VOLUNTEERS IN MEDICINE - SAN FRANCISCO: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
VOLUNTEERS IN MEDICINE - SAN FRANCISCO (EIN 26-2593712)
Tax period
2012-07-01 to 2013-06-30
Filed
2013-10-17
IRS object ID
201322909349300042
Schema version
2012v2.0
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2013-10-17T16:40:21-07:00Timestamp
Tax Period End Date2013-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1Claridad & Crowe CPAsBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1PO Box 907AddressLine1
CityMill ValleyCity
StateCAState
ZIP Code94942ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN262593712EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1VOLUNTEERS IN MEDICINE - SAN FRANCISCOBusinessNameLine1
Business Name Line2DBA CLINIC BY THE BAYBusinessNameLine2
FieldValueIRS element (for citing)
Name ControlVOLUNameControl
Phone4154050222Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line14877 MISSION STREETAddressLine1
CitySAN FRANCISCOCity
StateCAState
ZIP Code94112ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameJANET REILLYName
TitlePresidentTitle
Date Signed2013-10-16DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameJASMINE C CLARIDADName
PTINP00377442PTIN
Phone4158883645Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Gross Receipts673728GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
All Affiliates IncludedfalseAllAffiliatesIncluded
Organization501c3XOrganization501c3
Web SiteWWW.CLINICBYTHEBAY.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation2008YearFormation
State Legal DomicileCAStateLegalDomicile
Activity Or Mission DescriptionTO ENGAGE VOLUNTEERS TO PROVIDE QUALITY HEALTH CARE IN A FREE CLINIC FOR THE WORKING UNINSURED.ActivityOrMissionDescription
Nbr Voting Members Governing Body14NbrVotingMembersGoverningBody
Nbr Independent Voting Members13NbrIndependentVotingMembers
Total Nbr Employees7TotalNbrEmployees
Total Nbr Volunteers195TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year543304ContributionsGrantsPriorYear
Contributions Grants Current Year672480ContributionsGrantsCurrentYear
Program Service Revenue CY0ProgramServiceRevenueCY
Investment Income Prior Year66InvestmentIncomePriorYear
Investment Income Current Year1248InvestmentIncomeCurrentYear
Other Revenue Current Year-3550OtherRevenueCurrentYear
Total Revenue Prior Year543370TotalRevenuePriorYear
Total Revenue Current Year670178TotalRevenueCurrentYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year339332SalariesEtcPriorYear
Salaries Etc Current Year387909SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year38451TotalFundrsngExpCurrentYear
Other Expense Prior Year146764OtherExpensePriorYear
Other Expenses Current Year163654OtherExpensesCurrentYear
Total Expenses Prior Year486096TotalExpensesPriorYear
Total Expenses Current Year551563TotalExpensesCurrentYear
Revenues Less Expenses Prior Year57274RevenuesLessExpensesPriorYear
Revenues Less Expenses CY118615RevenuesLessExpensesCY
Total Assets BOY268533TotalAssetsBOY
Total Assets EOY386014TotalAssetsEOY
Total Liabilities BOY9488TotalLiabilitiesBOY
Total Liabilities EOY8354TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY259045NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY377660NetAssetsOrFundBalancesEOY
Mission DescriptionTO UNDERSTAND AND SERVE, WITH DIGNITY AND RESPECT THE HEALTH AND WELLNESS NEEDS OF THE MEDICALLY UNDERSERVED IN THE SAN FRANCISCO BAY AREA.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense481012Expense
DescriptionPROGRAMS INCLUDE - FREE PRIMARY AND PREVENTIVE HEALTH CARE SERVICES FOR LOW INCOME WORKING UNINSURED ADULTS. SERVICES INCLUDE: PRIMARY CARE CLINIC VISITS; DENTAL CARE VISITS, COORDINATED REFERRALS FOR SPECIALTY, DIAGNOSTIC AND SURGICAL CARE; INDIVIDUAL AND GROUP HEALTH EDUCATION;COMMUNITY OUTREACH; AND PSYCHOSOCIAL ASSESSMENT AND REFERRALS.VOLUNTEER PROGRAM: CREATE AND SUPPORT MEANINGFUL, PROFESSIONAL OPPORTUNITIES FOR CIVIC ENGAGEMENT. RECRUITMENT, ORIENTATION, TRAINING AND ON-GOING RETENTION OF HEALTH CARE PROFESSIONALS (MD, NP, RN) AND COMMUNITY MEMBERS TO PROVIDE FREE HEALTH CARE AND HEALTH EDUCATION TO LOW INCOME UNINSURED ADULTS.Description
Total Program Service Expense481012TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmttrueIndependentAuditFinancialStmt
Consolidated Audit Financial StmtfalseConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiestrueFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredfalseScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Invest Tax Exempt BondsfalseInvestTaxExemptBonds
Escrow AccountfalseEscrowAccount
On Behalf Of IssuerfalseOnBehalfOfIssuer
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntityfalseRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With10966NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingfalseComplianceWithBackupWitholding
Number Of Employees7NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Form990-T FiledfalseForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Number Of8282 Filed0NumberOf8282Filed
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Form8899 FiledfalseForm8899Filed
Form1098 C FiledfalseForm1098CFiled
Excess Business HoldingsfalseExcessBusinessHoldings
Taxable DistributionsfalseTaxableDistributions
Distribution To DonorfalseDistributionToDonor
Filed Lieu1041falseFiledLieu1041
Licensed More Than One StatefalseLicensedMoreThanOneState
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members14NbrVotingGoverningBodyMembers
Number Independent Voting Members13NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
Election Of Board MembersfalseElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OtherfalseCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
States Where Copy Of Return Is FiledCAStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonELIZA GIBSONNamePerson
Telephone Number4154050207TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line14877 MISSION STREETAddressLine1
CitySAN FRANCISCOCity
StateCAState
ZIP Code94112ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (14 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekAverage Hours Per Week RelatedAverageHoursPerWeekRelatedIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficer
CHARLIE WILSON MD
Director2.000.00X000
PAUL TUREK MD
Director2.000.00X000
SISTER THERESA RANDOLPH
Director2.000.00X000
KEN SHACHMUT
Director2.000.00X000
RITA SEMEL
Director2.000.00X000
SETH SCHOLAR
Director2.000.00X000
JOHN LEGNITTO
Director2.000.00X000
SHALLY SHALINI IYER
Director2.000.00X000
KAREN KAUFMAN
Director2.000.00X000
LYNN JIMENEZ CATCHINGS
Director2.000.00X000
CHERYL BARTH
Treasurer2.000.00X000X
SCOTT HAUGE
Vice President8.000.00X000X
JANET REILLY
President8.000.00X000X
ELIZA GIBSON
Executive Dir.40.000.009875006061X
FieldValueIRS element (for citing)
Total Reportable Comp From Org98750TotalReportableCompFromOrg
Total Other Compensation6061TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KfalseTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources
Number Of Contractors GT100 K0NumberOfContractorsGT100K
Fundraising Events153914FundraisingEvents
All Other Contributions518566AllOtherContributions
Total Contributions672480TotalContributions
Total Program Service Revenue0TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column1248TotalRevenueColumn
Related Or Exempt Function Income1248RelatedOrExemptFunctionIncome

