2012-05-15T12:43:08-05:00 2011-06-30 MARCUM LLP 2049 CENTURY PARK EAST 300 LOS ANGELES CA 90067 990 2010-07-01 237255435 TRI-CITY HEALTH CENTER TRI- 5107708133 39500 LIBERTY STREET FREMONT CA 94538 TED SHIMANUKI 5107708133 2012-05-14 1 SANDRA VAN KEUREN 3104539400 2010 2016-02-24 21:20:13Z TED SHIMANUKI 39500 LIBERTY STREET FREMONT CA 94538 18363440 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. 11 11 232 83 0 0 8137037 7708232 10069645 10638344 2525 1769 1840 15095 18211047 18363440 0 0 0 0 10988977 12245961 0 0 126984 5515905 5522621 16504882 17768582 1706165 594858 9534840 10744331 3440980 4055613 6093860 6688718 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 15055252 10653439 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. 15055252 1 1 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 1 232 1 0 0 0 0 0 0 0 0 0 0 X 11 11 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 155589 0 0 TED SHIMANUKI 37.50 X 120000 0 0 FRANCISCO CARPIO JR 37.50 X 157195 0 0 JAN VON DICKEY 37.50 X 167095 0 0 DURRIYAH MOGRI 37.50 X 176743 0 0 NIKHAT NAZNEEN 37.50 X 149524 0 0 ANGELIQUE GREEN 37.50 X 156629 0 0 1082775 0 0 12 0 1 0 M BARAKZOY DDS INC 38056 MARTHA AVENUE FREMONT CA 94536 DENTAL SERVICES 1020769 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 304432 5 7488693 219539 192257 7708232 PROG.SERV.REVENUE-RELA 621400 10638344 10638344 10638344 1769 1769 MISCELLANEOUS REVENUE 900099 15095 15095 15095 18363440 10653439 0 1769 1082774 888910 188365 5499 8419745 6912235 1464745 42765 2743442 2318467 412269 12706 2307513 2255345 45623 6545 14578 12039 2140 399 585716 442997 126392 16327 237137 131461 99575 6101 109961 83220 23677 3064 264355 210187 46884 7284 57503 42536 14967 SUPPLIES 1198875 1140906 52065 5904 CLIENT EXPENSES 218871 180771 32126 5974 TELEPHONE 110302 91101 16190 3011 BAD DEBT EXPENSE 109095 90104 16013 2978 DUES & SUBS 83960 69344 12324 2292 224755 185629 32991 6135 17768582 15055252 2586346 126984 54894 394282 1992623 1962959 787508 500214 2774394 3479610 199104 198296 69619 96471 6035434 1958182 3618603 4077252 38095 35247 9534840 10744331 1650379 1913602 252047 397061 1538554 1313276 0 431674 3440980 4055613 X 5793934 6402241 299926 286477 6093860 6688718 9534840 10744331 594858 0 X 0 1 1 X 1 1 X 4772186 5721380 5950482 8137037 7708232 32289317 4772186 5721380 5950482 8137037 7708232 32289317 32289317 12322 18271 2525 1769 34887 10096 7440 348 1840 15095 34819 32359023 0.99780 0.99800 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 901172 901172 3122907 953983 2168924 83041 67243 15798 1823208 936956 886252 105106 105106 4077252 OTHER LIABILITIES 431674 431674 18363440 17768582 594858 0 594858 18386315 22875 22875 18363440 0 18363440 17791457 22875 22875 17768582 0 17768582 X X 0 0 0 0 0 0 0 0 0 KATHLEEN A LIEVRE 139783 0 0 0 15806 0 0 0 0 0 155589 0 0 0 FRANCISCO CARPIO JR 146908 0 0 0 10287 0 0 0 0 0 157195 0 0 0 JAN VON DICKEY 156519 0 0 0 10576 0 0 0 0 0 167095 0 0 0 DURRIYAH MOGRI 165346 0 0 0 11397 0 0 0 0 0 176743 0 0 0 ANGELIQUE GREEN 138806 0 0 0 17823 0 0 0 0 0 156629 0 0 0 X EHR PROJECT 1 192257 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.