2022-09-29T16:42:58-05:00 2021-12-31 222027092 WITHUMSMITHBROWN PC 5000 EXECUTIVE PARKWAY SUITE 400 SAN RAMON CA 945834346 990 2021-01-01 943138272 TEAMSTERS MANAGED HEALTH CARE TRUST FUND TEAM 9254263555 PO BOX 757 PLEASANTON CA 945660075 JIM BEARD TRUSTEE 9254263555 2022-09-29 1 JIM BEARD 999009999 JOSEPH M THIERMANN P01066616 9252779100 3 AAL1 IAL1 2021 2022-09-23 18:48:47Z JIM BEARD PO BOX 757 PLEASANTON CA 945660075 90291232 0 X WWW.TMTFUNDS.ORG X 1991 CA TO PROVIDE HEALTH AND WELFARE BENEFITS FOR ELIGIBLE EMPLOYEES AND THEIR DEPENDENTS. 5 1 0 0 0 0 0 0 93065722 89606394 461184 684838 0 0 93526906 90291232 0 0 88481998 86202790 0 0 0 0 0 2145415 2171396 90627413 88374186 2899493 1917046 31910144 34990586 7200839 7944631 24709305 27045955 TO PROVIDE HEALTH AND WELFARE BENEFITS FOR ELIGIBLE EMPLOYEES AND THEIR DEPENDENTS. 0 0 PROVIDED HEALTH AND WELFARE BENEFITS FOR ELIGIBLE EMPLOYEES AND THEIR DEPENDENTS. 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 4 0 1 0 0 0 0 0 0 0 0 0 X 5 1 0 1 0 0 0 0 0 1 0 0 0 1 1 1 1 1 1 0 0 0 X DMC INSURANCE ADMINISTATORS 9254263555 1181 QUARRY LANE SUITE 400 PLEASANTON CA 94566 X JIM BEARD TRUSTEE 1.00 X 0 0 0 STACY MURPHY TRUSTEE 1.00 X 0 0 0 EFREN ALARCON TRUSTEE 1.00 X 0 0 0 BRUCE HEID TRUSTEE 1.00 X 0 0 0 DON GARCIA TRUSTEE 1.00 X 0 0 0 SEE SCHEDULE O FOR COMPENSATION PAID BY RELATED ORGANIZATIONS 0.00 X 0 0 0 0 0 0 0 0 0 0 DMC ADMINISTRATORS INC PO BOX 757 PLEASANTON CA 94566 THIRD-PARTY ADMINISTRATION SERVICES 1426038 LINDQUIST LLP 5000 EXECUTIVE PARKWAY SUITE 400 SAN RAMON CA 94583 ACCOUNTING SERVICE 179123 PHYSMETRICS PO BOX 25220 FRESNO CA 93729 BENEFITS ADMINISTRATION 126626 TEAMSTERS ASSISTANCE PROGRAM 80 SWAN WAY SUITE 320 OAKLAND CA 94621 BENEFITS ADMINISTRATION 104114 4 EMPLOYER CONTRIBUTIONS 900099 87693252 87693252 PARTICIPANT CONTRIBUTIONS 900099 1776517 1776517 LIQUIDATED DAMAGES 900099 136625 136625 89606394 684838 684838 90291232 89606394 0 684838 86202790 1426038 66368 179123 55521 309392 101931 519 32504 88374186 1126345 1120435 2069045 1207842 7444230 8487162 21270524 24175147 31910144 34990586 48100 90300 215939 175431 6936800 7678900 7200839 7944631 X 0 0 0 0 24709305 27045955 24709305 27045955 31910144 34990586 1917046 419604 0 X X 0 1 X 1 0 0 ACCUMULATED ELIGIBILITY CREDITS 7678900 7678900 X 90655315 419604 419604 90235711 55521 55521 90291232 87534365 0 87534365 55521 784300 839821 88374186 PART X, LINE 2: THE PLAN'S ADMINISTRATOR HAS ANALYZED THE TAX POSITIONS TAKEN BY THE PLAN AND HAS CONCLUDED THAT, AS OF DECEMBER 31, 2021, THERE ARE NO UNCERTAIN POSITIONS TAKEN, OR EXPECTED TO BE TAKEN, THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE FINANCIAL STATEMENTS. THE PLAN IS SUBJECT TO ROUTINE AUDITS BY THE TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. THE PLAN'S ADMINISTRATOR BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR THE FISCAL YEARS PRIOR TO 2018. PART XII, LINE 4B - OTHER ADJUSTMENTS: CHANGES IN BENEFIT OBLIGATIONS FORM 990, PART VI, SECTION A, LINE 3 THE PLAN HAS CONTRACTED WITH DMC ADMINISTRATORS, INC. TO PROVIDE ADMINISTRATIVE SERVICES FOR THE ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 8B THE ORGANIZATION HAS NO