998 59702939 35827590 6080000 6080000 0 0 2568289 1226413 0 0 0 35740470 36015820 44388759 43322233 15314180 -7494643 496709203 530223961 215702404 245905995 281006799 284317966 TO PROVIDE QUALITY HEALTHCARE AT A REASONABLE COST TO THE NCMC SERVICE COMMUNITY. 0 0 42129416 6080000 29103384 UNDER AN OPERATING AGREEMENT WITH BANNER HEALTH (AN ARIZONA 501(C)(3) ORGANIZATION), NCMC, INC. PROVIDES HOSPITAL FACILITIES, EQUIPMENT AND A BUSINESS FRANCHISE TO BANNER BY WHICH IT OPERATES NORTH COLORADO MEDICAL CENTER AS A CHARITABLE ENTITY. IN SO DOING, NCMC, INC. FULFILLS ITS OBLIGATIONS AS A SUPPORTING ORGANIZATION TO THE NORTH COLORADO MEDICAL CENTER BOARD OF TRUSTEES. 42129416 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 1 0 0 0 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 1 0 0 0 1 19 0 1 0 0 0 0 0 0 0 0 0 0 0 X 10 10 0 1 0 0 0 1 1 1 1 0 0 1 1 1 1 0 1 0 0 0 X KEN SCHULTZ 9708106052 1801 16TH STREET GREELEY CO 80631 X JEFFREY CARLSON PRESIDENT & CHAIR 1.00 X X 0 0 0 ROBERT NOFFSINGER VICE CHAIR (JAN-FEB) 1.00 X X 0 0 0 TOM GRANT VICE CHAIR (FEB-DEC) 1.00 X X 0 0 0 ROBERT E MURPHY TREASURER 1.00 X X 0 0 0 BRANDON HOUTCHENS SECRETARY 1.00 X X 0 0 0 AL DOMINGUEZ DIRECTOR 1.00 X 0 0 0 KAY KOSMICKI DIRECTOR 1.00 X 0 0 0 VICKI WILSON PHD RN DIRECTOR 1.00 X 0 0 0 MICHAEL J GEILE DIRECTOR (JANUARY) 1.00 X 0 0 0 SUSAN CARTER MD DIRECTOR 1.00 X 0 0 0 MARK LAWLEY DIRECTOR 1.00 X 0 0 0 MIKE SIMONE DIRECTOR 1.00 X 0 0 0 KEN SCHULTZ BOARD EXECUTIVE 35.00 X 0 0 0 0 0 0 0 0 0 0 GE JOHNSON CONSTRUCTION 25 N CASCADE AVE SUITE 400 COLORADO SPRINGS CO 80903 CONSTRUCTION-GENERAL CONTRACTOR 9666961 ADOLFSON & PETERSON CONSTRUCTION 797 VENTURA STREET AURORA CO 80011 CONSTRUCTION-GENERAL CONTRACTOR 3515632 HENSEL PHELPS CONSTRUCTION 420 6TH AVE GREELEY CO 80632 CONSTRUCTION-GENERAL CONTRACTOR 2259652 COE CONSTRUCTION INC 2302 E 13TH STREET LOVELAND CO 80537 CONSTRUCTION-GENERAL CONTRACTOR 1146720 NORTHSTAR DEMOLITION & REMEDIATION INC 5150 FOX STREET DENVER CO 80216 DEMOLITION & REMEDIATION 945071 12 90801 229734 320535 HOSPITAL FACILITY RENT 532000 42018828 42018828 78946 78946 42097774 4524347 4524347 573272 247618 325654 325654 325654 194269295 5250 195729612 73001 -1460317 -67751 -1528068 -1528068 ENVIRONMENTAL REMEDIATION BENEFIT 900099 3081205 3081205 INVESTMENT IN THE BLACKSTONE GROU 523000 533 533 LOSS ON REFINANCE OF DEBT 900099 -12994390 -12994390 -9912652 35827590 29103384 533 6403138 6080000 6080000 1226413 1226413 192211 192211 46742 46742 61875 61875 829734 829734 61002 61002 6505 5252 1253 49660 49660 39 39 1541 1541 6965660 6965660 27592667 27592667 61908 