2013-05-15T14:12:13-05:00 2012-06-30 111986323 MARCUM LLP 101 MONTGOMERY STREET 1900 SAN FRANCISCO CA 94104 990 2011-07-01 237255435 TRI-CITY HEALTH CENTER TRI- 5107708133 39500 LIBERTY STREET FREMONT CA 94538 ZETTIE PAGE 5107708133 2013-05-15 1 BARBARA A BOND P00294787 4159819400 2011 2016-02-24 21:20:13Z ZETTIE PAGE 39465 PASEO PADRE PKWY 3400 FREMONT CA 94538 20837323 0 X WWW.TRI-CITYHEALTH.ORG X 1970 CA TCHC IS COMMITTED TO DELIVERING EXCELLENT HEALTH SERVICES IN A CARING, NURTURING, AND RESPECTFUL ATMOSPHERE; WE PROMOTE OPTIMAL HEALTH, ELIMINATE PREVENTABLE DISEASES, AND IMPROVE THE QUALITY OF LIFE FOR EVERY INDIVIDUAL AND FAMILY IN OUR COMMUNITY. TCHC PROVIDES A WIDE SPECTRUM OF HEALTH EDUCATION, HEALTHCARE, AND SOCIAL SERVICES TO EVERYONE, WITHOUT REGARD TO FINANCIAL POSITION, ETHNICITY, LANGUAGE, CULTURE, SEXUAL ORIENTATION OR ANY OTHER CRITERION. TCHC IS A FISCALLY RESPONSIBLE, INDEPENDENT, NOT-FOR-PROFIT COMMUNITY HEALTH CENTER AND A KEY MEMBER OF OUR COMMUNITY'S VITAL HEALTH SAFETY-NET. 10 10 261 83 0 0 7708232 10805861 10638344 9562554 1769 472 15095 468436 18363440 20837323 0 0 0 0 12245961 13783030 0 0 673671 5522621 7099157 17768582 20882187 594858 -44864 10744331 10483576 4055613 4405586 6688718 6077990 X TRI-CITY IS A FISCALLY RESPONSIBLE NON-PROFIT HEALTH CENTER PROVIDING A DIVERSE SPECTRUM OF EDUCATION, HEALTHCARE AND SOCIAL SERVICES. WE ARE A FREE STANDING COMMUNITY HEALTH CENTER AND MEMBER OF A KEY SERVICE PROVIDER NETWORK WHO SERVE EVERYONE WITHOUT REGARD TO FINANCIAL POSITION, ETHNICITY, LANGUAGE, CULTURE, SEXUAL ORIENTATION OR ANY OTHER CRITERION. WITH A COMMITMENT TO SERVE IN A CARING, NURTURING ATMOSPHERE, WE STRIVE TO PROMOTE OPTIMAL HEALTH, ELIMINATE PREVENTABLE DISEASES, AND IMPROVE THE QUALITY OF LIFE FOR EVERY INDIVIDUAL AND FAMILY IN OUR SOUTH, EASTERN AND CENTRAL ALAMEDA COUNTY COMMUNITY. 0 0 15697401 10030990 TO PROVIDE PRIMARY AND PREVENTATIVE HEALTH CARE AND RELATED MEDICAL AND HEALTH EDUCATION SERVICES TO PERSONS OF EVERY AGE. TO PROVIDE QUALITY HEALTH CARE REGARDLESS OF THE PATIENT'S ABILITY TO PAY. 15697401 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1 233 0 1 261 1 0 0 0 0 0 0 0 0 0 0 X 10 10 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 CA X X THE ORGANIZATION 5107708133 39500 LIBERTY STREET FREMONT CA 95438 KIM DOUGLAS 1.00 X 0 0 0 ROBERT WYCKOFF 1.00 X 0 0 0 CHRIS BROWN 1.00 X 0 0 0 BRENDA QUILLIN 1.00 X 0 0 0 ANA ISABEL ALVAREZ 1.00 X 0 0 0 MARILYN CAMPO 1.00 X 0 0 0 ELAINE NAGEL 1.00 X 0 0 0 DIANA PADILLA 1.00 X 0 0 0 XOCHITL PASAYE 1.00 X 0 0 0 STEPHANIE REDDELL 1.00 X 0 0 0 LONA RUSS 1.00 X 0 0 0 KATHLEEN A LIEVRE 37.50 X 147064 0 0 TED SHIMANUKI 37.50 X 124350 0 0 FRANCISCO CARPIO JR 37.50 X 150604 0 0 ARUNA REDDY 37.50 X 136337 0 0 DURRIYAH MOGRI 37.50 X 157343 0 0 NIKHAT NAZNEEN 37.50 X 144555 0 0 KHANH DO 37.50 X 121175 0 0 981428 0 0 14 0 1 0 M BARAKZOY DDS INC 38056 MARTHA AVENUE FREMONT CA 94536 DENTAL SERVICES 1019430 ALAMEDA COUNTY MEDICAL CENTER 1411 EAST 31ST STREET OAKLAND CA 94602 HEALTHCARE - HIV 424454 OMNI CONSTRUCTION SERVICES INC 533 AIRPORT BOULEVARD 555 BURLINGAME CA 94010 CONSTRUCTION 349623 DATAWAY INC 180 REDWOOD STREET SUITE 300 SAN FRANCISCO CA 94102 COMPUTER SOFTWARE & HARDWARE 344373 QUEST DIAGNOSTICS PO BOX 515002 SACRAMENTO CA 95851 MEDICAL SERVICES 302641 11 9053704 1752157 105821 10805861 PATIENT & THIRD PARTY 621400 9562554 9562554 9562554 472 472 MISCELLANEOUS REVENUE 621400 468436 468436 468436 20837323 10030990 0 472 981428 762576 171980 46872 9615507 7471313 1684972 459222 3186095 2492884 575644 117567 3115981 2808535 302264 5182 15545 7649 7533 363 708522 48297 660225 261416 127447 124373 9596 104602 7621 96954 27 378680 115222 258533 4925 44293 27348 16945 SUPPLIES 1518736 1360377 150656 7703 CLIENT EXPENSES 214057 105328 103731 4998 BAD DEBT EXPENSE 143206 70465 69397 3344 TELEPHONE 127866 62917 61963 2986 466253 229422 225945 10886 20882187 15697401 4511115 673671 394282 -116629 1962959 321756 500214 1167003 3479610 3322889 198296 207615 96471 54108 7832224 2336862 4077252 5495362 35247 31472 10744331 10483576 1913602 2141887 397061 504380 1313276 1238309 431674 521010 4055613 4405586 X 6402241 5966818 286477 111172 6688718 6077990 10744331 10483576 X -44864 -565864 X X 0 1 1 X 1 1 X 5721380 5950482 8137037 7708232 10826734 38343865 5721380 5950482 8137037 7708232 10826734 38343865 38343865 12322 18271 2525 1769 427 35314 7440 348 1840 15095 468908 493631 38872810 0.98640 0.99780 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 901172 901172 3989912 1096463 2893449 101576 75718 25858 2304901 1164681 1140220 534663 534663 5495362 OTHER LIABILITIES 521010 521010 20837323 20882187 -44864 -565864 -565864 -610728 20290332 18873 -565864 -546991 20837323 0 20837323 20901060 18873 18873 20882187 0 20882187 PART XI, LINE 8 - OTHER ADJUSTMENTS: NET ASSETS RELEASED FROM RESTRICTIONS -565,864. PART XII, LINE 2D - OTHER ADJUSTMENTS: NET ASSETS RELEASED FROM RESTRICTIONS -565,864. X X 0 0 0 0 0 0 0 0 0 FRANCISCO CARPIO JR 124880 0 0 0 25724 0 0 0 0 0 150604 0 0 0 DURRIYAH MOGRI 154117 0 0 0 3226 0 0 0 0 0 157343 0 0 0 X SUPPLIES AND EQUIPMENT 1 105821 FAIR MARKET VALUE 0 0 0 FORM 990, PART VI, SECTION B, LINE 11 FORM 990 IS REVIEWED BY THE AUDIT COMMITTEE, AS DELEGATED BY THE BOARD OF DIRECTORS, BEFORE IT IS FILED. FORM 990, PART VI, SECTION B, LINE 12C YES, THE ORGANIZATION REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY. ALL EMPLOYEES SIGN A CONFLICT OF INTEREST QUESTIONNAIRE WHEN HIRED. FORM 990, PART VI, SECTION B, LINE 15 PAY GRADES ARE ESTABLISHED THROUGH INDEPENDENT ENTITIES, MARKET RESEARCH, AND EMPLOYMENT AGENCIES. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES AVAILABLE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS TO THE PUBLIC BY WRITTEN OR VERBAL REQUEST. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET ASSETS RELEASED FROM RESTRICTIONS -565,864. TOTAL TO FORM 990, PART XI, LINE 5: -565,864. FORM 990, PART XII, LINE 2C: NO CHANGES WERE MADE TO THE OVERSIGHT PROCESS OR SELECTION PROCESS.