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
FieldValueIRS element (for citing)
Cntrbtns Rprtd Fundraising Events153914CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses3550FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column-3550TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
FieldValueIRS element (for citing)
Total Other Revenue0TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column670178TotalRevenueColumn
Related Or Exempt Function Income1248RelatedOrExemptFunctionIncome

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total102500Total
Program Services91225ProgramServices
Management And General4100ManagementAndGeneral
Fundraising7175Fundraising

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total226659Total
Program Services207201ProgramServices
Management And General4548ManagementAndGeneral
Fundraising14910Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total0Total

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total30218Total
Program Services27834ProgramServices
Management And General546ManagementAndGeneral
Fundraising1838Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total28532Total
Program Services25430ProgramServices
Management And General998ManagementAndGeneral
Fundraising2104Fundraising

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total0Total

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total12045Total
Management And General12045ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total13135Total
Program Services11551ProgramServices
Management And General144ManagementAndGeneral
Fundraising1440Fundraising

Advertising Advertising

FieldValueIRS element (for citing)
Total0Total

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total0Total

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total0Total

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total62824Total
Program Services56541ProgramServices
Management And General1885ManagementAndGeneral
Fundraising4398Fundraising

Travel Travel

FieldValueIRS element (for citing)
Total0Total

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total0Total

Interest Interest

FieldValueIRS element (for citing)
Total0Total

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total7673Total
Program Services6906ProgramServices
Management And General230ManagementAndGeneral
Fundraising537Fundraising

Insurance Insurance

FieldValueIRS element (for citing)
Total10388Total
Program Services7884ProgramServices
Management And General2504ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
ANCILLARY SERVICES26272627
SMALL EQUIPMENT1149810834199465
SUPPLIES1270612192154360
ADMINISTRATIVE EXPENSES307582078747475224

