2021-02-12T18:01:02-06:00 2020-03-31 208149084 ANASTASI MOORE & MARTIN PLLC 9 S WASHINGTON ST STE 600 SPOKANE WA 99201 990 2019-04-01 911283260 NORTHWEST LABORERS - EMPLOYERS HEALTH AND SECURITY TRUST FUND NORT 2062824100 11724 NE 195TH STREET NO 300 BOTHELL WA 980118242 JERMAINE SMILEY SECRETARY 2062824100 2021-02-11 1 PAUL ANASTASI P00395796 5093230272 2021-02-09 2019 2022-09-23 18:48:47Z DAVE RATZKE 11724 NE 195TH STREET NO 300 BOTHELL WA 980118242 193316735 0 X N/A X 1969 WA TO PROVIDE HEALTH AND WELFARE BENEFITS. 11 11 38 11 0 0 0 0 102671166 109335504 2136911 4454199 5442721 4694785 110250798 118484488 0 0 91053716 102435965 0 0 0 0 0 7574573 8111937 98628289 110547902 11622509 7936586 111796366 128743749 42773232 50720910 69023134 78022839 TO PROVIDE HEALTH AND WELFARE BENEFITS. 0 0 110547902 INCOME IS USED TO PROVIDE HEALTH AND SECURITY BENEFITS TO QUALIFIED PARTICIPANTS IN THE PLAN. 110547902 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 0 0 38 1 0 0 0 0 0 0 0 0 0 0 X 11 11 0 1 0 0 0 0 0 1 1 0 0 1 0 1 1 0 0 0 X ZENITH AMERICAN SOLUTIONS INC 2062824100 11724 NE 195TH STREET BOTHELL WA 980118242 X ANDREW LEDBETTER CHAIRMAN 1.00 X 0 0 0 JERMAINE SMILEY SECRETARY 1.00 X 0 0 0 MARK HORTON TRUSTEE 1.00 X 0 0 0 DAN KUNEY TRUSTEE 1.00 X 0 0 0 ANISSA LINDGREN TRUSTEE 1.00 X 0 0 0 CARL STEWART TRUSTEE 1.00 X 0 0 0 KARI SHIFLETT TRUSTEE 1.00 X 0 0 0 BRIAN BELARDE TRUSTEE 1.00 X 0 0 0 DALE CANNON TRUSTEE 1.00 X 0 0 0 STACY MARTIN TRUSTEE 1.00 X 0 0 0 KAYNE SEGURA TRUSTEE 1.00 X 0 0 0 SHANNON STULL TRUSTEE 1.00 X 0 0 0 0 0 0 0 0 0 0 ZENITH AMERICAN SOLUTIONS 201 QUEEN ANNE AVENUE NORTH 100 SEATTLE WA 98109 ADMINISTRATION 3666156 PREMERA BLUE CROSS 7110 220TH ST SW MOUNTLAKE TERRACE WA 98043 CLAIMS PROCESSING 2373558 CARE ALLIES 1601 CHESTNUT STREET PHILADELPHIA PA 19192 CLAIMS PROCESSING 605100 DELTA DENTAL 9706 FOURTH AVE NE SEATTLE WA 98115 CLAIMS PROCESSING 333592 STOLL LAW GROUP 9101 N HARLAN ST 140 WESTMINSTER CO 80031 LEGAL & PROFESSIONAL 153042 9 EMPLOYER CONTRIBUTIONS 525100 102354897 102354897 EMPLOYEE AND RETIREE SELF-PAYMENT 525100 6980607 6980607 109335504 2562551 2562551 76723895 74832247 1891648 1891648 1891648 DRUG REBATES AND SUBSIDY 525100 4569244 4569244 LIQUIDATED DAMAGES 525100 125541 125541 4694785 118484488 114030289 0 4454199 102435965 102435965 4665303 4665303 209323 209323 117775 117775 241929 241929 2548226 2548226 284810 284810 10275 10275 20721 20721 STORAGE 7895 7895 INTERNATIONAL FOUNDATIO 5680 5680 110547902 110547902 0 0 7335463 11932338 1361510 798878 9285816 8368621 93813577 107643912 111796366 128743749 359878 360598 42413354 50360312 42773232 50720910 X 0 0 0 0 69023134 78022839 69023134 78022839 111796366 128743749 X 7936586 3428568 -2365449 X 0 1 X 0 0 0 BANK OVERDRAFTS 1020690 SECURITIES TRANSACTIONS 2023321 AMOUNTS DUE INSURANCE COMPANIES 167055 BENEFITS PAYABLE 6092809 CLAIMS IBNR 13105000 ACCUMULATED ELIGIBIILITY CREDITS 27951437 50360312 X 121671127 3428568 3428568 118242559 241929 241929 118484488 107229925 0 107229925 241929 3076048 3317977 110547902 PART X, LINE 2: THE TRUST ESTABLISHED UNDER THE PLAN TO HOLD THE PLAN'S ASSETS IS QUALIFIED PURSUANT TO THE APPROPRIATE SECTION OF THE INTERNAL REVENUE CODE (IRC), AND, ACCORDINGLY, THE TRUST'S NET INVESTMENT INCOME IS EXEMPT FROM INCOME TAXES. THE PLAN HAS OBTAINED A FAVORABLE DETERMINATION LETTER FROM THE INTERNAL REVENUE SERVICE (IRS), BUT HAS SINCE BEEN AMENDED. HOWEVER, THE PLAN ADMINISTRATOR BELIEVES THAT THE PLAN IS CURRENTLY DESIGNED AND BEING OPERATED IN COMPLIANCE WITH THE APPLICABLE REQUIREMENTS OF THE IRC. THEREFORE, THEY BELIEVE THAT THE PLAN IS QUALIFIED, AND THE RELATED TRUST IS TAX-EXEMPT AS OF THE FINANCIAL STATEMENT DATES. ACCORDINGLY, NO PROVISION FOR INCOME TAXES HAS BEEN INCLUDED IN THE PLAN'S FINANCIAL STATEMENTS. 