2023-05-15T09:55:36-05:00 2022-12-31 760269860 Blazek & Vetterling 2900 Weslayan Suite 200 Houston TX 77027 990PF 2022-01-01 205787382 Simon Bolivar Foundation Inc SIMO 18004950010 1293 Eldridge Parkway Houston TX 77077 Mariela Poleo President 2023-05-15 1 Mariela Poleo 999009999 1 Kurt Coburn P01638285 7134395739 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z X 2781022 X 3900000 7474 7474 0 -45 -45 3907429 7429 0 0 0 6525 0 13806 45109 0 45109 5994 0 60994 34076 3678 23641 91704 3678 143550 3972231 4975963 4063935 3678 5119513 -156506 3751 1164424 1089666 1089666 277095 284592 284592 2778 1278 2778 2778 1400000 2550000 1400000 1400000 3979 3986 3986 3996776 2781022 2781022 13210 7791 2496909 1443080 2510119 1450871 X 1486657 1330151 1486657 1330151 3996776 2781022 1486657 -156506 0 1330151 0 1330151 52 0 52 0 52 87 0 0 0 87 0 35 35 0 0 0 0 0 0 0 0 0 0 1 1 1 DE LA TX 1 0 0 0 0 1 https://simonbolivarfoundation.org Ms Grisell Nouis 8324864007 1293 Eldridge Parkway Houston TX 77077 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Mariela Poleo 1293 Eldridge Parkway Houston TX 77070 President 35.50 0 0 0 Oscar Montenegro 1293 Eldridge Parkway Houston TX 77070 Treasurer 0.20 0 0 0 Danny Rodriguez 1293 Eldridge Parkway Houston TX 77070 Assistant Treasurer 0.30 0 0 0 Holly Chastain Nini 1293 Eldridge Parkway Houston TX 77070 Secretary 10.40 0 0 0 Julie Okwara 1293 Eldridge Parkway Houston TX 77070 Assistant Secretary 0.00 0 0 0 Bob Shoemaker 1293 Eldridge Parkway Houston TX 77070 Controller & Ast. Treasurer 0.10 0 0 0 Andres Padilla 1293 Eldridge Parkway Houston TX 77070 Director 0.40 0 0 0 Pablo Perez 1293 Eldridge Parkway Houston TX 77070 Director 0.40 0 0 0 David Weaver 1293 Eldridge Parkway Houston TX 77070 Director 0.40 0 0 0 NONE 0 NONE 0 0 0 1436137 0 1436137 0 0 1436137 21542 1414595 70730 70730 52 52 70678 0 70678 0 70678 5119513 0 5119513 70678 0 0 11158236 12051363 4002061 3426199 2203195 32841054 5119513 0 0 0 70678 5048835 0 0 37889889 0 0 0 0 0 0 11158236 26731653 12051363 4002061 3426199 2203195 5048835 X Adelianny Rodriguez 1293 Eldridge Parkway Houston TX 77077 None I Medical assistance for liver transplant 37488 Alberto Arteaga 1293 Eldridge Parkway Houston TX 77077 None I Medical assistance for bone marrow transplant 1930 Amanda Merhi 1293 Eldridge Parkway Houston TX 77077 None I Medical assistance for bone marrow transplant 150 Antonio Gomez 1293 Eldridge Parkway Houston TX 77077 None I Medical assistance for bone marrow transplant 5759 Isabella Guevara 1293 Eldridge Parkway Houston TX 77077 None I Medical assistance for liver transplant 56907 Jose Gregorio Rangel 1293 Eldridge Parkway Houston TX 77077 None I Medical assistance to patient residing in Venezuela for treament not available in Venezuela 1965 Luis Fernando Beltran 1293 Eldridge Parkway Houston TX 77077 None I Medical assistance to patient residing in Venezuela for treament not available in Venezuela 72559 Marco Bello 1293 Eldridge Parkway Houston TX 77077 None I Medical assistance for liver transplant 46656 Maria de los Angeles Amaya 1293 Eldridge Parkway Houston TX 77077 None I Medical assistance for liver transplant 47963 Mauricio Andres Suarez 1293 Eldridge Parkway Houston TX 77077 None I Medical assistance to patient residing in Venezuela for treament not available in Venezuela 23114 Maximo Guevara 1293 Eldridge Parkway Houston TX 77077 None I Medical assistance for bone marrow transplant 6303 Nelson Useche 1293 Eldridge Parkway Houston TX 77077 None I Medical assistance for liver transplant 263927 Stephanie Milagros Rodriguez 1293 Eldridge Parkway Houston TX 77077 None I Medical assistance to patient residing in Venezuela for treament not available in Venezuela 572 Valeria Sanchez 1293 Eldridge Parkway Houston TX 77077 None I Medical assistance for bone marrow transplant 6452 Victoria Garcia 1293 Eldridge Parkway Houston TX 77077 None I Medical assistance to patient residing in Venezuela for treament not available in Venezuela 20614 Ximena Longa 1293 Eldridge Parkway Houston TX 77077 None I Medical assistance for liver transplant 49774 Aid for Aids 131 Varick St Suite 1006 New York NY 10013 N/A PC Small grants program 41515 Baylor College of Medicine One Baylor Plaza Houston TX 770303411 N/A PC Networking and educational program 12238 Big Little JC Organization 18235 Westridge bend Ln Cypress TX 77433 N/A PC Small grants program 50000 Cadena Foundation Inc 8900 NE 25th Ave Miami FL 33180 N/A PC Humanitarian health program 30869 Fundacion Caring for Colombia 139 W 120 th ST New York NY 10027 N/A PC Humanitarian health program 69926 Friends of the Children of Venezuela Inc 1333 S Miami Avenue Suite 100 Miami FL 33130 N/A PC Humanitarian health