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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 />

Katherine T. Wertzler<br />

Scholarship recipient<br />

08/13/09<br />

Scholarship to University <strong>of</strong><br />

Washington<br />

$2,000.00<br />

Katherine T. Wertzler<br />

Scholarship recipient<br />

12/02/09<br />

Scholarship to University <strong>of</strong><br />

Washington<br />

$2,000.00<br />

Katie M. Shelly<br />

Scholarship recipient<br />

12/02/09<br />

Scholarship to Foothill<br />

College<br />

$1,500.00<br />

Katie M. Shelly<br />

Scholarship recipient<br />

08/13/09<br />

Scholarship to Foothill<br />

College<br />

$1,500.00<br />

Kene Me-Wu Family<br />

Healing<br />

Non-pr<strong>of</strong>it, non-foundation<br />

07/31/09<br />

2008 - 2010 Shelter<br />

Initiative<br />

$5,000.00<br />

Kids Come First<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 />

Kings Community Action<br />

Organization<br />

Non-pr<strong>of</strong>it, non-foundation<br />

07/31/09<br />

2008 - 2010 Shelter<br />

Initiative<br />

$5,000.00<br />

Korean Community Center<br />

<strong>of</strong><br />

Non-pr<strong>of</strong>it, non-foundation<br />

07/31/09<br />

2008 - 2010 Shelter<br />

Initiative<br />

$5,000.00<br />

Korean Health Education<br />

In<strong>for</strong>mation and Research<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 />

LEON AND SYLVIA<br />

PANETTA INSTITUTE<br />

FOR<br />

Non-pr<strong>of</strong>it, non-foundation<br />

11/19/09<br />

General Support<br />

$20,000.00<br />

La Casa de las Madres<br />

Non-pr<strong>of</strong>it, non-foundation<br />

08/13/09<br />

2008 - 2010 Shelter<br />

Initiative<br />

$10,000.00<br />

La Clínica de la Raza, Inc.<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 />

La Cocina, Inc.<br />

Non-pr<strong>of</strong>it, non-foundation<br />

12/30/09<br />

General Operating Support<br />

$5,000.00<br />

La Maestra Family Clinic,<br />

I<br />

Non-pr<strong>of</strong>it, non-foundation<br />

09/18/09<br />

<strong>2009</strong> Community Clinic<br />

Initiative<br />

$30,000.00<br />

Laguna Beach Community<br />

Clinic<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 />

Lake Family Resource<br />

C t<br />

Non-pr<strong>of</strong>it, non-foundation<br />

07/31/09<br />

2008 - 2010 Shelter<br />

Initiative<br />

$5,000.00<br />

Lassen Family Services,<br />

I<br />

Non-pr<strong>of</strong>it, non-foundation<br />

07/31/09<br />

2008 - 2010 Shelter<br />

Initiative<br />

$5,000.00<br />

Laura's House<br />

Non-pr<strong>of</strong>it, non-foundation<br />

07/31/09<br />

2008 - 2010 Shelter<br />

Initiative<br />

$10,000.00<br />

Legal Aid <strong>Foundation</strong> <strong>of</strong><br />

Los<br />

Non-pr<strong>of</strong>it, non-foundation<br />

01/13/09<br />

Immigrant Rights <strong>for</strong><br />

Domestic Violence Victims<br />

$30,000.00<br />

Lestonnac Free Clinic<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 />

Liberty Hill <strong>Foundation</strong><br />

Non-pr<strong>of</strong>it, non-foundation<br />

01/30/09<br />

Leadership Development<br />

Grant<br />

$4,000.00<br />

Lifelong Medical Care<br />

Non-pr<strong>of</strong>it, non-foundation<br />

10/01/09<br />

<strong>2009</strong> Community Clinic<br />

Initiative<br />

$30,000.00<br />

Linsey T. Huffman<br />

Scholarship recipient<br />

08/13/09<br />

Scholarship to San Joaquin<br />

Delta College<br />

$2,000.00<br />

Linsey T. Huffman<br />

Scholarship recipient<br />

12/02/09<br />

Scholarship to San Joaquin<br />

Delta College<br />

$2,000.00<br />

Livingston Community<br />

Health<br />

Non-pr<strong>of</strong>it, non-foundation<br />

02/18/09<br />

2008 Community Clinic and<br />

Consortium Core Support<br />

Initiative<br />

$25,000.00<br />

Livingston Community<br />

Health<br />

Non-pr<strong>of</strong>it, non-foundation<br />

09/04/09<br />

<strong>2009</strong> Community Clinic<br />

Initiative<br />

$25,000.00<br />

Page 13 <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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