2022-10-14T12:52:13-05:00 2021-12-31 043508036 MANZI & ASSOCIATES LLC 855 TURNPIKE STREET NORTH ANDOVER MA 01845 990 2021-01-01 042149479 TEAMSTERS LOCAL 653 WELFARE FUND TEAM 5082307140 4 B HAMPDEN DRIVE SOUTH EASTON MA 02375 MICHAEL CLARK TRUSTEE 5082307140 2022-10-14 1 MICHAEL CLARK 999009999 JEANNIE MICKEL P01058630 9789751099 3 AAL1 IAL1 2021 2022-09-23 18:48:47Z MICHAEL CLARK 4 B HAMPDEN DRIVE SOUTH EASTON MA 023751158 38859946 0 X N/A X H&W FUND 1952 MA PROVIDE HEALTH BENEFITS TO MEMBERS OF SPONSORING ORGANIZATION UNDER CBA 6 6 3 0 0 0 0 0 29029299 29632583 1446684 2958817 1750 265 30477733 32591665 0 0 26472060 28335795 382153 335558 0 0 0 1446500 1773112 28300713 30444465 2177020 2147200 69783998 71353172 3830121 2444123 65953877 68909049 PROVIDE HEALTH BENEFITS TO MEMBERS OF THE SPONSORING ORGANIZATION UNDER COLLECTIVE BARGAINING AGREEMENT 0 0 PROVIDE WELFARE BENEFITS TO EMPLOYEES UNDER COLLECTIVE BARGAINING AGREEMENT 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 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 2 0 1 3 1 0 0 0 0 0 0 0 0 0 0 X 6 6 0 0 0 0 1 0 0 1 1 0 0 1 0 0 0 1 1 0 X MICHAEL CLARK 5082307140 4 B HAMPDEN DRIVE SOUTH EASTON MA 02375 X MICHAEL EPSTEIN TRUSTEE 10.00 X 0 0 0 WILLIAM BURKE TRUSTEE 10.00 X 0 0 0 WILLIAM TRASK TRUSTEE 10.00 X 0 0 0 GEORGE WIESENDANGER TRUSTEE 10.00 X 0 0 0 MICHAEL CLARK TRUSTEE 10.00 X 0 0 0 RONALD DAWBER TRUSTEE 10.00 X 0 0 0 0 0 0 0 0 0 0 BLUE CROSS BLUE SHIELD 401 PARK DR 14 BOSTON MA 02129 CLAIMS ADMIN 898015 MORGAN STANLEY SMITH BARNEY 25 RECREATION PK DR HINGHAM MA 02043 INVESTMENT FEES 407152 REGAN ASSOCIATES 45 SCHOOL ST 3 BOSTON MA 02108 LEGALCLAIMS FEES 395936 3 EMPLOYER CONTRIBUTIONS 900099 28591857 28591857 EMPLOYEE CONTRIBUTIONS 900099 719424 719424 321302 321302 29632583 1470409 1470409 7756689 6268281 1488408 1488408 1488408 HALL RENTAL 532000 265 265 265 32591665 29311546 0 3280119 28335795 187578 73636 61978 12366 41763 58977 407152 181763 14182 9526 15169 2065 34603 23712 STOPLOSS 906629 REPAIRS AND MAINTENANCE 34355 ACA COMPLIANCE FEES 18975 REAL ESTATE TAXES 11998 12243 30444465 4999572 2938135 1360930 1405852 3339818 3083515 14178 13377 1443954 837308 624298 606646 56136662 46118770 13702885 3308540 3483992 69783998 71353172 26047 43739 71515 3804074 2328869 3830121 2444123 X 0 0 0 0 65953877 68909049 65953877 68909049 69783998 71353172 2147200 807972 0 X X 0 1 X 1 0 115200 115200 1094119 631873 462246 234635 205435 29200 606646 DOUBLELINE CORE FIXED MUTUAL