program 250000 Fundahigado America Foundation 3900 Westerre Parkway Suite 300 Richmond VA 23233 N/A PC Humanitarian health program 138836 Global Impact 1199 North Fairfax Street Suite 300 Alexandria VA 22314 N/A PC Humanitarian health program 125000 GlobalGiving Foundation One Thomas Circle NW suite 800 Washington DC 20005 N/A PC Humanitarian health program 868000 Hermanos de la calle 240 Crandon Blvd Suite 263 Key Biscayne FL 33149 N/A PC Small grants program 32000 International Federation of Red Cross 1209 Petit-Saconnex Geneva 19 SZ N/A PC Humanitarian health program 633357 International Medical Corps 12400 Wilshire Boulevard Suite 1500 Los Angeles CA 35321 N/A PC Humanitarian health program 115250 Latin Ladies Foundation of Houston 4722 Natural Bridge Dr Kingwood TX 77345 N/A PC Networking and educational program 5000 MedGlobal Inc 10604 Sothwest Highway Suite 107 Chicago Ridge IL 60415 N/A PC Humanitarian health program 124850 Medical Teams International 14150 SW Milton Court Tigard OR 97224 N/A PC Humanitarian health program 125000 Pan American Development Foundation 1889 F street NW Second Floor Coconut Creek FL 33073 N/A PC Humanitarian health program 425000 Project Hope-The people 7500 Old Georgetown Road Suite 600 Bethesda MD 20814 N/A PC Humanitarian health program 200000 Saludos connection 3770 Farber St Houston TX 77005 N/A PC Networking and educational program 15000 Scalabrini Intl Migration Network Inc 307 East 60th Street New York NY 100221505 N/A PC Humanitarian health program 90000 Sociedad Amigos Del Hep 9600 NW 25th Street Suite 6D Doral FL 33172 N/A PC Humanitarian health program 200000 Texas Children's Hospital 1919 S Braeswood Blvd 5th Floor Houston TX 77030 N/A PC Humanitarian health program 124989 Universidad Central De Venezuela Urbanizacion Los Chaguaramos Cuidad Universitaria Caracas VE N/A GOV Networking and educational program 130000 Ven da Tu Mano Fundacion Inc 2825 South Miami Avenue Miami FL 33129 N/A PC Humanitarian health program 175000 Venezuela Now Inc PO Box 2855 Acworth GA 30102 N/A PC Humanitarian health program 250000 Wellness for Growth Foundation 14053 Memorial Dr 204 Houston TX 77079 N/A PC Networking and educational program 2000 World Central kitchen 655 New York Ave NW 6th Floor Washington DC 20001 N/A PC Humanitarian health program 100000 4975963 Adelianny Rodriguez 1293 Eldridge Parkway Houston TX 77077 None I Medical assistance for liver transplant 129819 Isabella Guevara 1293 Eldridge Parkway Houston TX 77077 None I Medical assistance for liver transplant 111119 Luis Fernando Beltran 1293 Eldridge Parkway Houston TX 77077 None I Medical assistance to patient residing in Venezuela for treament not available in Venezuela 42669 Marco Bello 1293 Eldridge Parkway Houston TX 77077 None I Medical assistance for liver transplant 77058 Maria de los Angeles Amaya 1293 Eldridge Parkway Houston TX 77077 None I Medical assistance for liver transplant 110810 Mauricio Andres Suarez 1293 Eldridge Parkway Houston TX 77077 None I Medical assistance to patient residing in Venezuela for treament not available in Venezuela 16456 Nelson Useche 1293 Eldridge Parkway Houston TX 77077 None I Medical assistance for liver transplant 199724 Sebasthian Perez 1293 Eldridge Parkway Houston TX 77077 None I Medical assistance to patient residing in Venezuela for treament not available in Venezuela 9537 Stephanie Milagros Rodriguez 1293 Eldridge Parkway Houston TX 77077 None I Medical assistance to patient residing in Venezuela for treament not available in Venezuela 86518 Ximena Longa 1293 Eldridge Parkway Houston TX 77077 None I Medical assistance for liver transplant 58894 Asociacion Cardiovascular Centro Occidental Barrio La feria Prolongacion de la Carrera 17 con calle 12 Barquisimeto Lara VE N/A NC Hospital equipment program in Venezuela 100000 Medical Teams International 14150 SW Milton Court Tigard OR 97224 N/A PC Humanitarian health program 125000 Scalabrini Intl Migration Network Inc 307 East 60th Street New York NY 100221505 N/A PC Humanitarian health program 90000 Texas Children's Hospital 1919 S Braeswood Blvd 5th Floor Houston TX 77030 N/A PC Humanitarian health program 124990 Ven Da Tu Mano Foundation 2825 South Miami Avenue Miami FL 33129 N/A PC Humanitarian health program 125000 Greater Houston Hispanic Chamber of Comm 1801 Main Street Suite 890 Houston TX 77002 N/A PC Networking and educational program 30000 Fundacion Academia Nacional Av Universidad Edif Palacio de las Academias Caracas VE N/A NC Networking and educational program 5000 1442594 14 7474 Foreign exchange loss 01 -45 0 7429 0 7429 0 0 0 0 0 0 0 0 0 0 X X 1 CITGO Petroleum Corporation PO Box 4689 Houston TX 77210 3900000 X Audit, tax planning & compliance 45109 0 45109 See Part XIV Line 3a 1293 Eldridge Parkway Houston TX 77077 The Foundation made distributions of cash to the grantees listed in the attachment to Part XIV, Line 3a; each such grant was made solely for the charitable purpose listed on the schedule. Although the Foundation technically experienced a "substantial contraction," it will continue in existence and has no plans for dissolution. 