2014-12-08T17:36:12-06:00 2014-03-31 911194016 CLARK NUBER PS 10900 NE 4TH STREET SUITE 1700 BELLEVUE WA 98004 990 2013-08-27 463517778 MLCHC COMMUNITY SERVICES MLCH 5097646102 605 SOUTH COOLIDGE STREET MOSES LAKE WA 98837 AMANDA DUZON CHIEF FINANCIAL OFFICER 5097646102 2014-12-02 1 KATHRYN J ONG P00746598 4254544919 2014-12-02 2013 2015-11-30 17:44:51Z X SHEILA A CHILSON 605 SOUTH COOLIDGE STREET MOSES LAKE WA 98837 139518 0 X WWW.MLCHC.ORG X 2013 WA MLCHC COMMUNITY SERVICES WAS CREATED FOR THE NEW MARKET TAX CREDIT TRANSACTION. THIS ALLOWED FOR THE CONSTRUCTION OF A NEW QUINCY FACILITY. 5 4 0 4 0 0 139518 0 0 0 139518 0 0 0 0 0 54940 54940 84578 9511488 9426910 84578 MLCHC COMMUNITY SERVICES WAS CREATED FOR THE NEW MARKET TAX CREDIT TRANSACTION. THIS ALLOWED FOR THE CONSTRUCTION OF A NEW QUINCY FACILITY. 0 0 MLCHC COMMUNITY SERVICES IS ORGANIZED AND OPERATED EXCLUSIVELY TO BENEFIT MOSES LAKE COMMUNITY HEALTH CENTER (MLCHC), A WASHINGTON NONPROFIT CORPORATION, BY PERFORMING THE FUNCTIONS OF, OR CARRYING OUT THE PURPOSES OF MLCHC; SUCH PURPOSES BEING TO PROVIDE HEALTH SERVICES TO, IMPROVE HEALTH SERVICES OF, AND OTHERWISE IMPROVE THE HEALTH CONDITIONS OF MIGRATORY AGRICULTURAL WORKERS, RESIDENT SEASONAL AGRICULTURAL WORKERS, RURAL AND COMMUNITY POOR AND THEIR FAMILIES. 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 1 2 0 1 0 0 0 0 0 0 0 0 0 0 0 X 5 4 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 X AMANDA DUZON 5097646102 605 SOUTH COOLIDGE STREET MOSES LAKE WA 98837 SHEILA A CHILSON CHAIR 1.00 40.00 X X 0 159881 18312 JOHN BROWNE DIRECTOR 1.00 0.00 X 0 0 0 SCOTT CAMPBELL SECRETARY 1.00 2.00 X X 0 0 0 MATTHEW BENSON TREASURER 1.00 1.50 X X 0 0 0 LEANNE PARTON DIRECTOR 1.00 0.00 X 0 0 0 0 159881 18312 0 0 1 0 ALDRICH & ASSOCIATES 810 240TH STREET SE BOTHELL WA 980219397 GENERAL CONTRACTOR 3569226 1 139518 139518 139518 139518 0 0 0 447 447 54493 54493 54940 0 54940 0 0 2428176 6568575 7057 0 6561518 0 521794 0 9511488 0 695910 0 8731000 0 9426910 X 0 84578 0 84578 0 9511488 84578 0 X 0 1 X 1 0 X X X X 0 0 0 MOSES LAKE COMMUNITY HEALTH CENTER 911537371 7 1 1 1 0 1 0 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 244518 244518 181466 7057 174409 6142591 6142591 6561518 21744558 0 21744558 -21605040 -21605040 139518 20397935 20342995 20342995 54940 0 54940 PART XI, LINE 4B - OTHER ADJUSTMENTS: REVENUE FROM AFFILIATES -21,605,040. PART XII, LINE 2D - OTHER ADJUSTMENTS: EXPENSES FROM AFFILIATES 20,342,995. 0 0 0 0 0 0 0 0 0 SHEILA A CHILSON CHAIR 0 159479 0 100 0 302 0 5540 0 12772 0 178193 0 0 X 1 139518 COST 0 0 0 0 PART I, COLUMN (B): THE NUMBER REPORTED ON PART I, COLUMN B, REPRESENTS THE NUMBER OF CONTRIBUTIONS RECEIVED. FORM 990, PART I, LINE 6: THE BOARD OF DIRECTORS PER MLCHC COMMUNITY SERVICES BYLAWS REQUIRES A BOARD COMPOSITION OF 5 MEMBERS. ALL VOLUNTEER POSITIONS ARE RELATED TO INVOLVEMENT ON THE BOARD, EITHER AS AN ELECTED MEMBER OR ADVISORY MEMBER. THESE INDIVIDUALS CONTRIBUTE A MINIMUM OF 1 HOUR PER YEAR IN THIS CAPACITY. ONE MEMBER OF THE BOARD IS COMPENSATED BY MOSES LAKE COMMUNITY HEALTH CENTER, A RELATED ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 11 UPON COMPLETION OF THE FORM 990, THE RETURN WILL BE REVIEWED IN DETAIL WITH THE BOARD FINANCE COMMITTEE OF MLCHC, A RELATED ORGANIZATION, AND THEN IN SUMMARY WITH THE BOARD OF DIRECTORS OF MLCHC. UPON APPROVAL BY THE BOARD OF DIRECTORS, THE FINAL FORM 990 WILL BE SUBMITTED TO THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION C, LINE 19 THESE DOCUMENTS ARE AVAILABLE UPON REQUEST FOR VIEWING AT THE ORGANIZATION'S MAIN BUSINESS OFFICE IN THE PRESENCE OF THE CFO OR CEO OF MOSES LAKE COMMUNITY HEALTH CENTER, A RELATED ORGANIZATION. FORM 990, PART VI, LINES 12, 13, AND 14: MLCHC COMMUNITY SERVICES RELIES ON THE CONFLICT OF INTEREST POLICY, WHISTLEBLOWER POLICY AND DOCUMENT RETENTION AND DESTRUCTION POLICY OF MOSES LAKE COMMUNITY HEALTH CENTER, A RELATED ORGANIZATION. MOSES LAKE COMMUNITY HEALTH CENTER 605 SOUTH COOLIDGE STREET MOSES LAKE WA 98837 911537371 PRIMARY HEALTH SERVICES WA 501(C)(3) LINE 7 N/A 0 0 0 1 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1