2016-11-14T17:22:38-06:00 2015-12-31 PricewaterhouseCoopers LLP 101 SEAPORT BLVD BOSTON MA 02210 990 2015-01-01 050508742 CVS HEALTH CHARITY CLASSIC INC % JEFFREY E CLARK CVSH 4017651500 ONE CVS DRIVE WOONSOCKET RI 028956146 JEFFREY E CLARK ASSISTANT SECRETARY 4017651500 2016-11-14 true PAUL J TANIS P01441612 6175305000 2015 2017-02-10 21:41:12Z EILEEN H BOONE ONE CVS DRIVE WOONSOCKET RI 02895 8979870 false X www.cvshealthcharityclassic.com X 1999 RI SEE SCHEDULE O 3 2 0 770 0 0 2419220 4212533 0 0 228 191 -355854 -2993236 2063594 1219488 1238955 1329972 0 0 0 0 674796 288000 288000 0 0 1913751 1617972 149843 -398484 1640884 1624915 245237 516400 1395647 1108515 X SEE SCHEDULE O false false 1329972 1329972 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 $20.84 million in charitable donations to hundreds of organizations. 1329972 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 false false false false false true true false false false true 22 0 true 0 false false false false false true true true 18 false false false X 3 2 true false false false false false false true false false false true true true true true true false false false X JEFFREY E CLARK 4017701500 ONE CVS DRIVE WOONSOCKET RI 028956146 X X Eileen H Boone President/Director 0.5 40.5 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 CAROL A DENALE VICE PRESIDENT/TREASURER 0.5 40.5 X 0 0 0 THOMAS S MOFFATT SECRETARY 0.5 40.5 X 0 0 0 MELANIE K LUKER ASSISTANT SECRETARY 0.5 40.5 X 0 0 0 JEFFREY E CLARK ASSISTANT SECRETARY 0.5 40.5 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 1142930 RHODE ISLAND COUNTRY CLUB 150 NAYATT ROAD PO BOX 74 BARRINGTON RI 02806 Rental services 403215 CAA SPORTS LLC 2000 AVENUE OF THE STARS LOS ANGELES CA 90067 CONSULTING SERVICES 416254 SPECTRUM PO BOX 7130 WOODLANDS TX 77007 CATERING SERVICES 298208 ENTERTAINMENT SERVICES 101 CIRCUIT DRIVE NORTH KINGSTON RI 02852 ENTERTAINMENT 205864 8 3591479 621054 0 24108 4212533 0 191 0 191 0 0 0 0 0 0 4767146 3591479 7760382 -2993236 -2993236 0 0 0 1219488 0 -2993045 1329972 1329972 0 0 0 0 0 0 0 0 0 0 0 0 0 288000 288000 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1617972 1329972 0 288000 1227452 1251932 0 0 0 0 270988 307152 0 0 0 0 0 0 141086 65531 0 0 0 0 0 0 0 0 0 0 0 1358 300 1640884 1624915 245237 516400 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 245237 516400 X 1374487 1084731 21160 23784 0 0 1395647 1108515 1640884 1624915 X -398484 87568 23784 X false true X true false X 2913764 2529711 2685179 2419220 4212533 14760407 0 0 2913764 2529711 2685179 2419220 4212533 14760407 3726552 11033855 721 512 438 228 191 2090 0 0 14762497 19532179 0.74743 0.78893 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 9091222 87568 7760382 7847950 1243272 -23784 -23784 1219488 9378354 7760382 7760382 1617972 1617972 SCHEDULE D, PART XI, LINE 2D $7,760,382 RECLASSIFY FUNDRAISING EXPENSES. SCHEDULE D, PART XI, LINE 4B $(23,784) SPONSORSHIPS SCHEDULE D, PART XII, LINE 2D $7,760,382 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 Jacobson SportsLLC 9400 SW Barnes Rd 550 Portland OR 97225 Marketing false 8358625 288000 8070625 8358625 288000 8070625 GOLF/AUCTION 8358625 3591479 4767146 1747000 1519083 658220 588882 3247197 0 8358625 3591479 4767146 1747000 1519083 658220 588882 3247197 7760382 -2993236 true American Heart Association One State Street Suite 200 Providence RI 02908 135613797 501(C)(3) 25000 FMV Health & Human Services American Red Cross 105 Gano St Providence RI 02906 050196605 501(C)(3) 25000 FMV Disaster Relief 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) 25000 FMV Youth Development Boys & Girls Clubs of Providence 550 Wickenden St Provodence RI 02903 050258929 501(C)(3) 25000 FMV Youth Development Brain Injury Association of Rhode Island 935 Park Ave Ste 8 Cranston RI 02910 222528586 501(C)(3) 50000 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 Crossroads Rhode Island 160 Broad Street Providence RI 02903 050259094 501(C)(3) 35000 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) 20000 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) 15000 FMV 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) 50000 FMV Education Our Sister's School 145 Brownell Ave New Bedford MA 02740 260367118 501(C)(3) 20000 FMV Education PeaceLove Foundation 171 Main Street Pawtucket RI 02860 272224246 501(C)(3) 40000 FMV Arts & Culture San Miguel Education Center 525 Branch Avenue Providence RI 02904 223232973 501(C)(3) 20000 FMV Education Save The Bay 100 Save The Bay Drive Providence RI 02905 050343046 501(C)(3) 27500 FMV Education Serve Rhode Island 655 Broad St Po Box 72822 Providence RI 02907 050479705 501(C)(3) 10000 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) 20000 FMV Health & Human services Tap In PO Box 252 Barrington RI 02806 222481382 501(C)(3) 8750 FMV Community Services Tides Family Services 215 Washington Street West Warwick RI 02893 222478229 501(C)(3) 20000 FMV Health & Human Services Youth Pride Inc 743 Westminster Street Providence RI 02903 050478645 501(C)(3) 20000 FMV Health & Human Services Community Scholarship Fund of Barrington PO Box 300 Barrington RI 02806 300798085 501(C)(3) 10000 FMV Education 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 Donate Life America 701 East Byrd St 16th Fl Richmond VA 23219 541626038 501(C)(3) 10000 FMV Healthcare The Station Fire Memorial Foundation 78 Wilbur Avenue Cranston RI 02920 562382562 501(C)(3) 10000 FMV Community Services Waterfire Providence 101 Regent Avenue Providence RI 02908 222951612 501(C)(3) 10000 FMV Arts & Culture Woonsocket Little League 777 Providence Street Woonsocket RI 02895 521234693 501(C)(3) 10000 FMV Youth Development 38 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 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. 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. Independent Voting Members Form 990, Part I, Line 3 Eileen Howard Boone, the president and director of CVS Health Charity Classic, is also an officer of CVS Pharmacy, Inc. Description of Relationships Form 990, Part VI, SECTION A, Line 2 Eileen Howard Boone, a director on the CVS Health Charity Classic's Board, is also an officer of CVS Pharmacy, Inc. Jeffrey E. Clark 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, will 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 19 Governing documents, financial statements, and the organization's conflict of interest policy are available to the public upon request. Compensation of Officers Form 990, Part VI, Section B, Line 15 All persons serving as officers and directors of the organization are employed by CVS HEALTH Corporation and are compensated by CVS HEALTH Corporation for their services to CVS HEALTH Corporation. They serve voluntarily as officers and directors of the organization on an uncompensated basis. RECONCILIATION OF NET ASSETS Form 990, Part XI, Line 9 $23,784 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 false 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 SERVICE OH NA C CORP true CVS HEALTH CORPORATION ONE CVS Drive WOONSOCKET RI 02895 050494040 HOLDING COMPANY 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 true false false false false false false