2022-05-13T11:50:31-05:00 2021-12-31 760269860 Blazek & Vetterling 2900 Weslayan Suite 200 Houston TX 77027 990PF 2021-01-01 205787382 Simon Bolivar Foundation Inc SIMO 18004950010 1293 Eldridge Parkway Houston TX 77077 Mariela Poleo President 2022-05-13 1 Mariela Poleo 999009999 Kurt Coburn P01638285 7134395739 3 AAL1 IAL1 2021 2022-09-23 18:48:47Z X 3996776 X 2050000 42 42 0 -1 -1 2050041 41 0 0 0 53113 0 36865 57778 0 57778 81794 0 45294 12525 696 19816 205210 696 159753 3196028 2150888 3401238 696 2310641 -1351197 0 1939219 1164424 1164424 277055 277095 277095 1278 3935 1278 1278 2550000 2000000 2550000 2550000 3979 3979 4220209 3996776 3996776 25888 13210 1356467 2496909 1382355 2510119 X 2837854 1486657 2837854 1486657 4220209 3996776 2837854 -1351197 0 1486657 0 1486657 0 0 0 0 0 87 0 0 0 87 0 87 87 0 0 0 0 0 0 0 0 0 0 1 1 1 DE IL LA TX 1 0 0 0 0 1 https://simonbolivarfoundation.org Ms Grisell Nouis 8324864007 1293 Eldridge Parkway Houston TX 77077 1 VE 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 0 Mariela Poleo 1293 Eldridge Parkway Houston TX 77070 President 29.90 0 0 0 Oscar Montenegro 1293 Eldridge Parkway Houston TX 77070 Treasurer 1.00 0 0 0 Danny Rodriguez 1293 Eldridge Parkway Houston TX 77070 Assistant Treasurer 2.50 0 0 0 Holly Chastain Nini 1293 Eldridge Parkway Houston TX 77070 Secretary 12.50 0 0 0 Julie Okwara 1293 Eldridge Parkway Houston TX 77070 Assistant Secretary 0.25 0 0 0 Bob Shoemaker 1293 Eldridge Parkway Houston TX 77070 Controller & Ast. Treasurer 0.20 0 0 0 Gina Renee Coon 1293 Eldridge Parkway Houston TX 77070 Director 2.20 0 0 0 Imgard Carolina Molleda 1293 Eldridge Parkway Houston TX 77070 External Director 0.90 0 0 0 Andres Padilla 1293 Eldridge Parkway Houston TX 77070 Director 1.20 0 0 0 Luisa Palacios 1293 Eldridge Parkway Houston TX 77070 Director 0.40 0 0 0 Pablo Perez 1293 Eldridge Parkway Houston TX 77070 Director 1.20 0 0 0 David Weaver 1293 Eldridge Parkway Houston TX 77070 Director 0.20 0 0 0 NONE 0 NONE 0 0 0 1746940 0 1746940 0 0 1746940 26204 1720736 86037 86037 0 86037 21409 107446 0 107446 2310641 0 2310641 107446 0 0 14756862 11158236 12051363 4002061 3426199 45394721 2310641 0 0 0 107446 2203195 0 0 47597916 0 0 0 0 0 0 14756862 32841054 11158236 12051363 4002061 3426199 2203195 X Adelianny Rodriguez 1293 Eldridge Parkway Houston TX 77077 None I Medical assistance for liver transplant 52618 Alberto Arteaga 1293 Eldridge Parkway Houston TX 77077 None I Medical assistance for bone marrow transplant 8959 Amanda Merhi 1293 Eldridge Parkway Houston TX 77077 None I Medical assistance for bone marrow transplant 150 Cesar Guitierrez 1293 Eldridge Parkway Houston TX 77077 None I Medical assistance to patient residing in Venezuela for treament not available in Venezuela 16654 Felix Marin 1293 Eldridge Parkway Houston TX 77077 None I Medical assistance to patient residing in Venezuela for treament not available in Venezuela 38102 Isabella Guevara 1293 Eldridge Parkway Houston TX 77077 None I Medical assistance for liver transplant 56869 Jose Gregorio Rangel 1293 Eldridge Parkway Houston TX 77077 None I Medical assistance to patient residing in Venezuela for treament not available in Venezuela 52207 Luis Fernando Beltran 1293 Eldridge Parkway Houston TX 77077 None I Medical assistance to patient residing in Venezuela for treament not available in Venezuela 71558 Marco Bello 1293 Eldridge Parkway Houston TX 77077 None I Medical assistance for liver transplant 59762 Maria de los Angeles Amaya 1293 Eldridge Parkway Houston TX 77077 None I Medical assistance for liver transplant 47056 Mauricio Andres Suarez 1293 Eldridge Parkway Houston TX 77077 None I Medical assistance to patient residing in Venezuela for treament not available in Venezuela 42230 Nelson Useche 1293 Eldridge Parkway Houston TX 77077 None I Medical assistance for liver transplant 265965 Stephanie Milagros Rodriguez 1293 Eldridge Parkway Houston TX 77077 None I Medical assistance to patient residing in Venezuela for treament not available in Venezuela 60 Victoria Garcia 1293 Eldridge Parkway Houston TX 77077 None I Medical assistance to patient residing in Venezuela for treament not available in Venezuela 106028 Ximena Longa 1293 Eldridge Parkway Houston TX 77077 None I Medical assistance for liver transplant 36152 Zulay Martinez 1293 Eldridge Parkway Houston TX 77077 None I Medical assistance to patient residing in Venezuela for treament not