61908 BOND FEES 85611 85611 SALES AND USE TAX AND O 57426 57426 ALL OTHER EXPENSES 3239 3239 43322233 42129416 1192817 0 11942852 7909047 174623 87032 517758902 297148518 214875829 220610384 222093133 273313056 29539837 10002513 3670929 3670929 14412000 14631000 496709203 530223961 6628094 3685031 190266188 231162303 18808122 11058661 215702404 245905995 X 281006799 284317966 281006799 284317966 496709203 530223961 X -7494643 5577215 5228595 X 0 1 X 1 0 X X 1 NCMC BOARD OF TRUSTEES 846000813 6 1 6080000 49621000 1 6080000 49621000 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 X 1 1 PART I, LINE 11G, COLUMN (VI): IN ADDITION TO DIRECT GRANTS PROVIDED, THE ORGANIZATION FUNDED CAPITAL OUTLAYS TOTALING $31,799,000 AND FUNDED NET PRINCIPAL AND INTEREST PAYMENTS OF $17,822,000 ON LONG-TERM DEBT. PART IV, SECTION A, LINE 2: THE ORGANIZATION SUPPORTS THE NCMC BOARD OF TRUSTEES, WHICH IS NOT REQUIRED TO OBTAIN RECOGNITION OF EXEMPT STATUS BECAUSE IT IS CONSIDERED TO BE A GOVERNMENTAL ENTITY. PART IV, SECTION D, LINE 3: THE SUPPORTED ORGANIZATION HAS A SIGNIFICANT VOICE IN THE ORGANIZATION'S INVESTMENT POLICIES AND IN DIRECTING THE USE OF THE ORGANIZATION'S INCOME OR ASSETS. ALL THREE OF THE REPRESENTATIVES APPOINTED BY THE SUPPORTED ORGANIZATION ARE VOTING MEMBERS OF THE ORGANIZATION'S BOARD OF DIRECTORS AND PARTICIPATE IN THE DECISION-MAKING PROCESS AT THE HIGHEST LEVEL. IN ADDITION, ONE REPRESENTATIVE OF THE SUPPORTED ORGANIZATION SERVES ON THE FINANCE COMMITTEE, WHICH GENERALLY OVERSEES THE OPERATIONS AND FINANCIAL CONDITION OF THE ORGANIZATION, INCLUDING ITS INVESTMENT POLICIES. TWO REPRESENTATIVES OF THE SUPPORTED ORGANIZATION SERVE ON AN INTERNAL COMMITTEE WHICH MONITORS ADHERENCE TO ANY QUALITATIVE CONTRACTUAL REQUIREMENTS. NO NEW DEBT IS INCURRED BY THE ORGANIZATION WITHOUT THE APPROVAL OF THE SUPPORTED ORGANIZATION. LASTLY, THE SUPPORTED ORGANIZATION IS GIVEN A SIGNIFICANT VOICE IN THE CONDUCT OF THE ORGANIZATION'S AFFAIRS BY VIRTUE OF ITS OPERATING SUBLEASE WITH THE ORGANIZATION. PART IV, SECTION E, LINE 2A: THE ORGANIZATION SUPPORTS THE NCMC BOARD OF TRUSTEES BY CONTRACTING WITH BANNER HEALTH (AN ARIZONA 501(C)(3) ORGANIZATION) TO OPERATE THE NORTH COLORADO MEDICAL CENTER. UNDER THE TERMS OF THE CONTRACT, BANNER HEALTH SYSTEM PAYS AN ANNUAL USE CHARGE TO THE ORGANIZATION FOR HOSPITAL FACILITIES, EQUIPMENT AND THE BUSINESS FRANCHISE. THESE FUNDS, TOGETHER WITH OTHER CASH RESERVES, ARE USED BY THE ORGANIZATION TO PROVIDE THE NORTH COLORADO MEDICAL CENTER WITH LIQUID WORKING CAPITAL AND FUNDING FOR MAJOR AND ROUTINE CAPITAL EXPENDITURES. THE ORGANIZATION