2026-08-13T07:15:12-05:00 2025-09-30 161226221 FUSTCHARLES LLP 220 S WARREN STREET SYRACUSE NY 13202 990 2024-10-01 061718419 EMT OF CVPH INC EMTO 5185612000 75 BEEKMAN STREET PLATTSBURGH NY 12901 MATEJ KOLLAR VICE PRESIDENT 5185612000 2026-08-06 1 1 THOMAS J GIUFRE P00841958 3154463600 2026-08-06 2024 2025-03-06 01:10:19Z MICHELLE LEBEAU 75 BEEKMAN ST PLATTSBURGH NY 12901 4682321 0 X WWW.CVPH.ORG X 2004 NY THE MISSION OF EMT OF CVPH IS TO PROVIDE COST EFFECTIVE EMERGENCY MEDICAL TRANSPORTATION SERVICES. 3 0 0 0 0 0 745665 0 3679447 4682321 0 0 0 0 4425112 4682321 0 0 0 0 0 0 0 0 0 5274157 5444421 5274157 5444421 -849045 -762100 904477 1468766 1117913 2444302 -213436 -975536 THE MISSION OF EMT OF CVPH INC IS TO PROVIDE COST EFFECTIVE EMERGENCY TRANSPORTATION SERVICES. 0 0 5075247 4682321 THE ORGANIZATION SERVES THE LOCAL COMMUNITY'S NEEDS BY PROVIDING STAFFS 28 FULL-TIME, 9 PER-DIEM, AND 6 PART-TIME EMT'S. DURING 2025 AMBULATORY SERVICES PROVIDED BY THESE EMT'S AMOUNTED TO 4,699 TRANSPORTS, AND 281 NO TRANSPORTS (ASSISTANCE PROVIDED ON SITE). THE ORGANIZATION'S EMTS ALSO PROVIDE BACKUP TRANSPORT SERVICE AND ASSISTANCE TO AREA TOWNSHIPS WHEN OUTFLOW EXISTS, THEREBY FURTHER SERVING LOCAL COMMUNITIES. 5075247 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 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 2 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 3 0 0 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 0 0 0 NY X MATEJ KOLLAR 5185612000 75 BEEKMAN STREET PLATTSBURGH NY 12901 MICHELLE LEBEAU PRESIDENT/COO 1.00 49.00 X X 0 729287 133642 MATEJ KOLLAR VICE PRESIDENT 1.00 49.00 X X 0 375259 53427 BRENDAN OWENS SECRETARY/TREASURER 1.00 49.00 X X 0 0 0 0 1104546 187069 0 0 1 0 MULTIMED BILLING SERVICE INC 21 OSWEGO ST BALDWINSVILLE NY 13027 BILLING SERVICES 310702 1 AMBULATORY TRANSPORTAT 621910 3914113 3914113 CONTRACT REVENUE 621990 768208 768208 4682321 4682321 4682321 0 0 X 1853 1853 4385771 4018450 367321 12232 12232 57715 57715 1986 1986 104008 104008 BAD DEBT EXPENSE 670330 670330 FACILITY & EQUIPMENT MA 91060 91060 MEDICAL & SURGICAL EQUI 46736 46736 LEASED EQUIPMENT 17241 17241 55489 55489 5444421 5075247 369174 0 76094 332681 753145 702386 14034 14008 1236872 817181 61204 419691 904477 1468766 72576 256545 1045337 2187757 1117913 2444302 X 0 0 0 0 -213436 -975536 -213436 -975536 904477 1468766 -762100 0 X 0 1 X 1 0 X 688400 708442 724356 745665 794288 3661151 2682323 3238621 3290839 3679447 3888033 16779263 3370723 3947063 4015195 4425112 4682321 20440414 0 0 0 20440414 3370723 3947063 4015195 4425112 4682321 20440414 1.00000 1.00000 0.00000 X 1236872 817181 419691 419691 DUE TO CVPH MEDICAL CENTER - LONG TERM 2002849 DUE TO CVPH MEDICAL CENTER - SHORT TERM 184908 2187757 X PART X, LINE 2: EMT OF CVPH IS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS FOR THE UNIVERSITY OF VERMONT HEALTH NETWORK. PAGE 17 OF THE CONSOLIDATED FINANCIAL STATEMENTS CONTAINS A FOOTNOTE INDICATING THAT NO PROVISION FOR FEDERAL INCOME TAXES HAS BEEN RECORDED. 