Schedule I
(Form 990)
Department of the Treasury
Internal Revenue Service
Grants and Other Assistance to Organizations,
Governments and Individuals in the United States
Complete if the organization answered "Yes," to Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990.
lBullet Information about Schedule I (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public
Inspection
Name of the organization
Innovis Health LLC
 
Employer identification number
26-1175213
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient
that received more than $5,000. Part II can be duplicated if additional space is needed.
(a) Name and address of organization
or government
(b) EIN (c) IRC section
if applicable
(d) Amount of cash grant (e) Amount of non-cash
assistance
(f) Method of valuation
(book, FMV, appraisal,
other)
(g) Description of
non-cash assistance
(h) Purpose of grant
or assistance
(1) Essentia Health Foundation
502 E 2nd St
Duluth,MN55805
27-1984704 501(c)(3) 349,153       Program Support
(2) FARGO MARATHON
405 W MAIN AVE
WEST FARGO,ND58078
43-2043293 501(C)(3) 25,000       Sponsorship
(3) CHAMBER OF COMMERCE-FARGO MOORHEAD
PO BOX 2443
FARGO,ND581082443
45-0448041 501(c)(6) 25,680       Sponsorship
(4) American Heart Association
PO Box 4002902
Des Moines,IA503402902
13-5613797 501(c)(3) 39,000       Sponsorship
(5) Sheyenne Valley Community Foundation
250 West Main St
Valley City,ND58072
46-4371645 501(c)(3) 20,000       Program Support
(6) Fargo Moorhead Area Foundation
409 7th St S
Fargo,ND58103
45-6010377 501(c)(3) 10,000       Program Support
(7) American Red Cross
2025 E Street NW
Washington,DC20006
53-0196605 501(c)(3) 10,000       Sponsorship
(8) American Cancer Society Inc
250 Williams Street NW
Suite 400
Atlanta,GA30303
13-1788491 501(c)(3) 6,000       Sponsorship
(8)
(9)
(10)
(11)
(12)
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
7
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
1
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2014
Page 2

Schedule I (Form 990) 2014
Page 2
Part III
Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" to Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.
(a) Type of grant or assistance (b) Number of
recipients
(c) Amount of
cash grant
(d) Amount of
non-cash assistance
(e) Method of valuation (book,
FMV, appraisal, other)
(f) Description of non-cash assistance
(1)
(2)
(3)
(4)
(5)
(6)
(7)
Part IV
Supplemental Information. Provide the information required in Part I, line 2, Part III, column (b), and any other additional information.
Return Reference Explanation
Schedule I, Part I, Line 2 Procedures for monitoring grants: ESSENTIA HEALTH WEST MANAGEMENT REVIEWS THE GRANT ACTIVITY BY REVIEWING AND DOCUMENTING EACH EXPENDITURE REQUEST AND APPROVING THE EXPENSE.
Schedule I (Form 990) 2014



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