2022-11-15T17:51:08-06:00 2021-12-31 450250958 EIDE BAILLY LLP 10681 FOOTHILL BLVD STE 300 RANCHO CUCAMONGA CA 917303831 990 2021-01-01 946401544 U A LOCAL 393 HEALTH & WELFARE TR UALO 4084368210 1731 TECHNOLOGY DRIVE SUITE 570 SAN JOSE CA 95110 ERIC MUSSYNSKI CHAIRMAN 4084368210 2022-11-14 1 ERIC MUSSYNSKI 999009999 CATHERINE L GRAY CPA P01294460 9094664410 2022-11-11 3 AAL1 IAL1 2021 2022-09-23 18:48:47Z ERIC MUSSYNSKI 1731 TECHNOLOGY DRIVE SUITE 570 SAN JOSE CA 95110 72961531 0 X N/A X 1952 CA TO PROVIDE ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS WITH HEALTH & WELFARE BENEFITS. 11 11 2 10 8998236 0 0 0 59120248 63963151 2465513 8998236 688027 144 62273788 72961531 0 0 59699765 57418816 81218 160310 0 0 0 2558188 2731985 62339171 60311111 -65383 12650420 176765580 194792933 75056071 77297841 101709509 117495092 TO PROVIDE HEALTH & WELFARE BENEFITS ACCORDING TO COLLECTIVE BARGAINING AGREEMENTS. 0 0 TO PROVIDE ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS WITH HEALTH & WELFARE BENEFITS ACCORDING TO COLLECTIVE BARGAINING AGREEMENTS BETWEEN EMPLOYERS AND THE UNION. 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 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 198 0 1 2 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 11 11 0 1 0 0 0 0 0 1 0 0 0 0 1 1 1 1 1 0 0 0 X BENESYS ADMINISTRATORS 4084368210 1731 TECHNOLOGY DRIVE SUITE 570 SAN JOSE CA 95110 X STEVE FLORES CHAIRMAN 5.00 X X 0 186580 68389 ALEX HALL CO-CHAIR 5.00 X X 0 0 0 MICHAEL J VLAMING TRUSTEE 5.00 X 0 0 0 LEROY GINN TRUSTEE 5.00 X 0 0 0 TIM WHALEN TRUSTEE 5.00 X 0 0 0 WAYD LA PEARLE TRUSTEE 5.00 X 0 0 0 GARY GLENN TRUSTEE 5.00 X 0 0 0 GREGORY GONZALES TRUSTEE 5.00 X 0 0 0 EDWARD NICHOLS TRUSTEE 5.00 X 0 0 0 KARL BAUMHECKEL TRUSTEE 5.00 X 0 0 0 BOB DILLS TRUSTEE 5.00 X 0 0 0 NANCY C FERGUSON MEMBER ADVOCATE 40.00 X 122393 0 84896 SUZANNE H NEEDHAM PLAN DIRECTOR 40.00 X 130691 0 56102 253084 186580 209387 2 0 1 0 BENESYS INC 700 TOWER DR SUITE 300 TROY MI 48098 THIRD PARTY ADMINISTRATION 715508 COLUMBIA MANAGEMENT NW 7702 - PO BOX 1450 MINNEAPOLIS MN 554857702 INVESTMENT MANAGEMENT 392774 KAUFMANN AND GOBLE 160 WEST SANTA CLARA SUITE 1550 SAN JOSE CA 95113 BENEFIT PLANNING CONSULTANT 122750 EIDE BAILEY LLP 10681 FOOTHILL BLVD SUITE 300 RANCHO CUCAMONGA CA 917303831 AUDITTING SERVICES 122081 KRAW & KRAW 605 ELLIS STREET SUITE 200 MOUNTAIN VIEW CA 94043 LEGAL 103372 5 EMPLOYER CONTRIBUTIONS 56633949 56633949 ERA CONTRIBUTIONS 7098082 7098082 COBRA CONTRIBUTIONS 203176 203176 LIQUIDATED DAMAGES 27944 27944 63963151 3338764 3338764 5659472 0 5659472 5659472 5659472 OTHER INCOME 144 144 144 72961531 63963295 8998236 0 57418816 160310 728352 102643 118963 573147 1098052 10910 9720 POSTAGE 36624 PRINTING 35913 