Under section 501(6), 527, or 4947/aK1) of the Internal Revenue Code (except black tung, Denefit rust or private foundation) a 990 Return of Organization Exempt From Income Tax 3009 epee Try ‘Open to PubIiC Siztvncwetuns”” | _De The reanzation may havo to use a copy oft rotum to sats stato reporting requirements. | frepecton A For the 2009 calendar year, or tax year beginning MAY 1, 2009 and ending R30, 2010 B ont, | nau [© Name of crganzaton © Employer identifcation number St |r| (Costs |g WALLEY EMERGENCY MEDICAL SERVICES, INC. obes, | [bong susiness As 22-2483894 (Pa | se, | Number and svoet (or P.0 box mais not dorado svee adres) [Roow/suie | Telephone number (Cher |e P.O. BOX 837 203-627-3030 Cokes] "= | “cay ortown, state or country, and ZIP + 4 G Gosreongie 1.471,06' Csr ERBY, CT 06418 ‘Hfa) Is this a group return 200 TF Name and address of prnopal offcor TERRY SCHWAB for atftates? Cves GXINo 484 OXFORD ROAD, OXFORD, CT 06478 Ho) Ave allaates mctuded?L_]ves [_] No 1 Taxexempt status [XT sore) (3 <4 insert no. -4947(a\) or [J 527 If No,” attach a bist. (see instructions) “J Website: > WHW. VALLEVEMS ORG. | njc) Group exemption number Pe Form of organwanon: [X] Corporation [] Trust [J Assocation [—] Other D> [x Year of formation: 1.9 8 3) aa State of lenal domicie: CT Part {| Summary 1 Brofly describe the organeation's mason of most sgniicant actwtes TO PROVIDE FIRST RESPONDER | PARAMEDIC SERVICE BETWEEN THE VALLEY TOWNS AND MEDICAL FACILITIES E| 2 checkin box Be L_] the organaation dicontinued ts operations o isposed of mare than 25% of ds net assets | 8. Number of votng member of the governing body Pate 1) 3 8) 4 number ofindopendent voting members ofthe governing body Part Vt, lne 1b) 4 F| § Totalrumber of emptovees Pat V, 0 2a) | 6 Total numbor of vointors (estate f necessary) B| 70 Tota gross unrelated busnss revenve rom Pat Vil. column (tne 12 b Not undated bsness table cof on eareagsy ee | Revere Prior Year ‘Current Year 8 Contnbutions and grants (Part VI, ihe 1h) 3 283,621. 413,311. 2] 9 Proaram sernce revenue Par Vil, WSS) FEB 2 2 2011 [9 852,372.| 1,055,219. 3} 10 investmentincome (Part Vil, columa A nes 3,4, and 70) | 3,203. 2,537. © 144. Other revenue (Pat Vil, column (A), bnes'S BATE Ge ib, ape 116) | 12 Tore. ines tug Lime GEO alone 12 1,139,196. 1,471,067. 43. Grants and sear amounts paid (Par 1X, column (A, ines 13) 414 Benefits pad to or for members (Pat IX, column (A), ine 4) 418. Salanes, ther compensation, employee benefits (Pat IX, column (A), nes 510) 636,971, 780,665. 16a Professional fundrassing fes (Pat IX, column (A), hne 116) ' Total fundrasing expenses Part I, column (), ne 25) De Expenses 17 Other expenses Part, column (fines Ta-t16, 11240) 435,998, 377,180. 18 Total expenses. Add ines 13-47 (must equal Part IX, column (ine 25) 1,072,969.| 1,157,845. 19 Revenue less expenses, Subtract ine 18 from ine 12 66,227. 313,222. 4 sinning of ConentYeur | End ot Year $5! 20. Total assets (Part X, ne 16) 424, 680.| 795,496. S$5| 21 Total iabites Pan X, ine 26) 70,176. 127,770. SBE| ce Not assets or fund balances Subtract ine 21 fom ine 20 354,504, 667,726 [Parti [Signature Block _] Sige eases tg. ana a age aed eis poe enap ae sCAA eS Hasna PaO Re DC Oy nan aOR NaH SO, meee frase as ones Rares Be ee Vaal ae |__2-y9-s/ aiet oo a DERRY SCHWAB, PRESIDENT Type or printname and we cA) [EC WAR repr a aT ee fo lommce D J el ea N00)c oe | camemccmmianes Usednly [rove . APICELLA, TESTA™& COMHANY,' P.C. Ene wren 680 BRIDGEPORT AVENUE zr +4 SHELTON, CT 06484 [Phone no. B (203)925-9494 Ht dacs ha eu wah he prapreshown above? ne mci) Tx ves [In ‘s32001 02-08-10 LHA For Privacy Act and Paperwork Reduction Act Notice, see the separate instructions. Form 990 (2009) SEE SCHEDULE 0 FOR ORGANIZATION MISSION STATEMENT CONTINUATION aww ppFo 980.2009) VALLEY EMERGENCY MEDICAL SERVICES, INC. _22-2483894 _Page2 Part Il | Statement of Program Service Accomplishments Bey descnbe the organization's mssion: NONE. ‘Dd the arganation undertake any signdicant program services dung the year which wore aot sted on the pro Form 550 or 5052? res Eno Wea" dscrbe these new services on Schade Dd te ergunaaton cease conducting, ov mae signa’ changesin how conducts, any program sences? res Ge tes," descnbe these changes on Schedule O. DDesente the exempt purpose achievements for each ofthe organaation's three largest program services by expenses. ‘Section 501(c)(3) and 501(¢@) organaations and section 4947(a\.