IRS Form 990-PF for 2009 - Blue Shield of California Foundation

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Blue Shield of California Foundation 990PF- Part XV 3a-Paid during the year California Physicians' Service Fdn (dba Blue Shield of California Fdn) FEIN: 94-2822302 Attachment A Organization Legal Name Foundation Status of Organization Payment Date Project Title Payment Amount Shasta Women's Refuge, Inc. Non-profit, non-foundation 08/13/09 2008 - 2010 Shelter Initiative $10,000.00 Shasta Community Health Center Non-profit, non-foundation 09/18/09 2009 Community Clinic Initiative $30,000.00 Shasta Community Health Center Non-profit, non-foundation 08/13/09 Health Information Exchange $62,500.00 Shasta Consortium of Community Health Centers Supporting Organization 12/02/09 2009 Clinic Fiscal Health Initiative $37,500.00 Shelter From The Storm, I Non-profit, non-foundation 07/31/09 2008 - 2010 Shelter Initiative $15,000.00 Shelter Outreach Plus Non-profit, non-foundation 07/31/09 2008 - 2010 Shelter Initiative $5,000.00 Shingle Springs Band of Miwok Indians Government/tribal/public entity 11/19/09 2009 Community Clinic Initiative $35,000.00 Shingletown Medical C t Non-profit, non-foundation 09/18/09 2009 Community Clinic Initiative $25,000.00 Sierra Family Medical Clinic, Non-profit, non-foundation 09/18/09 2009 Community Clinic Initiative $25,000.00 Silicon Valley Community Foundation Non-profit, non-foundation 05/14/09 2009 Healthy Kids Premium $156,940.00 Siskiyou Domestic Violence & Non-profit, non-foundation 07/31/09 2008 - 2010 Shelter Initiative $5,000.00 Siskiyou Family Healthcare Non-profit, non-foundation 10/29/09 2009 Community Clinic Initiative $25,000.00 Six Rivers Planned Parenthood Non-profit, non-foundation 09/18/09 2009 Community Clinic Initiative $25,000.00 Small Business Majority Foundation, Inc. Non-profit, application pending 07/15/09 Small Business Healthcare Project $300,000.00 Small Business Majority Foundation, Inc. Non-profit, application pending 12/18/09 Small Business Healthcare Project $300,000.00 Society of General Internal Medicine Non-profit, non-foundation 10/29/09 Journal of the Society of General Internal Medicine $5,000.00 Solano Coalition for Better Health Non-profit, non-foundation 04/30/09 2009 Healthy Kids Premium $83,481.00 Sonoma Valley Community Health Center Non-profit, non-foundation 10/01/09 2009 Community Clinic Initiative $25,000.00 Sonoma Valley Hospital Government/tribal/public entity 03/26/09 Sonoma Valley Hospital Telemedicine Program $12,500.00 Sonoma Valley Hospital Government/tribal/public entity 10/01/09 CHAIPI Phase II $10,000.00 South Bay Children's Health Non-profit, non-foundation 09/18/09 2009 Community Clinic Initiative $25,000.00 South Bay Community Services Non-profit, non-foundation 07/31/09 2008 - 2010 Shelter Initiative $10,000.00 South Bay Family Health C Non-profit, non-foundation 09/04/09 2009 Community Clinic Initiative $30,000.00 South Central Family Health Non-profit, non-foundation 09/18/09 2009 Community Clinic Initiative $35,000.00 Southern CA Alcohol & Drug Non-profit, non-foundation 09/04/09 2008 - 2010 Shelter Initiative $10,000.00 Southern California Grantmakers Non-profit, non-foundation 12/02/09 2009-2010 General Support $10,000.00 Southern Indian Health Council, Inc. Non-profit, non-foundation 09/18/09 2009 Community Clinic Initiative $35,000.00 Page 21 of 26 January 26, 2010 Data contained in this report was filtered on Payment Date between 01/01/09 and 12/31/09, Payment Status of 'Paid'.