available in Venezuela 376 Baylor College of Medicine One Baylor Plaza Houston TX 770303411 N/A PC Knowledge and educational program 85030 Big Little JC Organization 18235 Westridge bend Ln Cypress TX 77433 N/A PC Knowledge and educational program 10000 Cadena Foundation Inc 8900 NE 25th Ave Miami FL 33180 N/A PC Humanitarian health program 61737 Center for Disaster Philanthropy One Thomas Circle NW Suite 700 Washington DC 20005 N/A PC Knowledge and educational program 20000 Foundation Caring for Colombia LTD 139 W 120 th ST New York NY 10027 N/A PC Humanitarian health program 69926 Fundacion Academia Nacional de la Medicina Av Universidad Edif Palacio de las Academias Caracas Caracas VE N/A GOV Knowledge and educational program 56 GlobalGiving Foundation One Thomas Circle NW suite 800 Washington DC 20005 N/A PC Humanitarian health program 282000 International Federation of Red Cross 1209 Petit-Saconnex Geneva 19 SZ N/A PC Humanitarian health program 250000 Johns Hopkins University 3400 N Charles Street Baltimore MD 21218 N/A PC knowledge and educational program 74365 Pan American Development Foundation 1889 F street NW Second Floor Coconut Creek FL 33073 N/A PC Networking and Education 28500 Pan American Development Foundation 1889 F street NW Second Floor Coconut Creek FL 33073 N/A PC Humanitarian health program 75000 Project Hope-The people 7500 Old Georgetown Road Suite 600 Bethesda MD 20814 N/A PC Humanitarian health program 199998 Salesian Women Association 8300 NW 53 rd Street Suite 350 Doral FL 33166 N/A PC Small grants program 20000 Universidad Central De Venezuela Urbanizacion Los Chaguaramos Cuidad Universitaria Caracas VE N/A GOV Small grants program 19530 World Central kitchen 655 New York Ave NW 6th Floor Washington DC 20001 N/A PC Humanitarian health program 100000 2150888 Adelianny Rodriguez 1293 Eldridge Parkway Houston TX 77077 None I Medical assistance for liver transplant 135138 Alberto Arteaga 1294 Eldridge Parkway Houston TX 77078 None I Medical assistance for bone marrow transplant 2938 Amanda Merhi 1295 Eldridge Parkway Houston TX 77079 None I Medical assistance for bone marrow transplant 19867 Antonio Gomez 1296 Eldridge Parkway Houston TX 77080 None I Medical assistance for bone marrow transplant 6343 Edgardo Armas 1298 Eldridge Parkway Houston TX 77082 None I Medical assistance for bone marrow transplant 38238 Isabella Guevara 1299 Eldridge Parkway Houston TX 77083 None I Medical assistance for liver transplant 161890 Jorge Parra 1300 Eldridge Parkway Houston TX 77084 None I Medical assistance for bone marrow transplant 7965 Jose Gregorio Rangel 1301 Eldridge Parkway Houston TX 77085 None I Medical assistance to patient residing in Venezuela for treament not available in Venezuela 11944 Kelvin Lopez 1302 Eldridge Parkway Houston TX 77086 None I Medical assistance to patient residing in Venezuela for treament not available in Venezuela 25377 Leymar Guerrero 1303 Eldridge Parkway Houston TX 77087 None I Medical assistance for bone marrow transplant 7305 Luis Fernando Beltran 1304 Eldridge Parkway Houston TX 77088 None I Medical assistance to patient residing in Venezuela for treament not available in Venezuela 40056 Marco Bello 1305 Eldridge Parkway Houston TX 77089 None I Medical assistance for liver transplant 117805 Maria de los Angeles Amaya 1306 Eldridge Parkway Houston TX 77090 None I Medical assistance for liver transplant 133582 Mauricio Andres Suarez 1307 Eldridge Parkway Houston TX 77091 None I Medical assistance to patient residing in Venezuela for treament not available in Venezuela 24395 Maximo Guevara 1308 Eldridge Parkway Houston TX 77092 None I Medical assistance for bone marrow transplant 4988 Nelson Useche 1309 Eldridge Parkway Houston TX 77093 None I Medical assistance for liver transplant 341976 Oscar Breto 1310 Eldridge Parkway Houston TX 77094 None I Medical assistance for bone marrow transplant 4922 Sebasthian Perez 1311 Eldridge Parkway Houston TX 77095 None I Medical assistance for bone marrow transplant 8178 Stephanie Milagros Rodriguez 1312 Eldridge Parkway Houston TX 77096 None I Medical assistance to patient residing in Venezuela for treament not available in Venezuela 87081 Valeria Sanchez 1313 Eldridge Parkway Houston TX 77097 None I Medical assistance for bone marrow transplant 4974 Victoria Garcia 1314 Eldridge Parkway Houston TX 77098 None I Medical assistance to patient residing in Venezuela for treament