MAY BORROW MONEY TO FUND CAPITAL PROJECTS, WHICH RESULTS IN THE ORGANIZATION SERVICING THE DEBT INCURRED. IN ADDITION, THE ORGANIZATION ALSO PROVIDES GRANTS TO SUPPORT LOCAL HEALTHCARE CHARITIES. PLEASE SEE SCHEDULE A, PART I, LINE 11G FOR THE AMOUNT OF SUPPORT PROVIDED. THESE ACTIVITIES DIRECTLY FURTHER THE EXEMPT PURPOSE OF THE ORGANIZATION, WHICH IS TO PROVIDE QUALITY HEALTHCARE AT A REASONABLE COST TO THE NORTH COLORADO MEDICAL CENTER SERVICE AREA. PART IV, SECTION E, LINE 2B: IF THE ORGANIZATION DID NOT CONDUCT THE ACTIVITIES DESCRIBED IN SECTION E, LINE 2A, THE SUPPORTED ORGANIZATION WOULD HAVE TO DIRECTLY UNDERTAKE THE ACTIVITIES. THE SUPPORTED ORGANIZATION WAS FORMED TO PROVIDE FOR HEALTHCARE NEEDS OF THE REGION, WHICH INCLUDES THE AVAILABILITY OF HOSPITAL FACILITIES. THE SUPPORTED ORGANIZATION IS PROVIDING FOR THE HEALTHCARE NEEDS OF THE REGION THROUGH THE USE OF THE ORGANIZATION AND ITS ACTIVITIES. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 4185365 4185365 13379305 314805416 161498321 166686400 1502710 1489979 12731 171433255 126897704 44535551 5861886 6590965 7262514 5190337 220610384 INTEREST RATE SWAP 5086968 ASSET RETIREMENT OBLIGATIONS 5000000 DUE TO BANNER 971693 11058661 X 37904202 5577215 -596758 4980457 32923745 2903845 2903845 35827590 34593035 -2899464 -2899464 37492499 5829734 5829734 43322233 PART X, LINE 2: NCMC, INC. IS A COLORADO NONPROFIT CORPORATION AND HAS BEEN RECOGNIZED BY THE INTERNAL REVENUE SERVICE (IRS) AS EXEMPT FROM FEDERAL INCOME TAXES UNDER INTERNAL REVENUE CODE SECTION 501(C)(3), AND IS EXEMPT FROM FEDERAL AND STATE INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 509(A)(3) OF THE CODE. NCMC, INC. IS ANNUALLY REQUIRED TO FILE A RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX (FORM 990) WITH THE IRS. IN ADDITION, THE CORPORATION MAY BE SUBJECT TO INCOME TAX ON NET INCOME THAT IS DERIVED FROM BUSINESS ACTIVITIES THAT ARE UNRELATED TO ITS EXEMPT PURPOSE. NCMC FILES AN EXEMPT ORGANIZATION BUSINESS INCOME TAX RETURN (FORM 990T) WITH THE IRS TO REPORT ITS UNRELATED BUSINESS TAXABLE INCOME. NORMEDCO CARE, LLC; SOUTHSIDE INVESTMENTS, LLC; AND SHEEP DRAW FARMS, LLC ARE CONSIDERED DISREGARDED ENTITIES AND THEIR INCOME AND EXPENSES ARE REPORTED IN THE TAX RETURN OF THE SOLE MEMBER (NCMC). NCMC BELIEVES THAT IS HAS APPROPRIATE SUPPORT FOR ANY TAX POSITIONS TAKEN AFFECTING ITS ANNUAL FILING REQUIREMENTS AND, AS SUCH, DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS THAT ARE MATERIAL TO THE FINANCIAL STATEMENTS. NCMC WOULD RECOGNIZE FUTURE ACCRUED INTEREST AND PENALTIES RELATED TO UNRECOGNIZED TAX