2022-11-15T15:32:13-06:00 2021-12-31 135565207 KPMG LLP 60 SOUTH STREET BOSTON MA 02111 990 2021-01-01 050508742 CVS HEALTH CHARITY CLASSIC INC CVSH 4017651500 ONE CVS DRIVE WOONSOCKET RI 028956146 JOSHUA COLE ASSISTANT TREASURER 4017651500 2022-11-15 1 JOSHUA COLE 999009999 STEPHANIE LONCZAK P01880207 6179881000 3 AAL1 IAL1 2021 2022-09-23 18:48:47Z EILEEN H BOONE ONE CVS DRIVE WOONSOCKET RI 028956146 3685734 0 X WWW.CVSHEALTHCHARITYCLASSIC.COM X 1999 RI SEE SCHEDULE O 5 3 0 12 0 0 2655534 2219522 0 0 0 0 -535434 -601022 2120100 1618500 1502500 1621500 0 0 0 0 0 0 0 0 6500 1502500 1628000 617600 -9500 1678584 1599387 461953 407256 1216631 1192131 X SEE SCHEDULE O 0 0 1628000 1621500 THE CVS HEALTH CHARITY CLASSIC, INC. WAS ESTABLISHED TO RAISE MONEY VIA A WORLD CLASS GOLF VENUE FOR THE SUPPORT OF OTHER NON-PROFIT AGENCIES THROUGHOUT NEW ENGLAND. SINCE 1999, THE CVS HEALTH CHARITY CLASSIC, INC. HAS ALLOCATED OVER $28 MILLION IN CHARITABLE DONATIONS TO HUNDREDS OF ORGANIZATIONS. 1628000 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 4 0 1 0 0 0 0 0 0 1 1 1 0 0 0 0 0 X 5 3 1 0 0 0 0 0 0 1 0 0 0 1 1 1 1 1 1 0 0 0 X JEFFREY E CLARK 4017705815 ONE CVS DRIVE WOONSOCKET RI 028956146 X EILEEN H BOONE PRESIDENT/DIRECTOR 0.50 41.50 X X 0 0 0 WAYNE CHARNESS DIRECTOR 0.50 0.00 X 0 0 0 SCOTT COWPER DIRECTOR 0.50 0.00 X 0 0 0 MARK G KOLLIGIAN DIRECTOR 0.50 0.00 X 0 0 0 FAITH WEINER DIRECTOR 0.50 40.50 X 0 0 0 CAROL A DENALE VICE PRESIDENT/ TREASURER 0.50 41.50 X 0 0 0 THOMAS S MOFFATT SECRETARY 0.50 41.50 X 0 0 0 JEFFREY E CLARK ASSISTANT SECRETARY 0.50 41.50 X 0 0 0 MELANIE K ST ANGELO ASSISTANT SECRETARY 0.50 41.50 X 0 0 0 0 0 0 0 0 0 0 OCTAGON INC 290 HARBOR DRIVE STAMFORD CT 06902 ENTERTAINMENT 825000 1 1444795 774727 2219522 1466212 1444795 2067234 -601022 -601022 1618500 0 0 -601022 1621500 1621500 PHOTOGRAPHY 6500 6500 1628000 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STREET BARRINGTON RI 02806 050258878 501(C)(3) 35000 0 FMV GENERAL BOSTON GLOBE SANTA 1 EXCHANGE PL STE 201 BOSTON MA 02109 042731195 501(C)(3) 10000 0 FMV GENERAL EAST LAKE FOUNDATION 2606 ALSTON DRIVE SE ATLANTA GA 30317 582204306 501(C)(3) 10000 0 FMV GENERAL FAMILY AID BOSTON 3815 WASHINGTON ST BOSTON MA 021303745 042105756 501(C)(3) 15000 0 FMV GENERAL HABITAT FOR HUMANITY 9 SOUTH WASHINGTON ST ATTLEBORO MA 02740 043014778 501(C)(3) 10000 0 FMV GENERAL LEGACY FUNDSOCIAL IMPACT CENTER (ROXBURY MA) 328 WARREN STREET ROXBURY MA 02119 043506648 501(C)(3) 15000 0 FMV GENERAL NEW ENGLAND PATRIOTS FOUNDATION ONE PATRIOT PLACE FOXBORO MA 02035 043244069 501(C)(3) 25000 0 FMV GENERAL THE RED SOX FOUNDATION INC 4 JERSEY WAY BOSTON MA 02215 331007984 501(C)(3) 25000 0 FMV GENERAL HOLE IN THE WALL GANG FUND INC 555 LONG WHARF DR NEW HAVEN CT 065116107 061157655 501(C)(3) 50000 0 FMV GENERAL 76 PART I, LINE 2: DESCRIPTION OF ORGANIZATIONAL PROCEDURES THE PARTICIPATING ORGANIZATIONS ARE ASKED TO COMPLETE A GRANT APPLICANT QUESTIONNAIRE IN WHICH THEY ARE REQUIRED TO PROVIDE INFORMATION REGARDING PROGRAMS, FINANCES, TAX STATUS INFORMATION & COPIES OF TAX RETURNS. THE CVS HEALTH CHARITY CLASSIC REVIEWS ALL DOCUMENTS SUBMITTED BY GRANT APPLICANTS AND INDEPENDENTLY VERIFIES TAX-EXEMPT