SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
MediumBullet Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.
OMB No. 1545-0047
2015
Open to Public
Inspection
Name of the organization
Collier Health Services Inc
 
Employer identification number

59-1741277
Return Reference Explanation
Amended return infomation Part VII Line 1a (9), Column E: Added reportable compensation from related organizations of $410,000.Part VII Line 1d, Column E: Added reportable compensation from related organizations of $410,000.Schedule L Part IV Line 4, Column C: Added $410,000 for compensation received from IHPSchedule L Part V: Revised paragraph 1 of the explanation to include details on the $410,000 of compensation from a related organization.Schedule J Part II Line 4(ii), Column B(i): Added $410,000 base compensation.
Form 990 governing body review Part VI line 11 The CFO reviews a draft copy of the tax return for accuracy and completeness prior to signing the tax return. In addition, the Organizations finance committee reviews the tax return and a copy of the return is provided to all Board Members for review before filing.
Conflict of interest policy compliance Part VI line 12c Procurement and contracting policies include references to conflict of interest policy and procurement and contracting staff monitors transactions closely for compliance.
CEO executive director top management comp Part VI line 15a An independent compensation consultants services are utilized to review salaries.
Other officer or key employee compensation Part VI line 15b An independent compensation consultants services are utilized to review salaries.
Governing documents etc available to public Part VI line 19 The Organizations governing documents, conflict of interest policy, and financial statements are available to the public upon request without charge.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2015


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