4975963 Additional information regarding programs Part XIV, Line 3a Simon Bolivar Foundation Inc. primarily funds charitable grants to improve the health of vulnerable populations affected by disaster, conflict and poverty, with special attention to mothers and children, in and out of Venezuela, with three main objectives: i) increasing access to medicine and nutrition thereby improving the wellbeing of vulnerable populations, ii) enhancing capacity of medical professionals and caregivers to serve and treat patients in need through education and support and iii) empowerment of charitable and non-governmental organizations (NGOs) to serve the health needs of the most vulnerable individuals in their communities. The charitable programs approved by the Foundation's Board of Directors are divided into two categories: 1. Humanitarian Health grants that provide support to charitable programs and organizations that align with the Foundation's goals of expanding access to medicine and nutrition that ultimately improves the well-being of the most vulnerable individuals in and from Venezuela. These programs include strategic partnerships with renowned and long-standing 501(c)(3) not-for-profit organizations and other qualified charitable organizations with demonstrated capacity to execute humanitarian health programs in Venezuela, the United States and the Latin American region and knowledge transfer grants that aim to enhance the capacity of medical professionals and caregivers to serve and treat patients in need in Venezuela and the region; and 2. Medical grants that support critically ill patients in need. The Foundation is located in Houston, Texas. CITGO Petroleum Corporation ("CITGO") is the sole member and contributor of the Foundation at this time. During 2022 CITGO made contributions to support the programs of the Foundation in the amount of $3,900,000. Approximately 34 CITGO employees volunteer part of/all their time to the Foundation in providing services such as operational, accounting, tax, legal, procurement, audit and other services, for a total of approximately 10,377 volunteer hours. On January 28, 2019, the U.S. Department of Treasury's Office of Foreign Assets Control ("OFAC") added CITGO's ultimate parent company Petroleos de Venezuela, S.A. (PDVSA) to the List of Specially Designated nationals and Blocked Persons ("SDN List"), generally prohibiting U.S. persons from engaging in any transaction in which PDVSA or any entity owned 50 percent or more by PDVSA has any property interest. On February 26, 2019, OFAC issued special license No. Venezuela-EO13850-2019-359230-1 authorizing the Foundation to continue to provide charitable assistance and financial support for ongoing medical treatment, medicines, medical devices, and related services to patients referred by PDVSA, as well as to cover any remaining expenses in connection with such treatment pursuant to existing grant agreements with the patients and service agreements with the patients' healthcare providers and other providers entered into prior to January 28, 2019. This special license was subsequently extended until July 31, 2023 to allow more time to transition the remaining patients to other charitable organizations and/or medical institutions that can continue to assist with their long-term medical needs. The following information is submitted in accordance with Treasury Regulation Section 1.6043-3(a)(1) and the Form 990-PF instructions: The Foundation made distributions of cash to the grantees listed in the attachment to Part XIV, Line 3a; each such grant was made solely for the charitable purpose listed on the schedule. During this tax year, the Foundation paid grants in an amount representing more than 25% of the Foundation's net assets of $1,486,657 (as measured by fair market value) at the beginning of the Foundation's taxable year ending December 31, 2022. Although the Foundation technically experienced a "substantial contraction," it will continue in existence and has no plans for dissolution. General governance & counsel 6525 0 13806 Bank charges 3678 3678 0 Other patient expenses 9723 0 4800 Insurance 9560 0 9567 Advertising 11115 0 9274 Foreign exchange loss -45 -45 -45 Administrative services 3574 0 58574 Translation services 2420 0 2420