IRS Form 990-PF for 2009 - Blue Shield of California Foundation
IRS Form 990-PF for 2009 - Blue Shield of California Foundation
IRS Form 990-PF for 2009 - Blue Shield of California Foundation
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<strong>Blue</strong> <strong>Shield</strong> <strong>of</strong> Cali<strong>for</strong>nia <strong>Foundation</strong><br />
<strong>990</strong><strong>PF</strong>- Part XV 3a-Paid during the year<br />
Cali<strong>for</strong>nia Physicians' Service Fdn<br />
(dba <strong>Blue</strong> <strong>Shield</strong> <strong>of</strong> Cali<strong>for</strong>nia Fdn)<br />
FEIN: 94-2822302<br />
Attachment A<br />
Organization Legal Name<br />
<strong>Foundation</strong> Status <strong>of</strong><br />
Organization<br />
Payment Date<br />
Project Title<br />
Payment Amount<br />
Local Initiative Health<br />
Authority <strong>for</strong> Los Angeles<br />
County<br />
Government/tribal/public<br />
entity<br />
05/29/09<br />
<strong>2009</strong> Healthy Kids<br />
Premium<br />
$2,000,000.00<br />
Lodi Memorial Hospital<br />
Association, Inc.<br />
Non-pr<strong>of</strong>it, non-foundation<br />
10/14/09<br />
CHAIPI Phase II<br />
$10,000.00<br />
Long Beach Network <strong>for</strong><br />
Health<br />
Non-pr<strong>of</strong>it, non-foundation<br />
01/13/09<br />
Health In<strong>for</strong>mation<br />
Exchange<br />
$62,500.00<br />
Long Beach Network <strong>for</strong><br />
Health<br />
Non-pr<strong>of</strong>it, non-foundation<br />
08/13/09<br />
Health In<strong>for</strong>mation<br />
Exchange<br />
$62,500.00<br />
Long Valley Health Center<br />
Non-pr<strong>of</strong>it, non-foundation<br />
09/18/09<br />
<strong>2009</strong> Community Clinic<br />
Initiative<br />
$40,000.00<br />
Los Angeles Biomedical<br />
Research Institute at<br />
Harbor-UCLA Medical<br />
Center<br />
Non-pr<strong>of</strong>it, non-foundation<br />
10/14/09<br />
CHAIPI Phase II<br />
$10,000.00<br />
Los Angeles Christian<br />
Health<br />
Non-pr<strong>of</strong>it, non-foundation<br />
09/18/09<br />
<strong>2009</strong> Community Clinic<br />
Initiative<br />
$50,000.00<br />
Lyon-Martin Health<br />
Services, Inc.<br />
Non-pr<strong>of</strong>it, non-foundation<br />
09/04/09<br />
<strong>2009</strong> Community Clinic<br />
Initiative<br />
$50,000.00<br />
MACT Health Board, INC<br />
Non-pr<strong>of</strong>it, non-foundation<br />
01/13/09<br />
2008 Community Clinic and<br />
Consortium Core Support<br />
Initiative<br />
$40,000.00<br />
MACT Health Board, INC<br />
Non-pr<strong>of</strong>it, non-foundation<br />
10/29/09<br />
<strong>2009</strong> Community Clinic<br />
Initiative<br />
$40,000.00<br />
MEND<br />
Non-pr<strong>of</strong>it, non-foundation<br />
09/18/09<br />
<strong>2009</strong> Community Clinic<br />
Initiative<br />
$50,000.00<br />
MMC <strong>for</strong> Children &<br />
F ili<br />
Non-pr<strong>of</strong>it, non-foundation<br />
09/18/09<br />
<strong>2009</strong> Community Clinic<br />
Initiative<br />
$35,000.00<br />
Maitri Charitable Trust<br />
Non-pr<strong>of</strong>it, non-foundation<br />
07/31/09<br />
2008 - 2010 Shelter<br />
Initiative<br />
$5,000.00<br />
Marin Abused Women's<br />
Services<br />
Non-pr<strong>of</strong>it, non-foundation<br />
12/18/09<br />
Domestic Violence<br />
Advocates<br />
and Faith and Spiritual<br />
Community Leaders:<br />
Collaboratives <strong>for</strong><br />
$68,750.00<br />
Marin Abused Women's<br />
Services<br />
Non-pr<strong>of</strong>it, non-foundation<br />
07/31/09<br />
Domestic Violence<br />
Advocates<br />
and Faith and Spiritual<br />
Community Leaders:<br />
Collaboratives <strong>for</strong><br />
$68,750.00<br />
Marin Abused Women's<br />
Services<br />
Non-pr<strong>of</strong>it, non-foundation<br />
07/31/09<br />
2008 - 2010 Shelter<br />
Initiative<br />
$15,000.00<br />
Marin Community Clinics<br />
Non-pr<strong>of</strong>it, non-foundation<br />
09/04/09<br />
<strong>2009</strong> Community Clinic<br />
Initiative<br />
$40,000.00<br />
Marjaree Mason Center,<br />
I<br />
Non-pr<strong>of</strong>it, non-foundation<br />
07/31/09<br />
2008 - 2010 Shelter<br />
Initiative<br />
$15,000.00<br />
Martha's Village and<br />
Kitchen,<br />
Non-pr<strong>of</strong>it, non-foundation<br />
10/01/09<br />
<strong>2009</strong> Community Clinic<br />
Initiative<br />
$50,000.00<br />
Mathiesen Memorial Health<br />
Clinic<br />
Government/tribal/public<br />
entity<br />
09/18/09<br />
<strong>2009</strong> Community Clinic<br />
Initiative<br />
$35,000.00<br />
Matthew J. DeLaney<br />
Scholarship recipient<br />
12/02/09<br />
Scholarship to Cali<strong>for</strong>nia<br />
Polytechnic State<br />
$2,000.00<br />
Matthew J. DeLaney<br />
Scholarship recipient<br />
08/13/09<br />
Scholarship to Cali<strong>for</strong>nia<br />
Polytechnic State<br />
$2,000.00<br />
MayView Community<br />
Health<br />
Non-pr<strong>of</strong>it, non-foundation<br />
11/19/09<br />
<strong>2009</strong> Community Clinic<br />
Initiative<br />
$40,000.00<br />
Page 14 <strong>of</strong> 26<br />
January 26, 2010<br />
Data contained in this report was filtered on Payment Date between 01/01/09 and 12/31/09, Payment Status <strong>of</strong> 'Paid'.
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