}) sts are requred to report the amount of grants and Alocavons to others, the total expenses, and revenue, any, foreach program service reported (Code. Véspenses$ 945,372. including grants of $ }(Revenuos 1,816,400 EMERGENCY MEDICAL SERVICES ARE PROVIDED TO THE CONNNECTICUT TOWNS OF ANSONIA, DERBY, OXFORD, SEYMOUR AND SHELTON. “4 (Code: (Expenses & Tnouding grante of § V(Rovenue $ y “ae (Code, VtExpenses $ including grants of § Revenue $ D “4d_ Other program sernces (Descnbe m Schedule 0) spenses§ sncating grants of Revenue $ » “oTotal pram sonics expenses DS 945,37) Form 990 (2009) 2 10550203 759270 3479 2009.05000 VALLEY EMERGENCY MEDICAL SE 3479__1Form 9902000)" VALLEY EMERGENCY MEDICAL SERVICES, INC. 2-2483894 _ Page3 [Part Iv | Checklist of Required Schedules. Yes | No 1 ts the organzation descnbed mn section 501(c)6) or 4947) (other than a private foundation)? Yes," complete Scheduio A a|x 2. Isthecxganaton requred to complete Schedule B, Schedule of Contributors? 2[x 2. Dad the rganzation engage in direct or indirect pottical campaign activites on behalf of om oppostion to Candidates for public offic? "Yes," complete Schedule C, Part | 3 x 4 Section 501(6XS) organizations. Did the organizaton engage n lobbying actubes? I “Yes," complete Schedule C, Part it | 4 x ‘5. Section 501(6X4), 501(¢X5), and 501(cK_6) organizations. 's the organation subject to the section 6083(e) notice and reporting requirement and proxy tax’ I "Yes," complete Schedule C, Part 5 6 Od the erganzation mantain any donor advised funds or any simlar funds or accounts where donors have the nght to provide advice on the distnbuton or mvestment of amounts in such funds or accounts? I "Yes," complete Schedule D, Part! | 6. x 7 Did the organzaton receive or hold a conservation easement, including easements to preserve open space, {the envronment, histone land areas, of tstone structures? if *Yes," complate Schedule D, Part i! z x 8 Dd the organzaton mantan colections of works ofa, hsstoncal treasures, or other sear assots? I "Yas," complete ‘Schedule O, Part Il a x {9 Did the ocganzation report an amount n Part X, ne 21; serve as a custod.an for amounts not listed n Part X; or prowde ‘rect counseling, debt management, credit repar, or debt negotiation sences? If "Yes," complete Schedule D, Part V 2 x 40. Did the organzaton, directly or through a related organzation, hold assets term, permanent, or quasrendowments? 1 ¥es," complete Schedule D, PartV 10 x 111s the organzaton’s answer to any ofthe folowng questions "Yes"? If so, complete Schedule D, Parts VI Vi, VI, IX or X 2s applicable lx ‘© (0d the organization report an amount for land, buldings, and equipment in Part X, ina 107 “Yes,* complete Schedule O, Pat i ‘© Did the organzation report an amount for investments - other secunties in Part X, ine 12 thats 5% oF more of ts total ‘assets reported n Part X, ine 162 if "Yes," complete Schedule D, Part VI ‘© 1d the organization report an amaunt for investments - program related in Part X, hn 13 tha & SY or more oft total ‘assets reported n Part X, tne 167 "Yes," complete Schedule D, Part Vl ‘© the organization report an amount for other assets in Part X, bine 15 that is 6% or more of ts total assets reported in Part X, ne 167 "Yes," complete Schedule D, Part IX. ‘© Dic the organzaton report an amount for other labilties in Part X, ne 252 if "Yes," complete Schedule D, Part X ‘© Did the organization's separate or consolidated financial statements forthe tax year nchude a footnote that addresses ‘the organzation’slabity for uncertain tax posstions under FIN 487 if "Yes," complete Schedule D, Part X. 12__Did the ogarizaton obtain separate, independent audted frnancial statements forthe tax yaar? If "Yes," complate ‘Schedule D, Parts XX and XI 2{x {24 Was the organzaton nckided in consolidated, independent audited fnancal statements fr the tax year? Yes | No 1 "¥es,* completing Schedule O, Parts XI, XM, and Xil!s optional Cea x 19° ste organzaton a school descnbad in secton 170) 1)A) I "Yes," complete Schedule E 2 x ‘Y4a_ Dd the organization mantan an office, employees, or agents outside of the United States? vaa{ [x 'b Did the organzaton have aggregate revenues or expenses of more than $10,000 from grantmakng fundrasing, Business, and program serwce actwites outede the United States? if "Yes," complete Schedule F, Pat | sap} | x 48 Did the organzaton report on Part 1X, column (A, bre 3, more than $5,000 of grants or assistance to any organtzaon orentty located outaide the Unted States? If Yes,” complete Schedule F, Part I! 15 x 46 Di the ocganzaton report on Part 1x, column (A, bne 3, more than $5,000 of aggregate grants or assistance to mdividuals located outside the United States? If Yes,” complete Schedule F, Part It 16 x 47 Dd the ocganzation report a total of more than $15,000 of expenses for professional fundrasing services on Part IX, column (A), ines 6 and 1167 I “Yes," complete Schedule G, Part 7 x 48 Di the organzaton report mote than $15,000 total of fundrarsing event gross nceme and contributions on Part Vl, nes ‘te and 8a? If "Yes,* complete Schedule G, Part! 8 x 419 Did the ocganzaton report more than $15,000 of gross income from gaming activites on Part Vl, ine aH ‘complete Schedule G, Pat It 19 x 20 Did the organzation operate one or more hospitals” I "Yes," complete Schedule H. 20 x Form 990 (2008) 3 10550203 759270 3479 2009.05000 VALLEY EMERGENCY MEDICAL SE 3479__1