0 1 0 0 0 0 0 0 1 1 MICHELLE LEBEAU PRESIDENT/COO 0 537948 0 160216 0 31123 0 94579 0 39063 0 862929 0 0 MATEJ KOLLAR VICE PRESIDENT 0 293228 0 58290 0 23741 0 17241 0 36186 0 428686 0 0 PART I, LINE 3 CHAMPLAIN VALLEY PHYSICIANS HOSPITAL RELIED ON THE UNIVERSITY OF VERMONT HEALTH NETWORK ("UVM HEALTH NETWORK"), THE PARENT ORGANIZATION, TO ESTABLISH SENIOR EXECUTIVE COMPENSATION. UVM HEALTH NETWORK UTILIZED THE FOLLOWING METHODS TO ESTABLISH COMPENSATION: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - COMPENSATION SURVEY OR STUDY - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE PART I, LINE 8 SALARIES AND OTHER FIXED AMOUNTS PAYABLE TO EXECUTIVES SUCH AS OFFICERS AND CERTAIN KEY EMPLOYEES ARE SET BY CONTRACTS THAT ARE NEGOTIATED AND ENTERED INTO PRIOR TO THE COMMENCEMENT OF EACH EXECUTIVES' EMPLOYMENT. THE TERMS OF SUCH CONTRACTS ARE APPROVED IN ADVANCE BY THE APPROPRIATE COMPENSATION COMMITTEE OR OTHER BOARD-AUTHORIZED BODY, WHICH OBTAINS AND RELIES ON APPROPRIATE DATA AS TO COMPARABILITY PRIOR TO MAKING SUCH OFFER, AND CONCURRENTLY DOCUMENTS ITS BASIS FOR DETERMINATION. FORM 990, PART VI, SECTION A, LINE 6 COMMUNITY PROVIDERS INC IS THE SOLE MEMBER OF EMT OF CVPH. CPI MAY ELECT THE MEMBERS OF THE BOARD OF DIRECTORS OF THE ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7A EMT OF CVPH HAS AS ITS SOLE MEMBER COMMUNITY PROVIDERS INC (CPI). CPI MAY ELECT THE MEMBERS OF THE BOARD OF DIRECTORS OF THE ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 11B A COPY OF THE 990 WAS PROVIDED ELECTRONICALLY TO EACH BOARD MEMBER PRIOR TO ITS FILING. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION HAS A WRITTEN CONFLICT OF INTEREST POLICY AS PART OF ITS GOVERNING DOCUMENTS. THIS POLICY IS APPLICABLE TO MEMBERS OF THE GOVERNING BODY, OFFICERS, AND KEY EMPLOYEES. THE ORGANIZATION REQUIRES THAT MEMBERS HAVING A CONFLICT OF INTEREST IN A TRANSACTION RECUSE THEMSELVES OF VOTING ON THE MATTER. PROPOSED AND ONGOING TRANSACTIONS ARE REVIEWED BY APPROPRIATE GROUPS OF INDIVIDUALS (COMMITTEE AND/OR LEVELS OF REVIEW) TO ENSURE THE BEST INTEREST OF THE ORGANIZATION. THE ORGANIZATION SOLICITS FROM EACH MEMBER OF THE GOVERNING BODY, OFFICERS, AND KEY EMPLOYEES AN ANNUAL SIGNED STATEMENT CERTIFYING COMPLIANCE WITH THE ORGANIZATION'S CONFLICT OF INTEREST POLICY AND SELF-DISCLOSURE OF CERTAIN INTERESTS FOR EACH ANNUAL PERIOD. FORM 990, PART VI, SECTION C, LINE 19 PARTIES DESIRING A COPY OF THE ORGANIZATIONS GOVERNING DOCUMENTS,CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS MUST PRESENT THEMSELVES AT THE ADMINISTRATIVE OFFICES OR MAKE A REQUEST IN WRITING. FORM 990, PART IX, LINE 11G PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 4,018,450. MANAGEMENT AND GENERAL EXPENSES 367,321. