2023-12-01T09:57:22-06:00 2023-04-30 470900880 CALIBRE CPA GROUP PLLC 462 SEVENTH AVENUE 16TH FLOOR NEW YORK NY 10018 990 2022-05-01 136129427 HEALTH FUND 917 HEAL 5163263371 22 NORTH TYSON AVENUE 1 FL FLORAL PARK NY 11001 RALPH NATALE TRUSTEE 5163263371 2023-12-01 1 RALPH NATALE XXX-XX-XXXX 0 JOSEPH MORELLO P02146706 2126951300 2023-12-01 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z RAPLH NATALE 22 NORTH TYSON AVENUE 1 FL FLORAL PARK NY 11001 17969434 0 X N/A X 1950 NY TO PROVIDE HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS. 6 3 2 0 0 0 0 0 16907670 17047662 1542953 905525 0 0 18450623 17953187 0 0 17736636 15922285 186602 189075 0 0 0 366663 374581 18289901 16485941 160722 1467246 42995154 44050348 2887398 3282394 40107756 40767954 TO PROVIDE HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS. 0 0 TO PROVIDE HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS. 0 0 0 0 0 0 0 0 0 1 1 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 283 0 1 2 1 0 0 0 0 0 0 0 0 0 0 X 6 3 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 X BOARD OF TRUSTEES 5163263371 22 NORTH TYSON AVENUE FLORAL PARK NY 11001 DEMOS DEMOPOULOS TRUSTEE 2.00 0.00 X 0 0 0 RALPH NATALE TRUSTEE 2.00 40.00 X 0 139700 39527 ROY KOHN TRUSTEE 2.00 4.00 X 0 0 0 KIRK CONAWAY TRUSTEE 2.00 4.00 X 0 0 0 JEFFREY ISAACS TRUSTEE 2.00 0.00 X 0 0 0 DAVID PEREZ TRUSTEE 2.00 40.00 X 0 137100 39527 ANA TANG FUND ADMINISTRATOR 27.00 13.00 X 134677 0 41023 134677 276800 120077 1 0 1 0 EMPIRE BLUE CROSS AND BLUE SHIELD ONE LIBERTY PLAZA NEW YORK NY 10006 PPO ACCESS 399806 ZENITH AMERICAN SOLUTIONS 302 KNIGHTS RUN AVENUE TAMPA FL 33602 CLAIMS PROCESSING 343215 CALIBRE CPA GROUP 462 SEVENTH AVE NEW YORK NY 10018 AUDIT SERVICES 106450 3 EMPLOYER CONTRIBUTIONS 525100 16899005 16899005 COBRA CONTRIBUTIONS 525100 148657 148657 17047662 902567 902567 19205 16247 2958 2958 2958 17953187 17047662 0 905525 15922285 115154 37591 13038 14238 9054 36000 106450 29205 44000 42577 8749 73990 627 32983 16485941 832087 1143269 403470 776899 13582 13017 88988 85407 4455 3581 28891241 29053014 12822544 12734777 27775 325791 42995154 44050348 38398 43035 2849000 3239359 2887398 3282394 X 0 0 0 0 40107756 40767954 40107756 40767954 42995154 44050348 1467246 -807048 0 X 0 1 X 0 0 88988 85407 3581 3581 COLLECTIVE TRUST FUND 12734777 F 12734777 POSTRETIREMENT BENEFIT OBLIGATIONS 1095000 CLAIMS INCURRED BUT NOT REPORTED 1840000 OPERATING LEASE LIABILITY 304359 3239359 X 17116934 -807048 -807048 17923982 29205 29205 17953187 16370736 0 16370736 29205 86000 115205 16485941 PART X, LINE 2: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE PLAN MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE PLAN AND RECOGNIZE A TAX LIABILITY (OR ASSET) IF IT HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE. THE PLAN ADMINISTRATOR HAS ANALYZED THE TAX POSITIONS TAKEN BY THE PLAN, AND HAS CONCLUDED THAT AS OF APRIL 30, 2023 AND 2022, THERE WERE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY (OR ASSET) OR DISCLOSURE IN THE FINANCIAL STATEMENTS. THE PLAN IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. PART XII, LINE 4B - OTHER ADJUSTMENTS: INCREASE IN BENEFIT OBLIGATIONS 0 0 0 RALPH NATALE TRUSTEE 0 127400 0 0 0 12300 0 19499 0 20028 0 179227 0 0 DAVID PEREZ TRUSTEE 0 124800 0 0 0 12300 0 19499 0 20028 0 176627 0 0 ANA TANG FUND ADMINISTRATOR 134677 