STATUS. IN ADDITION, THE CVS HEALTH CHARITY CLASSIC REVIEWS THE IMPACT OF THE PROPOSED GRANT ON THE RESIDENTS OF RHODE ISLAND. FORM 990, PART I, LINE 1 AND PART III, LINE 1 THE PURPOSE OF THE ORGANIZATION IS TO ORGANIZE AND CONDUCT FUNDRAISING EVENTS IN ORDER TO RAISE MONEY TO MAKE CHARITABLE CONTRIBUTIONS TO ORGANIZATIONS THAT ARE EXEMPT FROM TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND WHOSE TAX EXEMPT PURPOSES RELATES DIRECTLY OR INDIRECTLY TO THE HEALTH EDUCATION AND/OR GENERAL WELFARE OF THE GENERAL PUBLIC. FORM 990, PART VI, SECTION A, LINE 2 EILEEN HOWARD BOONE, A DIRECTOR ON THE CVS HEALTH CHARITY CLASSIC'S BOARD, IS ALSO AN OFFICER OF CVS PHARMACY, INC. JEFFERY E. CLARK, FAITH WEINER AND MELANIE K. ST ANGELO ARE EMPLOYEES OF CVS PHARMACY, INC. CAROL A. DENALE AND THOMAS S. MOFFATT ARE OFFICERS OF CVS HEALTH CORPORATION. FORM 990, PART VI, SECTION A, LINE 8B COMMITTEE AUTHORITY THERE ARE NO COMMITTEES WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11B PROCESS FOR REVIEW OF FORM 990 CVS HEALTH EMPLOYEES GATHER ALL DATA FOR THE RETURN AND PROVIDE THE INFORMATION TO AN OUTSIDE ACCOUNTING FIRM FOR PREPARATION. THE RETURN IS REVIEWED BY CVS HEALTH MANAGEMENT AND THE OUTSIDE ACCOUNTING FIRM THAT SIGNS AS PREPARER. THE MANAGEMENT OF THE CHARITY CLASSIC REVIEWS THE RETURN AND MAKES ANY ADJUSTMENTS DEEMED NECESSARY TO FILE A COMPLETE AND ACCURATE RETURN. BEFORE FILING WITH THE IRS, THE COMPLETE FORM 990 IS PROVIDED TO THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 12C EACH DIRECTOR, OFFICER, AND MEMBER OF A COMMITTEE WITH BOARD-DELEGATED POWERS IS AN INTERESTED PERSON AND MUST ANNUALLY AFFIRM THAT THEY HAVE RECEIVED A COPY OF THE CONFLICT OF INTEREST POLICY OF CVS HEALTH CORPORATION, AND HAVE AGREED TO COMPLY WITH THE POLICY. IN CONNECTION WITH ANY ACTUAL OR POSSIBLE CONFLICT OF INTEREST, AN INTERESTED PERSON HAS AN ONGOING DUTY TO DISCLOSE THE EXISTENCE OF THE FINANCIAL INTEREST AND SHALL BE GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS TO THE DIRECTORS AND MEMBERS OF COMMITTEES WITH BOARD-DELEGATED POWERS CONCERNING THE PROPOSED TRANSACTION OR ARRANGEMENT. AFTER DISCLOSURE OF THE FINANCIAL INTEREST AND ALL MATERIAL FACTS, AND AFTER ANY DISCUSSIONS WITH THE INTERESTED PERSON, HE OR SHE SHALL LEAVE THE BOARD OR COMMITTEE MEETING DURING THE DISCUSSION OF THE POTENTIAL CONFLICT OF INTEREST AND THE VOTE ON WHETHER A CONFLICT OF INTEREST EXISTS. IF A CONFLICT OF INTEREST IS FOUND TO EXIST, THE CHAIRMAN OF THE BOARD OR THE COMMITTEE SHALL, IF APPROPRIATE, APPOINT A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT. AFTER EXERCISING DUE DILIGENCE, THE BOARD OR COMMITTEE SHALL DETERMINE WHETHER THE CORPORATION CAN OBTAIN WITH REASONABLE EFFORTS A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT FROM A PERSON OR ENTITY THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST. FORM 990, PART VI, SECTION C, LINE 19 PUBLIC ACCESS TO ORGANIZATION'S DOCUMENTS GOVERNING DOCUMENTS, FINANCIAL STATEMENTS AND THE ORGANIZATION'S CONFLICT OF INTEREST POLICY ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9: NET ASSETS RELATED FROM RESTRICTIONS -15,000. 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