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,385,771. UVM HEALTH NETWORK MEDICAL GROUP 111 COLCHESTER AVE BURLINGTON VT 05401 030225105 PHYSICIAN SERVICES VT 501(C)(3) LINE 12A, I UVMHN 1 UNIV OF VT MED CTR FOUNDATION INC 111 COLCHESTER AVE BURLINGTON VT 05401 263159849 FUNDRAISING VT 501(C)(3) LINE 12A, I UVMMC 1 UNIV OF VT MED CTR AUXILLIARY INC 111 COLCHESTER AVE BURLINGTON VT 05401 208022004 SERVICE VT 501(C)(3) LINE 12C, III-FI N/A 0 UNIV OF VT HEALTH NETWORK 111 COLCHESTER AVE BURLINGTON VT 05401 452880726 HOLDING COMPANY VT 501(C)(3) LINE 12A, I N/A 0 CENTRAL VT MEDICAL CENTER 111 COLCHESTER AVE BURLINGTON VT 05401 222547186 HOSPITAL VT 501(C)(3) LINE 3 UVM HLTH NET 1 UNIV OF HEALTH CENTER 111 COLCHESTER AVE BURLINGTON VT 05401 030229931 HOSPITAL VT 501(C)(3) LINE 12A, I UVMMC 1 COMMUNITY PROVIDERS INC 75 BEEKMAN STREET PLATTSBURGH NY 12901 222544844 HLTH SVC COORD NY 501(C)(3) LINE 12A, I UVM HLTH NET 1 CHAMPLAIN VALLEY PHYSICIANS HOSPITAL 75 BEEKMAN STREET PLATTSBURGH NY 12901 141338471 HOSPITAL NY 501(C)(3) LINE 3 CPI 1 ELIZABETHTOWN COMMUNITY HOSPITAL 75 PARK STREET ELIZABETHTOWN NY 12932 141364513 HOSPITAL NY 501(C)(3) LINE 3 UVMHN 1 CVPH MEDICAL CENTER FOUNDATION 75 BEEKMAN STREET PLATTSBURGH NY 12901 141727048 HLTH SVC COORD NY 501(C)(3) LINE 12B, II CVPH 1 LAKE CHAMPLAIN PHYSICIAN SERVICES PC 75 BEEKMAN STREET PLATTSBURGH NY 12901 273785445 PHYSICIAN SERVICES NY 501(C)(3) LINE 12A, I CVPH 1 UNIVERSITY MEDICAL EDUCATION ASSOCIATES 89 BEAUMONT AVENUE BURLINGTON VT 05401 237107832 EDUCATIONAL VT 501(C)(3) LINE 10 UVMHNMG 1 ALICE HYDE MEDICAL CENTER 133 PARK STREET MALONE NY 12953 150346515 HOSPITAL NY 501(C)(3) LINE 3 UVMHN 1 PORTER MEDICAL CENTER INC 115 PORTER DRIVE MIDDLEBURY VT 05753 030310862 SUPPORTING ORGANIZATION VT 501(C)(3) LINE 12C, III-FI UVM HLTH NET 1 HELEN PORTER NURSING HOME 37 PORTER DRIVE MIDDLEBURY VT 05753 030306549 NURSING HOME VT 501(C)(3) LINE 3 PCM 0 AUXILLARY OF PORTER MEDICAL CENTER 37 PORTER DRIVE MIDDLEBURY VT 05753 237363227 SUPPORTING ORGANIZATION VT 501(C)(3) LINE 12C, III-FI PCM 0 PORTER HOSPITAL 37 PORTER DRIVE MIDDLEBURY VT 05753 030181058 HOSPITAL VT 501(C)(3) LINE 3 PCM 0 UVMHN HOME HEALTH AND HOSPICE 1110 PRIM RD COLCHESTER VT 05446 030179603 SERVICE VT 501(C)(3) LINE 3 UVMHN 0 VMC INDEMNITY COMPANY INC 95 ST PAUL ST BURLINGTON VT 05401 831102018 INSURANCE VT 501(C)(3) LINE 12A, I UVMHN 0 CHAMPLAIN VALLEY HEALTH NETWORK 75 BEEKMAN STREET PLATTSBURGH NY 12901 161586102 ADMINISTRATIVE SERVICES NY COMMUNITY PROVIDERS INC C 0 MEDIQUEST INC PO BOX 1656 PLATTSBURGH NY 12901 141663061 MEDICAL OFFICE LEASE NY COMMUNITY PROVIDERS INC C 0 UVMHN VENTURES INC 111 COLCHESTER AVE BURLINGTON VT 05401 043380045 HOLDING COMPANY VT UVMHN C 0 UVM HEALTH NETWORK CREDENTIALING & ENROLLMENT 111 COLCHESTER AVE BURLINGTON VT 05401 030333056 ADMINISTRATIVE SERVICES VT UVMHN VENTURES C 0 CHARITABLE REMAINDER TRUST (6) SUPPORT VT UVMMCCVMC T 0 PERPETUAL TRUST (10) SUPPORT VT UVMMC T 0 CHARITABLE IRREVOCABLE TRUST (8) SUPPORT VT UVMMCCVMC T 0 0 0 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 0 0