0 0 0 0 0 19603 0 21420 0 175700 0 0 0 FORM 990, PART VI, SECTION B, LINE 11B LINE 11B EXPLANATION - THE RETURN PREPARER E-MAILS A COPY OF THE FINAL VERSION OF FORM 990 TO THE PLAN ADMINISTRATOR AND TRUSTEES FOR THEIR REVIEW AND APPROVAL. INQUIRIES ARE MADE TO THE PREPARER AS NEEDED. FORM 990, PART VI, SECTION C, LINE 19 FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC THROUGH THE ORGANIZATION'S ANNUAL FORM 5500 FILING. NO OTHER DOCUMENTS ARE AVAILABLE TO THE PUBLIC. LOCAL UNION 917 IBT 24 NORTH TYSON AVENUE FLORAL PARK NY 11001 135279293 LABOR UNION NY 501(C)(5) 0 LOCAL 917 PENSION FUND 22 NORTH TYSON AVENUE FLORAL PARK NY 11001 136086164 BENEFIT FUND NY 401(A) 0 LOCAL 868 I B OF T PENSION FUND 22 NORTH TYSON AVENUE FLORAL PARK NY 11001 132930439 BENEFIT FUND NY 401(A) 0 LOCAL 816 LABOR & MGMT PENSION TR FUND 22 NORTH TYSON AVENUE FLORAL PARK NY 11001 131869789 BENEFIT FUND NY 401(A) 0 19-20 INDUSTRY CITY CONTRIBUTING EMPLOYER 0 AF SUPPLY CONTRIBUTING EMPLOYER 0 ALLIED AVIATION CONTRIBUTING EMPLOYER 0 AMBRO OPERATING CORP CONTRIBUTING EMPLOYER 0 APPROVED OIL CONTRIBUTING EMPLOYER 0 BAKERY DRIVERS LOCAL CONTRIBUTING EMPLOYER 0 BARNEY'S SERVICE STATION CONTRIBUTING EMPLOYER 0 BAYSIDE FUEL CONTRIBUTING EMPLOYER 0 BLUE DIAMOND CONTRIBUTING EMPLOYER 0 BORO FUEL CONTRIBUTING EMPLOYER 0 BRONX AUTOMOTIVE CONTRIBUTING EMPLOYER 0 BUCKEYE PIPELINE CONTRIBUTING EMPLOYER 0 CARMEL GARAGE INC CONTRIBUTING EMPLOYER 0 CENTURY MOTORS INC CONTRIBUTING EMPLOYER 0 COHLER FUEL CONTRIBUTING EMPLOYER 0 DEBRAGGA & SPITLER CONTRIBUTING EMPLOYER 0 DORCHESTER HEATING CONTRIBUTING EMPLOYER 0 EAST COAST MECHANICAL CONTRIBUTING EMPLOYER 0 EAST COAST PETROLEUM CONTRIBUTING EMPLOYER 0 FANCY FOODS INC CONTRIBUTING EMPLOYER 0 FRED SCHILDWACHTER CONTRIBUTING EMPLOYER 0 GROCERY HAULERS CONTRIBUTING EMPLOYER 0 HEALTH FUND 917 CONTRIBUTING EMPLOYER 0 HEMSTEAD LINCOLN MERCURY CONTRIBUTING EMPLOYER 0 INTERSTATE FOODS INC CONTRIBUTING EMPLOYER 0 JM HUNTINGTON MOTORS CONTRIBUTING EMPLOYER 0 KARP VOLVO INC CONTRIBUTING EMPLOYER 0 LAB CORP CONTRIBUTING EMPLOYER 0 LAZ PARKING CONTRIBUTING EMPLOYER 0 LOCAL 553 PENSION FUND CONTRIBUTING EMPLOYER 0 LOCAL 917 IBT CONTRIBUTING EMPLOYER 0 LOCAL UNION 553 CONTRIBUTING EMPLOYER 0 MAJOR CHEVROLET INC CONTRIBUTING EMPLOYER 0 MAJOR WORLD CDJR LLC CONTRIBUTING EMPLOYER 0 MERRICK DODGE INC CONTRIBUTING EMPLOYER 0 MISSION OF THE IMMAC CONTRIBUTING EMPLOYER 0 MONTEBELLO COAL CONTRIBUTING EMPLOYER 0 NEW UTRECHT CONTRIBUTING EMPLOYER 0 PACIFIC PETROLEUM CONTRIBUTING EMPLOYER 0 PETRO CONTRIBUTING EMPLOYER 0 PLAZA OLDSMOBILE CONTRIBUTING EMPLOYER 0 PLAZA TOYOTA CONTRIBUTING EMPLOYER 0 PRIDE BUS CORP CONTRIBUTING EMPLOYER 0 ROCKWAY FUEL CONTRIBUTING EMPLOYER 0 RSTR MOTORS CONTRIBUTING EMPLOYER 0 SJ FUEL CONTRIBUTING EMPLOYER 0 SKAGGS & WALSH CONTRIBUTING EMPLOYER 0 SPEEDWAY-NJ CONTRIBUTING EMPLOYER 0 SPEEDWAY-NY CONTRIBUTING EMPLOYER 0 STANDARD PARKING CONTRIBUTING EMPLOYER 0 STATEWIDE OIL CONTRIBUTING EMPLOYER 0 THE CAR PARK CONTRIBUTING EMPLOYER 0 UNITED APOLLO PETROLEUM CONTRIBUTING EMPLOYER 0 UNITED JEWISH APPEAL CONTRIBUTING EMPLOYER 0 WELCOME PARKING CONTRIBUTING EMPLOYER 0 SPRAGUE RESOURCES CONTRIBUTING EMPLOYER 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 1 0 0 LOCAL 917 PENSION FUND Q 66470 TIME STUDY LOCAL 868 IBT PENSION FUND Q 42770 TIME STUDY LOCAL 816 LABOR & MGMT PENSION FUND Q 75921 TIME STUDY