Blue Shield of California Foundation 990PF- Part XV 3a-Paid during the year California Physicians' Service Fdn (dba Blue Shield of California Fdn) FEIN: 94-2822302 Attachment A Organization Legal Name Foundation Status of Organization Payment Date Project Title Payment Amount Southern Trinity Health Services, Inc. Non-profit, non-foundation 10/01/09 2009 Community Clinic Initiative $35,000.00 Southside Coaltion of Community Health Centers Southwest Community Health Center St. Anthony Foundation Non-profit, non-foundation Non-profit, non-foundation Non-profit, non-foundation 12/02/09 09/18/09 09/18/09 2009 Clinic Fiscal Health Initiative 2009 Community Clinic Initiative 2009 Community Clinic Initiative $57,000.00 $40,000.00 $50,000.00 St. James Infirmary St. John's Well Child and Family Center, Inc. St. Vincent De Paul Society, Particular Council of San Non-profit, non-foundation Non-profit, non-foundation Non-profit, non-foundation 09/18/09 09/18/09 07/31/09 2009 Community Clinic Initiative 2009 Community Clinic Initiative 2008 - 2010 Shelter Initiative $50,000.00 $40,000.00 $5,000.00 St. Vincent de Paul Village, Inc. Su Casa ~ Ending Domestic Support Network for Battered Women Non-profit, non-foundation Non-profit, non-foundation Non-profit, non-foundation 10/01/09 08/13/09 07/31/09 2009 Community Clinic Initiative 2008 - 2010 Shelter Initiative 2008 - 2010 Shelter Initiative $25,000.00 $10,000.00 $15,000.00 Sutter Delta Medical Center Non-profit, non-foundation 10/01/09 CHAIPI Phase II $22,500.00 Sutter Delta Medical Center Non-profit, non-foundation 10/14/09 CHAIPI Phase II $32,500.00 Sutter Health Sacramento Sierra Region Sutter Health Sacramento Sierra Region Non-profit, non-foundation Non-profit, non-foundation 12/30/09 10/01/09 CHAIPI Phase II: Sutter Roseville Medical Center CHAIPI Phase II: Sutter Auburn Faith Hospital $10,000.00 $10,000.00 Sutter Health Sacramento Sierra Region Sutter Health Sacramento Sierra Region Sutter Solano Medical C t Swords to Plowshares Veterans Rights Non-profit, non-foundation Non-profit, non-foundation Non-profit, non-foundation Non-profit, non-foundation 12/30/09 10/01/09 12/30/09 12/30/09 CHAIPI Phase II: Sutter Davis Hospital CHAIPI Phase II: Sutter Medical Center, CHAIPI Phase II Veteran Family Violence: Increasing Awareness and Access to Service $10,000.00 $10,000.00 $10,000.00 $124,927.00 T.H.E. Clinic, Inc. Non-profit, non-foundation 09/18/09 2009 Community Clinic Initiative $25,000.00 Tahoe Women's Services Taiwan Buddhist Tzu Chi Medical Foundation USA Taproot Foundation Non-profit, non-foundation Non-profit, non-foundation Non-profit, non-foundation 09/04/09 09/18/09 09/18/09 2008 - 2010 Shelter Initiative 2009 Community Clinic Initiative Service Grant Sponsorships for Blue Shield of California Foundation¿s Grantees in Los Angeles and the San $5,000.00 $60,000.00 $60,000.00 Taproot Foundation Non-profit, non-foundation 12/18/09 Building the Capacity of Blue Shield of California Foundation¿s Grantees: $50,000.00 Tehachapi Valley Healthcare Government/tribal/public entity 08/13/09 Health Information Exchange $62,500.00 Page 22 of 26 January 26, 2010 Data contained in this report was filtered on Payment Date between 01/01/09 and 12/31/09, Payment Status of 'Paid'.
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IRS Form 990-PF for 2009 - Blue Shield of California Foundation

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