FUND 3182643 F GUGGENHEIM LIMITED MUTUAL 3347348 F GUGGENHEIM TOTAL RETURN MUTUAL 3466790 F VANGUARD STK ETF 3706104 F 13702885 HEALTH CLAIMS PAYABLE 2325132 DUE TO AFFILIATES 3737 2328869 X 32992485 807972 807972 32184513 407152 407152 32591665 31508796 0 31508796 407152 -1471483 -1064331 30444465 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 DEPARTMENT OF LABOR AND INTERNAL REVENUE SERVICE. THE PLAN 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 ASSET) OR DISCLOSURE IN THE FINANCIAL STATEMENTS. PART XII, LINE 4B - OTHER ADJUSTMENTS: CHANGE IN BENEFITS PAYABLE -1,471,483. FORM 990, PART VI, SECTION A, LINE 6 COLLECTIVELY BARGAINED MULTIEMPLOYER PLAN FOR MEMBERS OF TEAMSTERS LOCAL 653 FORM 990, PART VI, SECTION B, LINE 11B BOARD OF TRUSTEES HAS GIVEN AUTHORITY TO THE FUND ADMINISTRATOR TO REVIEW TAX DOCUMENTATION BEFORE FILING. FORM 990, PART VI, SECTION B, LINE 12 AS AN EMPLOYEE BENEFIT PLAN, THE ORGANIZATION IS SUBJECT TO THE CONFLICTS OF INTEREST REQUIREMENTS OF ERISA FORM 990, PART VI, SECTION B, LINE 15 BOARD OF TRUSTEES REVIEWS KEY EMPLOYEES COMPENSATION WITH COMPARABILITY DATA ANNUALLY. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS AND AUDITED FINANCIAL STATEMENTS OF THE ORGANIZATION ARE AVAILABLE UPON REQUEST FORM 990, PART XII, LINE 2C: NO CHANGE IN OVERSIGHT PROCESS OR SELECTION OF INDEPENDANT ACCOUNTANT. 4 HAMPDEN DRIVE 4-1 HAMPDEN DRIVE SOUTH EASTON MA 02375 043552834 REALTY MA 501 0 INTERNATIONAL BROTHERHOOD OF TEAMSTERS LOCAL 653 TCWH 4 A HAMPDEN DRIVE SOUTH EASTON MA 02375 041472105 UNION MA 501 0 TEAMSTERS 25 HEALTH SERVICES 139 CAMPANELLI DRIVE MIDDLEBORO MA 02346 HEALTH INSURANCE 0 ABF FREIGHT SYSTEM INC AK N/A AGGREGATE INDUSTRIES INC CA N/A ALKAT TRANSPORT LLC MA N/A ARAMARK UNIFORM SERVICES INC CA N/A BURKE DISTRIBUTING CORPORATION MA N/A CBI SHAW & WEBSTER CONSTRUCTION TX N/A COLLINS CRANE & RIGGINS SERVICE INC MA N/A DAY & ZIMMERMAN NPS INC PA FAIRSIDE TRUCKING INC MA N/A FRITO-LAY INC MA N/A HALLAMORE CORPORATION MA N/A HORIZON BEVERAGE COMPANY INC MA N/A LORUSSO MATERIALS CORPPLAINVILLE MA N/A MARTIGNETTI COMPANIESUNITED LIQUORS MA N/A SM LORUSSO & SONS INC MA N/A SOUTHEASTERN CONCRETE INC MA N/A SOUTHEASTERN METAL FAB INC MA N/A UNITED PARCEL SERVICE OH N/A WH RILEY & SON INC (NA) MA N/A WH RILEY & SON INC (TAUNTON) MA N/A WILLIAMS POWER CORPORATION MA YRC WORLDWIDE INC KS N/A SYSCO BOSTON LLC MA 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 4 HAMPDEN DRIVE NOMINEE TRUST P 63911 CASH