Form 990, Part VI, Section A, Line 7A
“Election of members and their rights governing body is elected by the members”
Shirley Community Ambulance Corp
990 • Fiscal year 2019 • EIN 11-2468521
Siviq Scores
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Balance Sheet
Assets
Flat$837,648
Flat from 2019
Net Assets
Flat$785,859
Flat from 2019
Liabilities
Flat$51,789
Flat from 2019
Revenue And Expenses
Revenue
Down$889,863
Down $229,086 (-20%) from 2019
Expenses
Down$827,355
Down $229,086 (-22%) from 2019
Net Income
Flat$62,508
Flat from 2019
Historical Trend
Jump To
Filing Snapshot
- Filing Period
- Jan 1, 2019 to Dec 31, 2019
- Signed
- Nov 4, 2020
- Return Version
- 2019v5.1
- Gross Receipts
- $889,863
Mission and Program Overview
Mission
AMBULATORY SERVICES
Balance Sheet Detail
| Line | Beginning | End | Change |
|---|---|---|---|
| Assets | |||
| Rtn Earn Endowment Incm Other Fnds | $723,351 | $785,859 | ▲ $62,508 |
| Land, Buildings, and Equipment, Net | $309,007 | $486,718 | ▲ $177,711 |
| Savings and Temporary Cash Investments | $387,054 | $219,955 | ▼ $167,099 |
| Cash and Non-Interest-Bearing Accounts | $113,577 | $117,361 | ▲ $3,784 |
| Pd in Cap Srpls Land Bldg Eqp Fund | $0 | $0 | → $0 |
| Cap Stk Tr Prin Current Funds | $0 | $0 | → $0 |
| Total Assets | $809,888 | $837,648 | ▲ $27,760 |
| Other Assets Total | $250 | $13,614 | ▲ $13,364 |
| Liabilities | |||
| Other Liabilities | $86,537 | $51,789 | ▼ $34,748 |
| Total Liabilities | $86,537 | $51,789 | ▼ $34,748 |
| Net Assets / Fund Balance | |||
| Total Net Assets Fund Balance | $723,351 | $785,859 | ▲ $62,508 |
| Total Liabilities and Net Assets / Fund Balance | $809,888 | $837,648 | ▲ $27,760 |
Asset Categories
| Asset | Book Value | Depreciation | Basis |
|---|---|---|---|
| Other Land Buildings | $454,368 | $1,840,492 | $2,294,860 |
| Buildings | $32,350 | $150,955 | $183,305 |
Compensation and Service Providers
Board Members and Trustees
| Name | Title |
|---|---|
| Marc Lampart | President |
| James Deutesh | 1st Vice President |
| Ben Doll | 2nd Vice President |
| Anthony Minelli | Secretary |
| Christopher Colagiovanni | Treasurer |
Revenue and Support
Revenue Composition
- Contributions and Grants
- $887,730
- Program Service Revenue
- $0
- Investment Income
- $366
- Other Revenue
- $1,767
- Change in Net Assets
- $62,508
Expenses and Functional Allocation
Major Expense Lines
| Line Item | Amount |
|---|---|
| Other Expenses | $610,910 |
| Salaries, Compensation, and Employee Benefits | $216,445 |
| Grants and Similar Amounts Paid | $0 |
| Professional Fundraising Fees | $0 |
| Total Fundraising Expense | $0 |
Functional Expense Allocation
| Line Item | Program | Management | Fundraising | Total |
|---|---|---|---|---|
| Other Salaries and Wages | $200,409 | - | - | $200,409 |
| All Other Expenses | $157,177 | $13,573 | - | $170,750 |
| Depreciation Depletion | $102,995 | - | - | $102,995 |
| Other Expenses | $51,963 | - | - | $51,963 |
| Occupancy | $17,706 | $17,706 | - | $35,412 |
| Office Expenses | $16,366 | - | - | $16,366 |
| Payroll Taxes | $16,036 | - | - | $16,036 |
| Fees for Services Accounting | $1,000 | - | - | $1,000 |
| Travel | $891 | - | - | $891 |
| Total Functional Expenses | $796,076 | $31,279 | $0 | $827,355 |
Fundraising, Events, and Gaming
- Fundraising activities
- No
- Gaming activities
- No
- Professional fundraiser used
- No
Fundraising and Gaming Totals
| Line Item | Amount |
|---|---|
| Professional Fundraising Fees | $0 |
Political and Lobbying Activity
- Political campaign activity
- No
- Subject to proxy tax
- No
Debt and Bond Financing
Other Reported Liabilities
| Liability | Amount |
|---|---|
| L/p- US Bank Equip. Finance | $44,816 |
| Capital One Credit Card | $6,973 |
Governance and Compliance
Governance Checklist
- Compiled or reviewed by an accountant
- No
- Business relationship with 35% controlled entity
- No
- Business relationship with family members
- No
- Business relationship with organization members
- No
- Material changes to governing documents
- No
- Compensation from other sources disclosed
- No
- CEO compensation reviewed
- No
- Other officer compensation reviewed
- No
- Conflict-of-interest policy
- No
- Audited financial statements prepared
- No
- Key decisions subject to board approval
- No
- Management duties delegated
- No
Governance Explanations
Form 990, Part VI, Section B, Line 11B
“Organization's process to review form 990. No review was or will be conducted.”