BENEFITS AND LIABILITIES IN INCOME TAX EXPENSE, IF SUCH INTEREST AND PENALTIES ARE INCURRED. NCMC'S HISTORICAL FEDERAL AND STATE TAX RETURNS ARE SUBJECT TO EXAMINATIONS BY TAX AUTHORITIES. PART XI, LINE 2D - OTHER ADJUSTMENTS: CHARITY CARE GRANT TO BANNER HEALTH SYSTEM -5,000,000. INCREASE IN FAIR VALUE OF HEDGING INTEREST RATE SWAP 4,845,959. PENSION-RELATED CHANGES OTHER THAN NET PERIODIC PENSION COST 1,498,856. INVESTMENT MANAGEMENT FEES, INCLUDED IN INCOME FOR FINANCIAL STATEMENTS -829,734. NET LOSS ON NON-HEDGING INTEREST RATE SWAPS -1,111,839. PART XI, LINE 4B - OTHER ADJUSTMENTS: RENTAL EXPENSES INCLUDED IN REVENUES -181,741. THE BLACKSTONE GROUP K-1 INCOME 4,381. ENVIRONMENTAL REMEDIATION BENEFIT INCLUDED IN EXP FOR FINANCIAL STATEMENT 3,081,205. PART XII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES INCLUDED IN REVENUES 181,741. ENVIRONMENTAL REMEDIATION BENEFIT INCLUDED IN EXP FOR FINANCIAL STATEMENT -3,081,205. PART XII, LINE 4B - OTHER ADJUSTMENTS: CHARITY CARE GRANT TO BANNER HEALTH SYSTEM 5,000,000. INVESTMENT MANAGEMENT FEES, INCLUDED IN INCOME FOR FINANCIAL STATEMENTS 829,734. CENTRAL AMERICA AND THE CARIBBEAN - ANTIGUA & BARBUDA, ARUBA, BAHAMAS, 0 0 INVESTMENTS N/A 10002513 0 0 0 0 0 0 10002513 0 10002513 1 0 1 0 0 0 1 BANNER HEALTH SYSTEM 1801 16TH STREET GREELEY CO 80631 450233470 501(C)(3) 5000000 CHARITY CARE NCMC FOUNDATION 1801 16TH STREET GREELEY CO 80631 840718355 501(C)(3) 1080000 OPERATIONAL ASSISTANCE AND DONATION 2 0 PART I, LINE 2: THERE IS CURRENTLY NO PROCESS IN PLACE THAT MONITORS THE USE OF GRANT FUNDS BY THE RECIPIENTS. IT IS THE POLICY OF THE BOARD OF DIRECTORS TO DISTRIBUTE GRANTS ONLY TO NOT-FOR-PROFIT ENTITIES. MOST CHARITABLE CONTRIBUTIONS ARE MADE THROUGH NCMC INC'S DONOR ADVISED FUND WHICH IS MAINTAINED BY THE NCMC FOUNDATION. THE NCMC FOUNDATION DOES VET RECIPIENTS PRIOR TO MAKING GRANTS AND ALSO MONITORS THE USE OF PROCEEDS. A COLORADO HEALTH FACILITIES AUTHORITY 840752932 19648A6F7 2016-05-12 128136617 REFUND BONDS ISSUED 11/13/03 & REIMBURSE $40 MILLION OF CAPITAL EXPENDITURES 0 0 0 B COLORADO HEALTH FACILITIES AUTHORITY 840752932 2012-07-31 60000000 FUND MCP PROJECT AND ROUTINE CAPEX 0 0 0 C COLORADO HEALTH FACILITIES AUTHORITY 840752932 2013-05-15 82000000 REFINANCE 2008 BONDS ISSUED 10/27/08 AND 2009 BONDS ISSUED 11/17/09 0 0 0 A 531632 128136617 87041234 1090647 127045970 2016 0 1 1 1 B 14130000 60000000 3560432 595000 56439568 2016 0 0 1 1 C 20762286 82000000 618950 81381050 2013 1 0 1 1 A 0 1 0 0 0.00050 0.00000 0.00050 0 0 1 B 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 C 