2025-08-18T10:18:26-05:00 2024-12-31 410746749 CLIFTONLARSONALLEN LLP 600 WASHINGTON AVENUE SUITE 1800 ST LOUIS MO 63101 990 2024-01-01 853699288 PUEBLO PRIMARY CARE QALICB PUEB 7195438711 110 EAST ROUTT AVENUE PUEBLO CO 81004 DONALD E MOORE PRESIDENT 7195438711 2025-08-15 1 1 STEPHANIE MCCARTHY P01805699 3149254300 2025-07-24 2024 2025-03-06 01:10:19Z DONALD E MOORE 110 EAST ROUTT AVENUE PUEBLO CO 81004 258881 0 X WWW.PUEBLOCHC.ORG X 2020 CO TO SUPPORT PUEBLO COMMUNITY HEALTH CENTER. 3 3 0 3 0 0 0 0 63015 252060 10752 6821 11305 0 85072 258881 981449 0 0 0 0 0 0 0 0 2329875 2221914 3311324 2221914 -3226252 -1963033 23891003 22188745 29799225 30060000 -5908222 -7871255 TO SUPPORT PUEBLO COMMUNITY HEALTH CENTER. 0 0 2221914 0 252060 PUEBLO PRIMARY CARE QALICB (PPC QALICB) WAS FORMED IN OCTOBER OF 2020 TO FACILITATE THE NEW MARKETS TAX CREDIT FINANCING FOR PUEBLO COMMUNITY HEALTH CENTER TO CONSTRUCT THE EAST SIDE CLINIC EXPANSION. 2221914 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 3 3 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 1 0 0 0 X PHILLIP DAVIS 7195438718 110 E ROUTT AVE PUEBLO CO 81004 JAY RICHTER CHAIRPERSON 1.00 0.00 X X 0 0 0 MICHELLE HILL SECRETARY AND TREASURER 1.00 0.00 X X 0 0 0 REBECCA GOODMAN DIRECTOR 1.00 0.00 X 0 0 0 DONALD E MOORE PRESIDENT 2.00 40.00 X 0 227248 31214 0 227248 31214 0 0 1 0 0 RENT INCOME 531190 252060 252060 252060 6821 6821 258881 252060 0 6821 25200 25200 215147 215147 10 10 373121 373121 1608436 1608436 2221914 2221914 0 0 402144 277184 840768 654340 217566 25890634 4850979 22648091 21039655 23891003 22188745 29313 -290088 30060000 30060000 29799225 30060000 X -5908222 -7871255 -5908222 -7871255 23891003 22188745 -1963033 0 X X 0 1 X 1 0 X X X 1 PUEBLO COMMUNITY HEALTH CENTERS 840921521 7 1 613478 0 1 613478 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 X 1 0 PART IV, SECTION D, LINE 3: THE CEO OF PUEBLO COMMUNITY HEALTH CENTER IS THE PRESIDENT OF THE PPC QALICB AND THEREFORE HAS A VOICE IN THE DIRECTION OF THE PPC QALICB'S INCOME AND ASSETS. PART IV, SECTION E, LINE 2A: PUEBLO COMMUNITY HEALTH CENTER IS THE SOLE ORGANIZATION SUPPORTED BY PPC QALICB, WHICH WAS FORMED IN OCTOBER 2020 TO FACILITATE THE NEW MARKETS TAX CREDIT FINANCING FOR PUEBLO COMMUNITY HEALTH CENTER TO CONSTRUCT THE EAST SIDE EXPANSION CLINIC PROJECT. 1245922 1245922 24644712 4850979 19793733 21039655 X 258881 0 258881 0 258881 2221914 0 2221914 0 2221914 PART X, LINE 2: THE ORGANIZATION HAS PREVIOUSLY RECEIVED NOTICE OF EXEMPTION OF INCOME TAX FROM THE INTERNAL REVENUE SERVICE UNDER SECTION 501(C)(3) OF THE FEDERAL INTERNAL REVENUE CODE (IRC). THE ORGANIZATION IS NOT A PRIVATE FOUNDATION, AND CONTRIBUTIONS TO THE ORGANIZATION QUALIFY AS CHARITABLE TAX DEDUCTIONS BY THE CONTRIBUTOR. THE ORGANIZATION FOLLOWS THE ACCOUNTING STANDARDS REGARDING THE RECOGNITION AND MEASUREMENT OF UNCERTAIN TAX PROVISIONS. THE IMPLEMENTATION OF THE ACCOUNTING STANDARDS REGARDING UNCERTAIN TAX PROVISIONS HAD NO IMPACT ON THE ORGANIZATION'S FINANCIAL STATEMENTS. THE ORGANIZATION IS NOT AWARE OF ANY ACTIVITIES THAT WOULD JEOPARDIZE ITS TAX-EXEMPT STATUS OR AWARE OF ANY ACTIVITIES THAT ARE SUBJECT TO TAX ON UNRELATED BUSINESS INCOME OR EXCISE OR OTHER TAXES. 