not available in Venezuela 22018 Ximena Longa 1315 Eldridge Parkway Houston TX 77099 None I Medical assistance for liver transplant 98005 Zulay Martinez 1316 Eldridge Parkway Houston TX 77100 None I Medical assistance to patient residing in Venezuela for treament not available in Venezuela 6350 Cadena Foundation Inc 8900 NE 25th Ave Miami FL 33180 N/A PC Humanitarian health program 61739 Center for Disaster Philanthropy One Thomas Circle NW Suite 700 Washington DC 20005 N/A PC Knowledge and educational program 55000 Fundacion Academia National de Medicina Av Universidad Edif Palacio de las Academias Caracas Caracas VE N/A GOV Knowledge and educational program 5000 Fundacion Caring for Colombia 139 W 120 th ST New York NY 10027 N/A PC Humanitarian health program 69926 GlobalGiving Foundation One Thomas Circle NW suite 800 Washington DC 20005 N/A PC Humanitarian health program 718000 Pan American Development Foundation 1889 F street NW Second Floor Coconut Creek FL 33073 N/A PC Humanitarian health program 175000 World Central kitchen 655 New York Ave NW 6th Floor Washington DC 20001 N/A PC Humanitarian health program 100000 2496000 14 42 Foreign exchange loss 01 -1 0 41 0 41 0 0 0 0 0 0 0 0 0 0 X X 1 CITGO Petroleum Corporation PO Box 4689 Houston TX 77210 2050000 X Audit, tax planning & compliance 57778 0 57778 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. 2150888 I Love Venezuela Foundation 2825 South Miami Avenue Miami FL 33129 2020-10-15 100000 Donation of PPE for health care professionals in Venezuela 100000 No 09/02/2021 The grantor has no reason to doubt the accuracy or reliability of the report from the grantee; therefore, no independent verification of the report was made. I Love Venezuela Foundation 2826 South Miami Avenue Miami FL 33130 2020-05-27 50000 Food program for Venezuelan Diaspora 50000 No 10/21/2020 The grantor has no reason to doubt the accuracy or reliability of the report from the grantee; therefore, no independent verification of the report was made. I Love Venezuela Foundation 2827 South Miami Avenue Miami FL 33131 2020-05-26 39850 Donation to PPE for health care professionals in Venezuela 39850 No 07/14/2020, 08/20/2020, 04/20/2021 The grantor has no reason to doubt the accuracy or reliability of the report from the grantee; therefore, no independent verification of the report was made. I Love Venezuela Foundation 2828 South Miami Avenue Miami FL 33132 2020-07-27 10150 Donation to PPE for health care professionals in Venezuela 10150 No 06/16/2021 The grantor has no reason to doubt the accuracy or reliability of the report from the grantee; therefore, no independent verification of the report was made. Additional information regarding programs Part XIV, Line 3a Simon Bolvar 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 programs approved by the Foundation's Board of Directors are divided into two categories: -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 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.-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 2021 CITGO made contributions to support the programs of the Foundation in the amount of $2,050,000. Approximately 40 - 50 CITGO employees volunteer their time to the Foundation in providing services such as operational, accounting, tax, legal, procurement, audit and other services, for a total of approximately 16,590 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. The Foundation has encountered significant obstacles primarily due to delays and other complications in providing medical services relating to the COVID-19 pandemic and to transition them to other charitable organizations and medical institutions that can continue to assist with their long-term medical needs. It is unclear at this time whether or when the sanctions may be lifted or if additional sanctions may be put in place. 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 $2,837,854 (as measured by fair market value) at the beginning of the Foundation's taxable year ending December 31, 2021. Although the Foundation technically experienced a "substantial contraction," it will continue in existence and has no plans for dissolution. General governance & counsel 53113 0 36865 Bank charges 696 696 0 Other patient expenses 5820 0 9828 Insurance 5629 0 9608 Postage & freight 380 0 380 Foreign exchange loss -1 -1 -1 Administrative services 79254 0 42754 Translation services 2540 0 2540