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 0 0 0 0 0 0 1 B 0 0 0 0 0 0 0 0 1 C 0 0 0 0 1 1 BANCO BILBAO VIZCAYA ARGENTARIA 14.000000000000 0 0 0 0 1 A 1 B 1 C 1 FORM 990, SCHEDULE K, PART II, LINE 11 THE AMOUNT REPORTED ON SCHEDULE K, PART II, LINE 11, COLUMN A AND C INCLUDES THE AMOUNT OF BOND PROCEEDS USED TO REFUND THE PRIOR BONDS ISSUED. KEN SCHULTZ KEN IS NCMC INC. BOARD EXECUTIVE AND 50% OWNER OF NORTHSTAR MGMT 210580 PAYMENTS MADE TO NORTHSTAR MANAGEMENT GROUP, INC IN 2016 WERE $210,580. 0 FORM 990, PART VI, SECTION A, LINE 1 THE ORGANIZATION HAS AN EXECUTIVE COMMITTEE WHICH IS ABLE TO EXERCISE AUTHORITY OF THE BOARD WHEN THE BOARD IS NOT IN SESSION EXCEPT AS SUCH AUTHORITY IS LIMITED BY STATUTE OR BY RESOLUTION CREATING OR OTHERWISE CONTROLLING THE EXECUTIVE COMMITTEE. THE MEMBERSHIP OF THE EXECUTIVE COMMITTEE SHALL INCLUDE THE CHAIR AND PRESIDENT OF THE BOARD OF THE CORPORATION, THE CHAIR OF THE FINANCE COMMITTEE, THE CHAIR OF THE EXTERNAL COMMITTEE, THE CHAIR OF THE INTERNAL COMMITTEE AND THE VICE CHAIR OF THE BOARD. THE CHAIR AND PRESIDENT OF THE BOARD OF THE CORPORATION SHALL SERVE AS CHAIR OF THE COMMITTEE. THE EXECUTIVE COMMITTEE SHALL NOT HAVE THE AUTHORITY OF THE BOARD IN REFERENCE TO (I) APPOINTING, REMOVING OR FILLING VACANCIES IN THE MEMBERSHIP OF THE BOARD, BOARD COMMITTEES OR OFFICERS OF THE CORPORATION; (II) AMENDING THE ARTICLES OF INCORPORATION; (III) RESTATING THE ARTICLES OF INCORPORATION; (IV) ADOPTING A PLAN OF MERGER OR CONSOLIDATION WITH ANOTHER CORPORATION; (V) AUTHORIZING THE SALE, LEASE, EXCHANGE OR MORTGAGE OF ALL OR SUBSTANTIALLY ALL OF THE PROPERTY AND ASSETS OF THE CORPORATION; (VI) AUTHORIZING THE VOLUNTARY DISSOLUTION OF THE CORPORATION OR REVOKING PROCEEDINGS THEREFOR; (VII) ADOPTING A PLAN FOR THE DISTRIBUTION OF THE ASSETS OF THE CORPORATION OR (VIII) AMENDING, ALTERING OR REPEALING ANY RESOLUTION OF THE BOARD WHICH BY ITS TERMS PROVIDES THAT IT SHALL NOT BE AMENDED, ALTERED OR REPEALED BY SUCH COMMITTEE. FORM 990, PART VI, SECTION A, LINE 3 NORTHSTAR MANAGEMENT GROUP INC. IS THE MANAGEMENT COMPANY. KEN SCHULTZ IS A 50% OWNER OF THE MANAGEMENT COMPANY AND SUPERVISES ALL OF THE OPERATIONS OF NCMC, INC. PAYMENTS MADE TO NORTHSTAR MANAGEMENT GROUP FOR PROFESSIONAL FEES IN 2016 WERE $196,667 WHICH REPRESENTS THE COMPENSATION PAID TO THE BOARD EXECUTIVE FOR 2016. EXPENSE REIMBURSEMENTS PAID TO THE BOARD EXECUTIVE FOR 2016 TOTALED $13,913. FORM 990, PART VI, SECTION A, LINE 7A THE NCMC BOARD OF TRUSTEES APPOINTS A MAXIMUM OF THREE (3) BOARD MEMBERS OF NCMC, INC. NCMC, INC. IS A SUPPORTING ORGANIZATION OF NCMC BOARD OF TRUSTEES. NCMC