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total0Total

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total551563Total
Program Services481012ProgramServices
Management And General32100ManagementAndGeneral
Fundraising38451Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY195313BOY
EOY228542EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
EOY0EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY50940BOY
EOY99490EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
EOY0EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
EOY0EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
EOY0EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis82358LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec30576LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY16079BOY
EOY51782EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
EOY0EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
EOY0EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY6201BOY
EOY6200EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY268533BOY
EOY386014EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY9488BOY
EOY8354EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY9488BOY
EOY8354EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY171830BOY
EOY219363EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY87215BOY
EOY158297EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY259045BOY
EOY377660EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY268533BOY
EOY386014EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses118615ReconcilationRevenueExpenses
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement SeparateXFinancialStatementSeparate
FieldValueIRS element (for citing)
Audit CommitteefalseAuditCommittee
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org170b1 AviXPubliclySupportedOrg170b1Avi

Gifts Grants Contrib Received170 GiftsGrantsContribReceived170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years190825CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years342806CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years467615CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year543304CurrentTaxYearMinus1Year
Current Tax Year672480CurrentTaxYear
Total2217030Total

Tax Rev Levied For Org Benefit170 TaxRevLeviedForOrgBenefit170

FieldValueIRS element (for citing)
Total0Total

Value Srvc Fclts Furnished By Govt ValueSrvcFcltsFurnishedByGovt

FieldValueIRS element (for citing)
Total0Total

Total170 Total170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years190825CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years342806CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years467615CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year543304CurrentTaxYearMinus1Year
Current Tax Year672480CurrentTaxYear
Total2217030Total
FieldValueIRS element (for citing)
Amounts Subst Contributors Total506201AmountsSubstContributorsTotal
Public Support Total1701710829PublicSupportTotal170

Gross Investment Income170 GrossInvestmentIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years3CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years304CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years40CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year66CurrentTaxYearMinus1Year
Current Tax Year1248CurrentTaxYear
Total1661Total

Net UBI NetUBI

FieldValueIRS element (for citing)
Total0Total

Other Income170 OtherIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus3 Years976CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years324CurrentTaxYearMinus2Years
Total1300Total
FieldValueIRS element (for citing)
Total Support2219991TotalSupport
Public Support Pertcentage1700.77060PublicSupportPertcentage170
Thirty Three Percnt Tests CY170XThirtyThreePercntTestsCY170

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis25092OtherCostOrOtherBasis
Depreciation22170Depreciation
Book Value2922BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis57266OtherCostOrOtherBasis
Depreciation8406Depreciation
Book Value48860BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings51782TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionACCRUED VACATIONDescription
Amount$8,354Amount
FieldValueIRS element (for citing)
Total Of Amounts8354TotalOfAmounts
Tot Revenue Etc Audited Fincl Stmt1206781TotRevenueEtcAuditedFinclStmt
Donated Srvc And Use Of Facilities605135DonatedSrvcAndUseOfFacilities
Recoveries Of Prior Year Grants87215RecoveriesOfPriorYearGrants
Other Revenues3550OtherRevenues
Revenue Not Rptd F990695900RevenueNotRptdF990
Revenue Subtotal510881RevenueSubtotal
Other Revenues Not Included159297OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt159297RevenueNotRptdOnFinStmt
Total Revenue Per Form990670178TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt1160248TotExpensesEtcAuditedFinclStmt
Donated Services Use Of Facilities605135DonatedServicesUseOfFacilities
Other Expenses Included3550OtherExpensesIncluded
Expenses Not Rptd F990608685ExpensesNotRptdF990
Expenses Subtotal551563ExpensesSubtotal
Total Expenses Per Form990551563TotalExpensesPerForm990

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (3 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Part XII, Line 2dPart XII, Line 2d: Other expenses and losses per audited F/SSPECIAL EVENT - DIRECT EXPENSES $3550
Part XI, Line 4bPart XI, Line 4b: Other revenue amounts included on 990 but not included in F/SINC IN CURRENT YEAR TEMP REST REV $159297
Part XI, Line 2dPart XI, Line 2d: Other revenue amounts included in F/S but not included on form 990SPECIAL EVENT - DIRECT EXPENSES $3550

Schedule G IRS990ScheduleG

FieldValueIRS element (for citing)
Agreement Ref FundraisingfalseAgreementRefFundraising

