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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 />

Northern Sierra Rural<br />

Health<br />

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

02/18/09<br />

Promoting Rural Health<br />

Care<br />

Quality Through the<br />

Effective<br />

$198,231.00<br />

Northern Sierra Rural<br />

Health<br />

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

02/27/09<br />

Health In<strong>for</strong>mation<br />

Exchange<br />

$37,500.00<br />

Northern Sierra Rural<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 />

$37,500.00<br />

Northern Sierra Rural<br />

Health<br />

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

08/13/09<br />

Promoting Rural Health<br />

Care<br />

Quality Through the<br />

Effective<br />

$198,231.00<br />

Northern Valley Indian<br />

Health, 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 />

Oak Valley District Hospital<br />

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

10/01/09<br />

CHAIPI Phase II<br />

$10,000.00<br />

Ocean Park Community<br />

Center<br />

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

08/13/09<br />

2008 - 2010 Shelter<br />

Initiative<br />

$15,000.00<br />

Open Door Community<br />

Health Centers<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 />

Operation Access<br />

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

04/30/09<br />

<strong>2009</strong> General Operating<br />

Support<br />

$20,000.00<br />

Operation Care<br />

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

07/31/09<br />

2008 - 2010 Shelter<br />

Initiative<br />

$5,000.00<br />

Operation Samahan, Inc.<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 />

Operation USA<br />

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

05/14/09<br />

Community Clinics Support<br />

Program - Northern<br />

Cali<strong>for</strong>nia<br />

$50,000.00<br />

Option House, Inc.<br />

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

07/31/09<br />

2008 - 2010 Shelter<br />

Initiative<br />

$10,000.00<br />

Orange County Rescue<br />

Mission Health Care<br />

Services, Inc.<br />

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

11/19/09<br />

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

Initiative<br />

$50,000.00<br />

Pacific Business Group on<br />

Health<br />

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

04/15/09<br />

The Cali<strong>for</strong>nia Quality<br />

Collaborative: Improvement<br />

Support <strong>for</strong> Physician<br />

Groups in Lower-<br />

Per<strong>for</strong>ming<br />

$137,500.00<br />

Pasadena Hospital<br />

Association, LTD<br />

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

10/29/09<br />

CHAIPI Phase II<br />

$10,000.00<br />

Peace & Joy Care Center<br />

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

07/31/09<br />

2008 - 2010 Shelter<br />

Initiative<br />

$20,000.00<br />

Peace Over Violence<br />

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

07/31/09<br />

Building Healthy Teen<br />

Relationships<br />

$125,000.00<br />

Peace Over Violence<br />

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

12/18/09<br />

Building Healthy Teen<br />

Relationships<br />

$250,000.00<br />

Petaluma Health Center<br />

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

12/02/09<br />

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

Initiative<br />

$40,000.00<br />

Philanthropy Roundtable<br />

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

12/30/09<br />

<strong>2009</strong>-2010 General<br />

Support<br />

$1,000.00<br />

Pit River Health Service,<br />

I<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 />

Placer Womens Center dba<br />

PEACE <strong>for</strong> Families<br />

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

07/31/09<br />

2008 - 2010 Shelter<br />

Initiative<br />

$10,000.00<br />

Planned Parenthood<br />

Golden<br />

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

09/04/09<br />

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

Initiative<br />

$30,000.00<br />

Page 17 <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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