BOARD OF TRUSTEES IS A GOVERNMENT BODY APPOINTED BY THE COUNTY COMMISSIONERS. WELD COUNTY OWNS THE LAND ON WHICH THE HOSPITAL IS LOCATED. FORM 990, PART VI, SECTION A, LINE 7B BOND ISSUES MUST BE APPROVED BY WELD COUNTY COMMISSIONERS AND THE BOARD OF TRUSTEES. FORM 990, PART VI, SECTION B, LINE 11B KEN SCHULTZ AND THE FINANCE COMMITTEE WILL REVIEW A COPY OF THE DRAFT FORM 990 AND THEN PRESENT IT TO THE BOARD OF DIRECTORS FOR APPROVAL PRIOR TO FILING THE FINAL COPY. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST POLICY COVERS THE BOARD OF DIRECTORS. THE BOARD OF DIRECTORS RECEIVES THE CONFLICT OF INTEREST POLICY AT THE ANNUAL MEETING. KEN SCHULTZ RECEIVES THE RESPONSES AND FORWARDS THEM TO THE GENERAL COUNSEL OF THE BOARD. IF THERE ARE ANY ITEMS THAT COME UP FOR DISCUSSION IN WHICH A CONFLICT OF INTEREST IS PRESENT, THE BOARD MEMBER EXCUSES HIM OR HERSELF AND ABSTAINS FROM VOTING. THE BOARD HAS THE OPTION TO ALLOW THE MEMBER TO BE PART OF THE DISCUSSION. FORM 990, PART VI, SECTION C, LINE 19 THE GENERAL PUBLIC IS ALLOWED TO VIEW THE DOCUMENTS ON PREMISES BUT NOT ALLOWED TO MAKE COPIES AND TAKE THEM OFF OF THE PREMISES. FORM 990, PART XI, LINE 9: CHANGE IN VALUE OF HEDGING INTEREST RATE SWAPS 4,845,959. PENSION-RELATED CHANGES OTHER THAN NET PERIODIC PENSION COST 1,498,856. NET GAIN/LOSS ON NON-HEDGING INTEREST RATE SWAPS -1,111,839. THE BLACKSTONE GROUP L.P. K-1 INCOME -4,381. SHEEP DRAW FARMS LLC 1801 16TH STREET GREELEY CO 80631 680540676 HOLDS TITLE TO FARM RENT INCOME CO 8000 5786414 NCMC INC SOUTHSIDE INVESTMENTS 1801 16TH STREET GREELEY CO 80631 680611503 OWNS HOUSES ADJACENT TO THE HOSPITAL CO 114379 808874 NCMC INC NORMEDCO CARE LLC 1801 16TH STREET GREELEY CO 80631 742354112 OWNS FACILITY LEASED TO A FEDERALLY QUALIFIED HEALTH CENTER FOR $1 PER YEAR CO 1 1851969 NCMC INC NCMC BOARD OF TRUSTEES 1801 16TH STREET GREELEY CO 80631 846000813 GOVERNMENTAL ACTIVITY - HOSPITAL CO GOVERNMENTAL UNIT 6 WELD COUNTY BOARD OF COUNTY COMMISSIONERS 0 NCMCBH GREELEY I LLC 1801 16TH STREET GREELEY CO 80631 900824175 LAND INVESTMENT CO NCMC INC RELATED 2274755 0 1 0.50000 NCMCBH GREELEY II LLC 1801 16TH STREET GREELEY CO 80631 900824173 LAND INVESTMENT CO NCMC INC RELATED 1199921 0 1 0.50000 NMSI DBA NORTHCARE 1801 16TH STREET GREELEY CO 80634 742354291 MEDICAL CLAIMS PROCESSING CO NCMC INC C 12821 1.00000 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 SCHEDULE R, PART V: THE ORGANIZATION HAD NO DIRECT TRANSFERS WITH THE RELATED ENTITIES IDENTIFIED ON SCHEDULE R FOR SCHEDULE R, PART V REPORTING PURPOSES. SEE SCHEDULE A, PART VI FOR ADDITIONAL INFORMATION.