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event13RD ANNUAL SPRING FUNDRAISERNameOfEvent1
Gross Receipts Event1153914GrossReceiptsEvent1
Charitable Contributions Event1153914CharitableContributionsEvent1
Other Direct Expenses Event13550OtherDirectExpensesEvent1
Gross Receipts Total153914GrossReceiptsTotal
Charitable Contributions Total153914CharitableContributionsTotal
Other Direct Expenses Total Events3550OtherDirectExpensesTotalEvents
Direct Expense Summary Events3550DirectExpenseSummaryEvents
Net Income Summary-3550NetIncomeSummary

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV

Name Of Interested Person NameOfInterestedPerson

FieldValueIRS element (for citing)
Name PersonSCOTT HAUGE-CAL InsuranceNamePerson
FieldValueIRS element (for citing)
RelationshipBOARD DIRECTORRelationship
Amount Of Transaction300AmountOfTransaction
Description Of TransactionINSURANCE PREMIUMS PDDescriptionOfTransaction
Sharing Of RevenuesfalseSharingOfRevenues

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (6 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
NON-CASH CONTRIBUTIONS OF SERVICES & GOODSVolunteers in Medicine - San Francisco d.b.a. Clinic by the Bay is committed to creating meaningful opportunities for civic engagement and as such, donated professional services and goods are core to our operations. During fiscal year 2012-2013, volunteer physicians, nurse practitioners, nurses, receptionists, interpreters and other dedicated community members donated 10,907 hours to provide free health care to low-income working uninsured adults. These hours are valued at $463,966. Additionally, needed ancillary services (lab and radiology) were donated, valued at $105,037, as well as over-the-counter medications, medical and administrative supplies ($8,772). The other largest of donated services and goods is in the area of fundraising, including event space and service, food and drink, as well as donated items for a silent auction for our annual spring fundraiser ($27,360.) The total of in-kind services and goods for fiscal year 2012 - 2013 is $605,135.
NON-CASH ASSISTANCE TO INDIVIDUALSVOLUNTEERS IN MEDICINE-SAN FRANCISCO dba CLINIC BY THE BAY PROVIDES PRIMARY CARE MEDICAL SERVICES AND LIMITED DENTAL SERVICES FOR UNINSURED ADULTS.THE ELIGIBILITY CRITERIA FOR PRIMARY CARE MEDICAL SERVICES ARE - PATIENTS MUST BE 18 YEARS OR OLDER, LIVE IN ONE OF OUR NEARBY ZIP CODES (94112,94134,94014,94015), HAVE NO INSURANCE, AND HAVE INCOME AT OR BELOW 250% OF THE FEDERAL POVERTY LEVEL. ASSISTANCE INCLUDES PRIMARY CARE OFFICE VISITS, DIAGNOSTIC AND ANCILLARY SERVICES (RADIOLOGY AND LAB). FOR THE YEAR ENDED JUNE 30, 2013, ASSISTANCE TO 1,225 RECIPIENTS WAS PROVIDED WITH A FAIR MARKET VALUE OF $445,767. FMV IS BASED ON MEDICARE 4 & 5 RATES PLUS COSTS OF LAB AND RADIOLOGY SERVICES.
Form 990, Part VI, Line 19: Other Organization Documents Publicly AvailableTAX RETURNS AND ANNUAL FINANCIAL STATEMENTS ARE AVAILABLE UPON WRITTEN REQUEST.Form 990, Part VI, Line 19
Form 990, Part VI, Line 15a: Compensation Review & Approval Process - CEO, Top ManagementTHE EXECUTIVE COMMITTEE, ON AN ANNUAL BASIS, REVIEWS AND SETS THE EXECUTIVE DIRECTOR'S SALARY. THE COMMITTEE CONSIDERS COMPARABLE SALARIES IN SIMILAR ORGANIZATIONS AS WELL AS THE PERFORMANCE OF THE DIRECTOR.Form 990, Part VI, Line 15a
Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of ConflictsALL MEMBERS OF THE GOVERNING BOARD ARE REQUIRED TO REFRAIN FROM ENGAGING IN TRANSACTIONS THAT PRESENT A CONFLICT OF INTEREST TO THE ORGANIZATION, AND MUST (AT LEAST ANNUALLY), PROVIDE A WRITTEN STATEMENT TO THE BOARD THAT NO SUCH CONFLICTS EXIST.Form 990, Part VI, Line 12c
Form 990, Part VI, Line 11b: Form 990 Review ProcessTHE ORGANIZATION ENGAGED A CPA FIRM TO PREPARE THE TAX RETURNS, WHICH IS CLOSELY REVIEWED BY THE EXECUTIVE DIRECTOR. AN ELECTRONIC VERSION IS SUBMITTED TO ALL BOARD MEMBERS FOR COMMENT BEFORE FILING.Form 990, Part VI, Line 11b

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