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 ADMINISTRATOR HAS ANALYZED THE TAX POSITIONS TAKEN BY THE PLAN AND HAS CONCLUDED THAT AS OF MARCH 31, 2020, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF THE LIABILITY (OR ASSET) OR DISCLOSURE IN THE FINANCIAL STATEMENTS. THE PLAN IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS AND THE PLAN COULD BE SUBJECT TO INCOME TAX IF CERTAIN ISSUES WERE FOUND BY THE IRS THAT COULD RESULT IN THE DISQUALIFICATION OF THE PLAN'S TAX-EXEMPT STATUS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. PART XII, LINE 4B - OTHER ADJUSTMENTS: CHANGE IN BENEFIT OBLIGATIONS PAYABLE 3,076,048. FORM 990, PART VI, SECTION A, LINE 3 THE DAY TO DAY MANAGEMENT AND OPERATIONS OF THE PLAN ARE HANDLED BY A THIRD PARTY ADMINISTRATOR, ZENITH AMERICAN SOLUTIONS, INC. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS REVIEWED BY THE CHAIRMAN OF THE BOARD OF TRUSTEES AS WELL AS THE PLAN ADMINISTRATOR PRIOR TO ITS FILING. FORM 990, PART VI, SECTION C, LINE 19 THE PLAN PROVIDES FOR PARTICIPANT INSPECTION OF DOCUMENTS AND FINANCIAL STATEMENTS UPON REQUEST THROUGH THE PLAN ADMINISTRATORS. FORM 990, PART XI, LINE 9: CHANGE IN ACCUMULATED ELIGIBILITY CREDITS -2,365,449. ASSOCIATED GENERAL CONTRACTORS INLAND NORTHWEST AGC JEFFERSON COUNTY PUD LABORERS 348W LOCAL 242 LABORERS LOCAL 292 LABORERS LOCAL UNION 252 NW LAB-EMPLOYERS TRAINING PORT OF LONGVIEW PORT OF SEATTLE PUBLIC UTILITY DISTRICT #1 SEATTLE HOUSING AUTHORITY SEATTLE SCHOOL DISTRICT SUNNYSIDE VALLEY IRR TACOMA HOUSING AUTHORITY TACOMA SCHOOL DISTRICT WASH & NO IDAHO DIST COUNCIL YAKIMA-TIETON IRRIGATION DIST ADVANCED EXCAVATING SPECIALIST ALL CITY SAWING AND DRILLING ANDERSEN STRUCTURES LLC ASCENDENT LLC BARCOTT CONSTRUCTION LLC BC TRAFFIC LLC BIG MOUNTAIN ENTERPRISES LLC BRANDSAFWAY SERVICES LLC CAMERON-REILLY LLC CASTLE WALLS LLC CC COMMERCIAL CURBING TRI CITI CHANGING DIRECTIONS CHICK OF ALL TRADES DBA COAT F COLE CONCRETE LLC CONSTRUCTION BY CHAMPION LLC CONSTRUCTION GROUP INT'L LLC CORRIDOR CONTRACTORS LLC FENIX EARTHWORKS LLC FINKBONNER FLAGGING LLC GOODFELLOW BROS LLC HANGING H COMPANIES LLC HARRIS PACIFIC NW HIGHMARK CONCRETE CONT LLC HOWARD S WRIGHT CONSTRUCTORS JH KELLY LLC JSB 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CO INC TODD SHIPYARDS TOTEM ELECTRIC OF TACOMA INC TRAFFIC MANAGEMENT INC TUCCI & SONS INC TURNER CONSTRUCTION CO US PIPELINE INC UNIMARK CONST CO WALKER SPECIALTY CONST WALSH CONST DBA WALSH PACIFIC WAPATO POINT MANAGEMENT CO WARDS MASONRY INC WASTE TREATMENT COMPLETION CO WATSON ASPHALT PAVING WATTS CONSTRUCTION INC WAUNCH CONSTRUCTION & TRUCKING WEST COAST CONCRETE RESTORE WILCOX CONSTRUCTION INC WILLIAM WINKLER WILSON CONCRETE CONT INC YAKIMA-TIETON IRRIG DIST 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 CONTRIBUTIONS FROM TAX-EXEMPT ENTITIES S 4454625 CASH CONTRIBUTIONS FROM EMPLOYERS TAXED AS PARTNERSHIPS S 13620058 CASH CONTRIBUTIONS FROM EMPLOYERS TAXED AS CORPORATIONS S 77809038 CASH