COMMITTEES WITH AUTHORITY TO ACT ON BEHALF OF THE BOARD OF TRUSTEES. FORM 990, PART VI, SECTION B, LINE 11B A COPY OF THE FORM 990 IS PROVIDED TO EACH OF THE VOTING MEMBERS WITHIN THE GOVERNING BODY FOR REVIEW PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE BOARD OF TRUSTEES IS SUBJECT TO THE FIDUCIARY RESPONSIBILITY PROVISIONS OF THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974 (ERISA), AS AMENDED, INCLUDING THE CONFLICT-OF-INTEREST PROVISIONS OF ERISA SECTION 406. ANNUALLY AT THE BOARD OF TRUSTEES MEETING, THE TRUSTEES ARE REQUIRED TO DISCLOSE IF THERE ARE ANY CONFLICTS OF INTEREST. IF A CONFLICTING INTEREST EXISTS, THE PERSON WITH THE CONFLICT IS EXCLUDED FROM THE DISCUSSION AND APPROVAL OF SUCH TRANSACTION. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT-OF-INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XII, LINE 2C: THE ORGANIZATION HAS A BOARD OF TRUSTEES THAT ASSUMES RESPONSIBILITY FOR THE OVERSIGHT OF THE AUDIT AND ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED. TEAMSTERS MANAGED ANNUITY TRUST PO BOX 757 PLEASANTON CA 94566 943138275 TO PROVIDE SUPPLEMENTAL RETIREMENT SAVINGS PROGRAM TO ELIGIBLE PARTICIPANTS. CA 501(A) N/A N/A 0 INDUSTRIAL EMPLOYER AND DISTRIBUTORS ASSOCIATION 2200 POWELL STREET EMERYVILLE CA 94608 940294755 SPONSORING ORGANIZATION CA 501(C)6 N/A N/A 0 INTERNATIONAL BROTHERHOOD OF TEAMSTERS WAREHOUSE WHOLESALE LIQUOR SALESPERS 7750 PARDEE LANE OAKLAND CA 94621 940963930 SPONSORING ORGANIZATION CA 501(C)5 N/A N/A 0 BEARD AFFILIATESLLC 5 THOMAS MELLON CIRCLE SAN FRANCISCO CA 94134 043836946 SPONSORING ORGANIZATION CA N/A C 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 SCHEDULE R, IDENTIFICATION OF RELATED ORGANIZATIONS: THE FILING ORGANIZATION IS A TAFT-HARTLEY MULTI-EMPLOYER TRUST THAT PROVIDES HEALTH AND WELFARE BENEFITS TO ELIGIBLE EMPLOYEES AND THEIR DEPENDENTS. AS OF DECEMBER 31, 2021, THERE ARE 3 SPONSORING ORGANIZATIONS AND APPROXIMATELEY 154 EMPLOYERS THAT CONTRIBUTE TO THE TRUST. THE ADMINISTRATIVE OFFICE MAINTAINS A DATABASE OF THESE SPONSORING ORGANIZATIONS AND CONTRIBUTING EMPLOYERS, INCLUDING NAMES, ADDRESSES AND OTHER CONTACT INFORMATION. THE FEDERAL TAX CLASSIFICATIONS (DISREGARDED ENTITY, TAX-EXEMPT ORGANIZATION, PARTNERSHIP, TAXABLE CORPORATION OR TRUST) FOR EACH CONTRIBUTING EMPLOYER IS NOT ON FILE WITH THE ADMINISTRATIVE OFFICE AND IT COULD NOT BE REASONABLY OBTAINED. AS A RESULT, THE NAMES OF THE CONTRIBUTING EMPLOYERS ARE LISTED ON PART VII BELOW AND NOT ON PARTS II THROUGH IV BY FEDERAL TAX CLASSIFICATION. A PARATRANSIT ALAMEDA COUNTY FAIR ASSOCIATION ALLIED CONCRETE REDY MIX SERVICES ALSCO - CONCORD ALSCO - SACRAMENTO ALSCO - SANTA ROSA ALSCO, INC. ALUM ROCK USD - ARUSD AMERIPRIDE UNIFORM SERVICES AMPORTS AMPORTS - MACHINIST ANHEUSER BUSCH - BAY AREA SALES ANIXTER S F ARAMARK CLEANROOM SERVICES ARAMARK REFRESHMENT SERVICES ARAMARK REFRESHMENT SERVICES OCS ARCHER DANIELS MIDLAND COMPANY ASPIRE BAKERIES LLC AVIS BUDGET CAR RENTAL SYSTEM AVIS BUDGET GROUP - ROVERS BAUER'S INTELLIGENT TRANSPORTATION BAY AREA OCS BEST WESTERN GROSVENOR BOTTOMLEY DISTRIBUTING BRANNON EQUIPMENT BRENNTAG PACIFIC, INC BUCHANAN FOOD SERVICE CALAVERAS MATERIALS, INC. CALIFORNIA