0 0 0 0 0 0 0 0 0 DONALD E MOORE PRESIDENT 0 226248 0 1000 0 0 0 13635 0 17579 0 258462 0 0 PART I, LINE 3 COMPENSATION FOR THE CEO IS PAID BY THE BOARD OF THE RELATED ORGANIZATION PUEBLO COMMUNITY HEALTH CENTER. THE BOARD OF PUEBLO COMMUNITY HEALTH CENTER PERFORMS A THOROUGH REVIEW TO DETERMINE SUITABLE COMPENSATION FOR THE CEO. AFTER APPROVAL BY THE BOARD IN EXECUTIVE SESSION, A WRITTEN CONTRACT IS PREPARED AND SIGNED. COMPARABILITY DATA CAN INCLUDE COLORADO COMMUNITY HEALTH NETWORK OR MOUNTAIN STATES EMPLOYER'S COUNCIL COMPENSATION SURVEYS OR FORMS 990 OF SIMILAR ORGANIZATIONS. FORM 990, PART VI, SECTION A, LINE 7B PER THE ARTICLES OF INCORPORATION, PUEBLO COMMUNITY HEALTH CENTER HAS THE AUTHORITY TO AMEND THE ARTICLES OF INFORPORATION. FORM 990, PART VI, SECTION A, LINE 8B THERE ARE NO COMMITTEES WHO HAVE BEEN GRANTED AUTHORITY TO ACT ON BEHALF OF THE BOARD. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 WAS PREPARED BY AN INDEPENDENT CPA FIRM WITH INFORMATION PROVIDED BY MANAGEMENT. PRIOR TO FILING, THE 990 WAS REVIEWED IN ITS ENTIRETY BY PPC QALICB'S BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 12C PPC QALICB HAS A CONFLICT OF INTEREST POLICY THAT COVERS ALL BOARD MEMBERS, OFFICERS, DIRECTORS, MANAGERS, SUPERVISORS AND HIGHLY COMPENSATED EMPLOYEES. ALL COVERED INDIVIDUALS COMPLETE A CONFLICT OF INTEREST DISCLOSURE STATEMENT UPON JOINING PPC QALICB AND ANNUALLY THEREAFTER. ALL COVERED INDIVIDUALS HAVE AN OBLIGATION TO DISCLOSE ALL INTERESTS, ACTIONS OR RELATIONSHIPS THAT CREATE AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST OR THAT COULD CREATE SUCH. AFTER SUCH DISCLOSURE, THE INDIVIDUAL LEAVES THE MEETING WHILE THE BOARD, COMMITTEE OR SUPERVISOR DETERMINES WHETHER A CONFLICT EXISTS. IF A CONFLICT IS DEEMED TO EXIST, THE RELEVANT BODY EVALUATES WHETHER A MORE BENEFICIAL TRANSACTION IS AVAILABLE TO PPC QALICB. IF A MORE BENEFICIAL TRANSACTION IS NOT IDENTIFIED, THE RELEVANT BODY VOTES WHETHER TO ENTER THE TRANSACTION THAT INVOLVES THE CONFLICT OF INTEREST. THE INDIVIDUAL WITH THE CONFLICT DOES NOT PARTICIPATE IN THE VOTE. RECORDS ARE KEPT OF ALL SITUATIONS THAT INVOLVE AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST. IF AN INDIVIDUAL FAILS TO DISCLOSE A CONFLICT OF INTEREST, THE INDIVIDUAL IS GIVEN THE OPPORTUNITY TO EXPLAIN, AFTER WHICH THE RELEVANT BODY DETERMINES APPROPRIATE DISCIPLINARY ACTION, IF ANY. FORM 990, PART VI, SECTION C, LINE 19 PPC QALICB'S GOVERNING DOCUMENTS, CONFLICT OR INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART XII, LINE 2C: THE PROCESS FOR OVERSIGHT AND SELECTION OF AN INDEPENDENT ACCOUNTANT HAS NOT CHANGED FROM THE PRIOR YEAR. PUEBLO COMMUNITY HEALTH CENTER INC 110 EAST ROUTT AVENUE PUEBLO CO 81004 840921521 CLINIC CO 501(C)(3) LINE 7 N/A 0 0 0 0 0 1 0 0 0 0 1 0 0 1 1 1 1 1 1 1