Form 990, Part VI, Section C, Line 18
“No documents available to public”
Form 990, Part VI, Section C, Line 19
“Governing documents disclosure explanation, no documents available to the public”
Filing and Contact Details
Filer
- Filer Name
- Shirley Community Ambulance
- EIN
- 11-2468521
- Phone
- 6313995380
- Address
- PO BOX 72, SHIRLEY, NY 11967
Signing Officer
- Name
- Marc Lampart
- Title
- President
- Phone
- 6313995380
- Signed
- 2020-11-04
- Discuss with paid preparer
- Yes
Organization Details
- Principal Officer
- Marc Lampart
- Legal Domicile
- Ny
- Voting Board Members
- 58
- Independent Board Members
- 0
- Employees
- 19
- Volunteers
- 0
Preparer
- Firm
- Michael Verderosa CPA Pc
- Address
- 243 MADISON STREET, MASTIC BEACH, NY 11951
- Preparer
- Michael Verderosa
- Phone
- 6315787057
Supplemental Narrative
Additional Explanations
Form 990, Part IX, Line 24E
“Medical supplies: program service expenses 33,229. Management and general expenses 13,573. Fundraising expenses 0. Total expenses 46,802. Education: program service expenses 24,559. Management and general expenses 0. Fundraising expenses 0. Total expenses 24,559. Communication equipment: program service expenses 22,456. Management and general expenses 0. Fundraising expenses 0. Total expenses 22,456. Clothing and protective gear: program service expenses 20,369. Management and general expenses 0. Fundraising expenses 0. Total expenses 20,369. Medical equipment`: program service expenses 18,983. Management and general expenses 0. Fundraising expenses 0. Total expenses 18,983. Tools and supplies: program service expenses 13,480. Management and general expenses 0. Fundraising expenses 0. Total expenses 13,480. Conferences and seminars: program service expenses 11,771. Management and general expenses 0. Fundraising expenses 0. Total expenses 11,771. Keyless entry security: program service expenses 6,116. Management and general expenses 0. Fundraising expenses 0. Total expenses 6,116. Fundraising expenses: program service expenses 3,887. Management and general expenses 0. Fundraising expenses 0. Total expenses 3,887. Contracts: program service expenses 2,327. Management and general expenses 0. Fundraising expenses 0. Total expenses 2,327.”
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| IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt | 1 | ORGANIZATION'S PROCESS TO REVIEW FORM 990. NO REVIEW WAS OR WILL BE CONDUCTED. |
| IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt | 2 | NO DOCUMENTS AVAILABLE TO PUBLIC |
| IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt | 3 | GOVERNING DOCUMENTS DISCLOSURE EXPLANATION, NO DOCUMENTS AVAILABLE TO THE PUBLIC |
| IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt | 4 | MEDICAL SUPPLIES: PROGRAM SERVICE EXPENSES 33,229. MANAGEMENT AND GENERAL EXPENSES 13,573. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 46,802. EDUCATION: PROGRAM SERVICE EXPENSES 24,559. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 24,559. COMMUNICATION EQUIPMENT: PROGRAM SERVICE EXPENSES 22,456. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 22,456. CLOTHING AND PROTECTIVE GEAR: PROGRAM SERVICE EXPENSES 20,369. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 20,369. MEDICAL EQUIPMENT`: PROGRAM SERVICE EXPENSES 18,983. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 18,983. TOOLS AND SUPPLIES: PROGRAM SERVICE EXPENSES 13,480. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 13,480. CONFERENCES AND SEMINARS: PROGRAM SERVICE EXPENSES 11,771. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 11,771. KEYLESS ENTRY SECURITY: PROGRAM SERVICE EXPENSES 6,116. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 6,116. FUNDRAISING EXPENSES: PROGRAM SERVICE EXPENSES 3,887. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,887. CONTRACTS: PROGRAM SERVICE EXPENSES 2,327. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,327. |
| IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc | 0 | FORM 990, PART VI, SECTION A, LINE 7A |
| IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc | 1 | FORM 990, PART VI, SECTION B, LINE 11B |
| IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc | 2 | FORM 990, PART VI, SECTION C, LINE 18 |
| IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc | 3 | FORM 990, PART VI, SECTION C, LINE 19 |
| IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc | 4 | FORM 990, PART IX, LINE 24E |
| IRS990/SchoolOperatingInd | 0 | 0 |
| IRS990/SignificantChangeInd | 0 | 0 |
| IRS990/SignificantNewProgramSrvcInd | 0 | 0 |
| IRS990/SubjectToExcsTaxNetInvstIncInd | 0 | 0 |
| IRS990/SubjectToProxyTaxInd | 0 | 0 |
| IRS990/SubjToTaxRmnrtnExPrchtPymtInd | 0 | 0 |
| IRS990/TaxablePartyNotificationInd | 0 | 0 |
| IRS990/TaxExemptBondsInd | 0 | 0 |
| IRS990/TerminateOperationsInd | 0 | 0 |
| IRS990/TotalAssetsBOYAmt | 0 | 809888 |
| IRS990/TotalAssetsEOYAmt | 0 | 837648 |
| IRS990/TotalAssetsGrp/BOYAmt | 0 | 809888 |
| IRS990/TotalAssetsGrp/EOYAmt | 0 | 837648 |
| IRS990/TotalCompGreaterThan150KInd | 0 | 0 |
| IRS990/TotalContributionsAmt | 0 | 887730 |
| IRS990/TotalEmployeeCnt | 0 | 19 |
| IRS990/TotalFunctionalExpensesGrp/FundraisingAmt | 0 | 0 |
| IRS990/TotalFunctionalExpensesGrp/ManagementAndGeneralAmt | 0 | 31279 |
| IRS990/TotalFunctionalExpensesGrp/ProgramServicesAmt | 0 | 796076 |
| IRS990/TotalFunctionalExpensesGrp/TotalAmt | 0 | 827355 |
| IRS990/TotalGrossUBIAmt | 0 | 0 |
| IRS990/TotalLiabilitiesBOYAmt | 0 | 86537 |
| IRS990/TotalLiabilitiesEOYAmt | 0 | 51789 |
| IRS990/TotalLiabilitiesGrp/BOYAmt | 0 | 86537 |
| IRS990/TotalLiabilitiesGrp/EOYAmt | 0 | 51789 |
| IRS990/TotalNetAssetsFundBalanceGrp/BOYAmt | 0 | 723351 |
| IRS990/TotalNetAssetsFundBalanceGrp/EOYAmt | 0 | 785859 |
| IRS990/TotalOtherCompensationAmt | 0 | 0 |
| IRS990/TotalProgramServiceExpensesAmt | 0 | 796076 |
| IRS990/TotalReportableCompFromOrgAmt | 0 | 0 |
| IRS990/TotalRevenueGrp/ExclusionAmt | 0 | 0 |
| IRS990/TotalRevenueGrp/RelatedOrExemptFuncIncomeAmt | 0 | 2133 |
| IRS990/TotalRevenueGrp/TotalRevenueColumnAmt | 0 | 889863 |
| IRS990/TotalRevenueGrp/UnrelatedBusinessRevenueAmt | 0 | 0 |
| IRS990/TotalVolunteersCnt | 0 | 0 |
| IRS990/TotLiabNetAssetsFundBalanceGrp/BOYAmt | 0 | 809888 |
| IRS990/TotLiabNetAssetsFundBalanceGrp/EOYAmt | 0 | 837648 |
| IRS990/TotReportableCompRltdOrgAmt | 0 | 0 |
| IRS990/TravelGrp/ProgramServicesAmt | 0 | 891 |
| IRS990/TravelGrp/TotalAmt | 0 | 891 |