PCORI FEES 10360 MISCELLANEOUS 7301 60311111 979383 11642753 12480211 6468052 5375039 6377088 10683 11836 157406752 169601108 513512 692096 176765580 194792933 491960 761104 74564111 76536737 75056071 77297841 X 0 0 0 0 101709509 117495092 101709509 117495092 176765580 194792933 12650420 2928131 207032 0 X X 0 1 X 1 0 0 DUE TO OTHER FUNDS 418458 GROUP INSURANCE PREMIUMS PAYABLE 4105319 SELF-FUNDED BENEFIT CLAIMS PAYABLE 5023832 CLAIMS INCURRED BUT NOT REPORTED 1376400 BANK OF HOURS LIABILITY 19952000 PARTICIPANT RESERVE ACCOUNT 45660728 76536737 X 75316515 2928131 2928131 72388384 573147 573147 72961531 57876149 0 57876149 573147 1861815 2434962 60311111 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 THE PLAN HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE IRS. 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: CHANGE IN NET BENEFIT OBLIGATION 1,861,815. 0 0 0 STEVE FLORES CHAIRMAN 0 186580 0 0 0 0 0 36233 0 32156 0 254969 0 0 NANCY C FERGUSON MEMBER ADVOCATE 122393 0 0 0 0 0 53228 0 31668 0 207289 0 0 0 SUZANNE H NEEDHAM PLAN DIRECTOR 130691 0 0 0 0 0 37002 0 19100 0 186793 0 0 0 FORM 990, PART VI, SECTION A, LINE 3 THE ORGANIZATION DELEGATES CONTROL OVER MANAGEMENT DUTIES CUSTOMARILY PERFORMED BY OR UNDER THE DIRECT SUPERVISION OF OFFICERS, DIRECTORS, TRUSTEES OR KEY EMPLOYEES TO THE CONTRACT ADMINISTRATOR, BENESYS ADMINISTRATORS. FORM 990, PART VI, SECTION A, LINE 8B THE PLAN DOES NOT HAVE ANY COMMITTEES WITH THE AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11B THE TRUSTEES DESIGNATE THE ADMINISTRATOR TO REVIEW THE FORM. FORM 990, PART VI, SECTION B, LINE 12C REVIEW WITH BOARD OF TRUSTEES ANNUALLY. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST TO ALL PLAN PARTICIPANTS. FORM 990 PART VII SECTION A COLUMN E AND F TRUSTEES OF THE TRUST ARE EMPLOYEES OF CONTRIBUTING EMPLOYERS THAT ARE CONSIDERED RELATED ORGANIZATIONS UNDER THE DEFINITIONS IN SCHEDULE R. THE TRUST IS UNABLE TO REPORT COMPENSATION AND BENEFITS PAID TO THE TRUSTEES BY RELATED ORGANIZATIONS AS IT WAS UNABLE TO OBTAIN THE INFORMATION AFTER MAKING REASONABLE EFFORTS. THE TRUST REQUESTED THE COMPENSATION INFORMATION FROM THE TRUSTEE(S) BY PROVIDING A QUESTIONNAIRE REQUESTING THE REQUIRED INFORMATION ALONG WITH INSTRUCTIONS TO EXPLAIN THE INFORMATION NEEDED. THE QUESTIONNAIRES FOR THE TRUSTEES WERE NOT RECEIVED BACK PRIOR TO FILING THE TAX RETURN. FORM 990 PART VII SECTION A COLUMN D THE OVERALL COST FOR THE SALARY REPORTED IN COLUMN D IS SHARED BY THREE RELATED ORGANIZATIONS FORM 990, PART XI, LINE 2C THE BOARD OF TRUSTEES ASSUMES RESPONSIBILITY FOR OVERSEEING THE AUDIT OF THE ORGANIZATION'S FINANCIAL STATEMENTS AND FOR SELECTING THE INDEPENDENT AUDITOR. 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