TANK LINES CANTEEN VENDING - CLERICAL CANTEEN VENDING - SACRAMENTO CANTEEN VENDING - SAN JOSE CEMEX - ANTIOCH CEMEX CONSTRUCTION MATERIALS, LP CERTAINTEED - FREMONT CHERIN FURNITURE COMPANY CHRISTY VAULT COMPANY CITY OF TRACY TEAMSTERS CLEAR CHANNEL OUTDOOR, INC. CLS GLOBAL TRANSPORTATION COMPASS TRANSPORTATION - DRIVERS COMPASS TRANSPORTATION - NON DRIVERS CORE MARK CORRUGATED PACKAGING PRODUCTS, INC CTWI DAVIS INSTRUMENTS DOUBLE D TRANSPORTATION DOUGLAS PARKING - STANFORD DOUGLAS PARKING LLC FARMERS PRODUCE FARMERS RICE COOPERATIVE FARMERS RICE COOPERATIVE - WOODLAND FEDERATED LOGISTICS - HAYWARD FEDERATED LOGISTICS - UNION CITY FERALLOY PDM STEEL SERVICE CENTERS FERMA GREENBOX, INC. - DUMP TRUCK FIRST TRANSIT - ANTIOCH FIRST TRANSIT - OAKLAND FIRST TRANSIT - STANFORD FIRST TRANSIT - STANFORD (NON DRIVERS) G P GYPSUM, LLC - ANTIOCH FACILITY GCR TIRES & SERVICES GENESIS LOGISTICS GIUSTOS SPECIALTY FOODS, INC. GOLDEN BRANDS - SACRAMENTO GOLDEN GATE FIELDS HEATH CERAMICS HEATH CERAMICS - NON UNION HENKEL CORPORATION HERTZ - RENT A CAR HERTZ - SACRAMENTO HUTTIG BUILDING PRODUCTS HVYW8, INC. HYATT REGENCY - SFO IMPERIAL PARKING US, LLC JCDECAUX NORTH AMERICA KELLOGG USA, INC. KELLY SPICERS, INC. LAZ PARKING - KAISER LAZ PARKING - OAKLAND AIRPORT LOOP TRANSPORTATION - AMAZON LOOP TRANSPORTATION - APPLE LOOP TRANSPORTATION - FB LOOP TRANSPORTATION - STANFORD MACMURRAY PACIFIC MARTIN BROWER MARTIN BROWER - CLERICAL MASTER BUILDERS SOLUTIONS MATAGRANO, INC. MATAGRANO, INC. (NON UNION) MATHESON, INC - OAKLAND MCJUNKIN RED MAN CORPORATION MISSION LINEN SUPPLY - DRIVERS MISSION LINEN SUPPLY - INDUSTRIAL MOSAIC GLOBAL TRANSPORTATION - FB MV TRANSPORTATION - HALF MOON BAY MV TRANSPORTATION - LIVERMORE MV TRANSPORTATION - PRESIDIO MV TRANSPORTATION - SAN LEANDRO NAPA RECYCLING & WASTE SERVICES, LLC OUTFRONT MEDIA P & S SALES PEERLESS COFFEE COMPANY PGS - WESTSIDE I, INC. PRUDENTIAL CLEANROOM SERVICES PRUDENTIAL OVERALL SUPPLY R & K INDUSTRIAL PRODUCTS R & K INDUSTRIAL PRODUCTS - NON UNION REPUBLIC SERVICES REYES FLEET MANAGEMENT RIGHT AWAY REDY MIX-BRENTWOOD RIGHT AWAY REDY MIX-MARTINEZ RIGHT AWAY REDY MIX-OAKLAND RIGHT AWAY REDY MIX-PLEASANTON RIGHT AWAY REDY MIX-PLEASANTON SHOP RIGHT AWAY REDY MIX-UNION CITY RIVER DISTRIBUTING RIVER GARDEN FARMS RNDC - MERCHANDISERS & INSIDE SALES ROCK TRANSPORT, INC. RYDER TRUCK RENTAL RYERSON SACRAMENTO LOGISTICS - CLERICAL SACRAMENTO LOGISTICS GMD - RECEIVING SACRAMENTO LOGISTICS GMD- WAREHOUSE SAN LEANDRO VENDING SAN MATEO HOUSING AUTHORITY SCHAEFER COLD STORAGE SENTINEL TRANSPORTATION SFO SHUTTLE BUS COMPANY SGWS - MERCHANDISERS & INSIDE SALES SIERRA PACIFIC READY MIX SERVICES SIMS METAL MANAGEMENT - 150 SIMS METAL MANAGEMENT - 853 SOLANO GARBAGE - CLERICAL SOUTHERN WINE & SPIRITS SP PLUS CORPORATION SSA TERMINALS STORER TRANSIT SYSTEMS SUTTER BASIN GROWERS - CORP. T. MARZETTI COMPANY THE J. M. SMUCKER COMPANY TOWNSHIP RETAIL SERVICES, INC. TRACY LOGISTICS - CMSP TRACY LOGISTICS, LLC TRANSDEV - NAPA TRUCKIN' ROCKZ, LLC WASTE MANAGEMENT OF ALAMEDA COUNTY WEDRIVEU WEDRIVEU - GILEAD DRIVERS WEST COAST VENDING WHEELER - SONOMA PRINTERS YOUNG'S MARKET COMPANY EXPRESS ZENITH AMERICAN SOLUTIONS