| IRS990/TypeOfOrganizationCorpInd | 0 | X |
| IRS990/UnrelatedBusIncmOverLimitInd | 0 | 0 |
| IRS990/UponRequestInd | 0 | X |
| IRS990/USAddress/AddressLine1Txt | 0 | 22 SCHENK DRIVE |
| IRS990/USAddress/CityNm | 0 | SHIRLEY |
| IRS990/USAddress/StateAbbreviationCd | 0 | NY |
| IRS990/USAddress/ZIPCd | 0 | 11967 |
| IRS990/VotingMembersGoverningBodyCnt | 0 | 58 |
| IRS990/VotingMembersIndependentCnt | 0 | 0 |
| IRS990/WebsiteAddressTxt | 0 | HTTPS://SHIRLEYCOMMUNITYAMBULANCE.ORG/ |
| IRS990/WhistleblowerPolicyInd | 0 | 0 |
| ReturnHeader/BuildTS | 0 | 2021-04-22 16:20:28Z |
| ReturnHeader/BusinessOfficerGrp/DiscussWithPaidPreparerInd | 0 | 1 |
| ReturnHeader/BusinessOfficerGrp/PersonNm | 0 | MARC LAMPART |
| ReturnHeader/BusinessOfficerGrp/PersonTitleTxt | 0 | PRESIDENT |
| ReturnHeader/BusinessOfficerGrp/PhoneNum | 0 | 6313995380 |
| ReturnHeader/BusinessOfficerGrp/SignatureDt | 0 | 2020-11-04 |
| ReturnHeader/Filer/BusinessName/BusinessNameLine1Txt | 0 | SHIRLEY COMMUNITY AMBULANCE |
| ReturnHeader/Filer/BusinessNameControlTxt | 0 | SHIR |
| ReturnHeader/Filer/EIN | 0 | 112468521 |
| ReturnHeader/Filer/PhoneNum | 0 | 6313995380 |
| ReturnHeader/Filer/USAddress/AddressLine1Txt | 0 | PO BOX 72 |
| ReturnHeader/Filer/USAddress/CityNm | 0 | SHIRLEY |
| ReturnHeader/Filer/USAddress/StateAbbreviationCd | 0 | NY |
| ReturnHeader/Filer/USAddress/ZIPCd | 0 | 11967 |
| ReturnHeader/FilingSecurityInformation/AtSubmissionCreationDeviceId | 0 | 96677C81E385F3E46169356D34357317C1B67753 |
| ReturnHeader/FilingSecurityInformation/AtSubmissionFilingDeviceId | 0 | 96677C81E385F3E46169356D34357317C1B67753 |
| ReturnHeader/FilingSecurityInformation/FilingLicenseTypeCd | 0 | P |
| ReturnHeader/FilingSecurityInformation/IPAddress/IPv4AddressTxt | 0 | 69.125.127.53 |
| ReturnHeader/FilingSecurityInformation/IPDt | 0 | 2020-11-04 |
| ReturnHeader/FilingSecurityInformation/IPTimezoneCd | 0 | ES |
| ReturnHeader/FilingSecurityInformation/IPTm | 0 | 18:54:26 |
| ReturnHeader/PreparerFirmGrp/PreparerFirmEIN | 0 | 851395398 |
| ReturnHeader/PreparerFirmGrp/PreparerFirmName/BusinessNameLine1Txt | 0 | MICHAEL VERDEROSA CPA PC |
| ReturnHeader/PreparerFirmGrp/PreparerUSAddress/AddressLine1Txt | 0 | 243 MADISON STREET |
| ReturnHeader/PreparerFirmGrp/PreparerUSAddress/CityNm | 0 | MASTIC BEACH |
| ReturnHeader/PreparerFirmGrp/PreparerUSAddress/StateAbbreviationCd | 0 | NY |
| ReturnHeader/PreparerFirmGrp/PreparerUSAddress/ZIPCd | 0 | 11951 |
| ReturnHeader/PreparerPersonGrp/PhoneNum | 0 | 6315787057 |
| ReturnHeader/PreparerPersonGrp/PreparationDt | 0 | 2020-11-04 |
| ReturnHeader/PreparerPersonGrp/PreparerPersonNm | 0 | MICHAEL VERDEROSA |
| ReturnHeader/ReturnTs | 0 | 2020-11-04T18:56:15-06:00 |
| ReturnHeader/ReturnTypeCd | 0 | 990 |
| ReturnHeader/TaxPeriodBeginDt | 0 | 2019-01-01 |
| ReturnHeader/TaxPeriodEndDt | 0 | 2019-12-31 |
| ReturnHeader/TaxYr | 0 | 2019 |
Document Assets
No mirrored PDF or thumbnail assets are attached yet.
Filings
Displayed year
2019 • Form 990Detailed filing. Detailed filing data is available for this year.
- Assets
- $837,648
- Liabilities
- $51,789
- Net assets
- $785,859
- Revenue
- $889,863
- Expenses
- $827,355
- Net income
- $62,508