2021-11-09T18:57:39-06:00 2020-12-31 522385296 LINDQUIST LLP 5000 EXECUTIVE PARKWAY SUITE 400 SAN RAMON CA 94583 990 2020-01-01 936021475 OREGON TEAMSTER EMPLOYERS TRUST OREG 5032825581 PO BOX 4148 PORTLAND OR 972084148 STEPHEN S ERDMANN TRUSTEE 5032825581 2021-11-09 1 STEPHEN ERDMANN 999009999 JAMES N BROWNING P01451906 9252779100 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z STEPHEN S ERDMANN PO BOX 4148 PORTLAND OR 972084148 380759333 0 X N/A X 1957 OR TO PROVIDE HEALTH BENEFITS TO PARTICIPANTS AND THEIR ELIGIBLE DEPENDENTS. 12 3 0 0 0 0 0 0 205074263 212449337 4191895 5241872 42248 133804 209308406 217825013 0 0 182540789 171409102 0 0 0 0 0 8079924 7975170 190620713 179384272 18687693 38440741 119583907 159752614 33167949 32215704 86415958 127536910 PROVIDE HEALTH, DENTAL, VISION, LIFE INSURANCE AND OTHER BENEFITS TO ELIGIBLE PARTICIPANTS. 0 0 PROVIDED HEALTH, DENTAL, VISION, LIFE INSURANCE AND OTHER BENEFITS TO ELIGIBLE PARTICIPANTS. 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 12 3 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X THE WILLIAM C EARHART CO INC 5032825581 12029 NE GLEN WIDING DR PORTLAND OR 97220 X DAN RATTY TRUSTEE - PAST 1.00 X 0 0 0 STEVE KONOPA TRUSTEE 1.00 X 0 0 0 THOMAS WATT TRUSTEE - PAST 3.50 X 0 0 0 STEPHEN ERDMANN TRUSTEE 3.50 X 0 0 0 COLIN JACKSON TRUSTEE 1.00 X 0 0 0 ADAM WINSTON TRUSTEE 1.00 X 0 0 0 JERRY D'AMBROSIO TRUSTEE 1.00 X 0 0 0 MARK DAVISON TRUSTEE 1.00 X 0 0 0 KENNETH JOHNSON TRUSTEE - PAST 1.00 X 0 0 0 SEAN HAMMOND TRUSTEE 1.00 X 0 0 0 WALTER LACHAPELLE TRUSTEE 1.00 X 0 0 0 LESLIE SLOY TRUSTEE 1.00 X 0 0 0 CHRIS MUHS TRUSTEE 1.00 X 0 0 0 DAVID SCHMIDT TRUSTEE 1.00 X 0 0 0 DEBORAH OSTENDORP TRUSTEE 1.00 X 0 0 0 SEE SCHEDULE O FOR COMPENSATION PAID BY RELATED ORGANIZATIONS 0.00 X 0 1 0 0 1 0 0 0 0 0 REGENCE BLUE CROSS BLUE SHIELD 100 SW MARKET STREET PORTLAND OR 972015702 CLAIMS ADMINISTRATION 5343058 WILLIAM C EARHART CO INC 12029 NE GLENN WIDING DR PORTLAND OR 97220 THIRD PARTY ADMINISTRATIVE FEES 1330043 LOOMIS SAYLES & COMPANY LP 555 CALIFORNIA STREET SUITE 3300 SAN FRANCISCO CA 94104 INVESTMENT MANAGEMENT 287245 EXPRESS SCRIPTS 100 PARSON POND AVE FRANKLIN LAKES NJ 07417 CLAIMS ADMINISTRATION 283629 LINDQUIST LLP 5000 EXECUTIVE PARKWAY SAN RAMON CA 94583 AUDIT AND ACCOUNTING 195483 7 EMPLOYER CONTRIBUTIONS 900099 199604718 199604718 PRESCRIPTION & VISION REBATES 900099 6135622 6135622 PARTICIPANT CONTRIBUTIONS 900099 5451964 5451964 HRA CONTRIBUTIONS 900099 1058789 1058789 EXPERIENCE REFUND 900099 99924 99924 98320 98320 212449337 2314838 2314838 165861354 162934320 2927034 2927034 2927034 OTHER INCOME 900099 133804 133804 133804 217825013 212583141 0 5241872 171409102 1223850 120319 195483 322058 5724282 296868 17545 74765 179384272 5491998 10992342 19968379 20507319 11149 12743 94112381 128240210 119583907 159752614 1015432 1049746 405281 437606 31747236 30728352 33167949 32215704 X 0 0 0 0 86415958 127536910 86415958 127536910 119583907 159752614 38440741 2680211 0 X X 0 1 X 1 0 0 CLAIMS PAYABLE AND IBNR 14205000 PREMIUMS PAYABLE 1745563 ACCUMULATED ELIGIBILITY CREDITS 14155000 DUE TO BROKER/SECURITIES PURCHASED 622789 30728352 X 220183166 2680211 2680211 217502955 322058 322058 217825013 180703887 0 180703887 322058 -1641673 -1319615 179384272 PART X, LINE 2: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE THE TAX POSITIONS TAKEN BY THE PLAN AND TO RECOGNIZE A TAX LIABILITY IF THE PLAN HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE. THE PLAN HAS ANALYZED THE TAX POSITIONS TAKEN BY THE PLAN AND HAS CONCLUDED THAT, AS OF DECEMBER 31, 2020, 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 BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR THE FISCAL YEARS PRIOR TO 2017. PART XII, LINE 4B - OTHER ADJUSTMENTS: CHANGE IN BENEFIT OBLIGATIONS FORM 990, PART VI, SECTION A, LINE 3 THE PLAN HAS CONTRACTED WITH WILLIAM C. EARHART CO., INC TO PROVIDE DAY-TO-DAY ADMINISTRATIVE SERVICES TO THE ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PROVIDED TO THE GOVERNING BODY FOR THEIR REVIEW AND COMMENTS PRIOR TO FILING THE RETURN WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C ANY TRUSTEE OR SERVICE PROVIDER AUTHORIZED TO CONDUCT TRANSACTIONS ON BEHALF OF THE TRUST WHO HAS REASON TO BELIEVE THAT A PROPOSED TRANSACTION MIGHT CONSTITUTE A PROHIBITED TRANSACTION WITH A PARTY IN INTEREST SHOULD CONSULT WITH TRUST COUNSEL AND TAKE WHATEVER ADDITIONAL ACTION MAY BE APPROPRIATE TO ENSURE THAT THE PROPOSED TRANSACTION IS APPROPRIATE. ANY FIDUCIARY WHOSE PARTICIPATION IN A DECISION MAY RESULT IN A NON-EXEMPTED PROHIBITED TRANSACTION UNDER SECTION 406 OF ERISA SHALL RECUSE HIMSELF OR HERSELF FROM DISCUSSION OR VOTING ON SUCH DECISION. THE TRUST OFFICE SHALL ANNUALLY DISTRIBUTE A PARTY-IN-INTEREST QUESTIONNAIRE TO PLAN FIDUCIARIES IN CONJUNCTION WITH THE ANNUAL AUDIT. 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 VII, SECTION A, LINE 1A: TRUSTEES ARE NOT COMPENSATED BY THE TRUST. COMPENSATION PAID TO TRUSTEES EMPLOYED BY OTHER RELATED ORGANIZATIONS IS REPORTED ON THE FORM 990 FILED WITH THE INTERNAL REVENUE SERVICE BY THE RELATED TAX-EXEMPT ORGANIZATION. IF YOU WOULD LIKE ADDITIONAL INFORMATION, PLEASE CONTACT THE THIRD-PARTY ADMINISTRATOR, THE WILLIAM C. EARHART CO. FORM 990, PART XII, LINE 2C: THE BOARD OF TRUSTEES IS RESPONSIBLE FOR OVERSIGHT OF THE ANNUAL AUDIT AND FOR SELECTION OF THE INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. JOINT COUNCIL OF TEAMSTERS NO 37 1872 NE 162ND AVENUE PORTLAND OR 97230 930196193 LABOR ORGANIZATION OR 501(C)(5) 0 INT'L BROTHERHOOD OF TEAMSTERS UNION LOCAL NO 962 4480 ROGUE VALLEY HGWY CENTRAL POINT OR 97502 930236781 LABOR ORGANIZATION OR 501(C)(5) 0 GENERAL TEAMSTERS LOCAL 483 225 N 16TH STREET BOISE ID 83702 820171930 LABOR ORGANIZATION ID 501(C)(5) 0 INTL BROTHERHOOD OF TEAMSTERS LOCAL 324 2686 PORTLAND ROAD NE SALEM OR 97303 930196206 LABOR ORGANIZATION OR 501(C)(5) 0 DAIRY BAKERY & FOOD PROCESSORS IND TECH & AUTO LOCAL NO 305 1870 NE 162ND AVENUE PORTLAND OR 97230 930151383 LABOR ORGANIZATION OR 501(C)(5) 0 INTL BROTHERHOOD OF TEAMSTERS LOCAL 223 1230 NE 106TH AVENUE PORTLAND OR 97220 930179776 LABOR ORGANIZATION OR 501(C)(5) 0 GENERAL TEAMSTERS AUTO TRUCK DRIVERS & HELPERS LOCAL NO 162 1850 NE 162ND AVENUE PORTLAND OR 97230 930196219 LABOR ORGANIZATION OR 501(C)(5) 0 LINE DRIVERS LOCAL PICKUP & DELIVERY LOCAL UNION NO 81 1874 NE 162ND AVENUE PORTLAND OR 97230 930438697 LABOR ORGANIZATION OR 501(C)(5) 0 CHAUFFEURS TEAMSTERS & HELPERS LOCAL 58 2212 NE ANDRESEN ROAD VANCOUVER WA 98661 910436963 LABOR ORGANIZATION WA 501(C)(5) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 SCHEDULE R, IDENTIFICATION OF RELATED ORGANIZATIONS: EXPLANATION: THE FILING ORGANIZATION IS A TAFT-HARTLEY MULTIEMPLOYER TRUST THAT PROVIDES HEALTH AND WELFARE BENEFITS TO ELIGIBLE EMPLOYEES AND THEIR DEPENDENTS. AS OF DECEMBER 31, 2020, THERE ARE APPROXIMATELY 190 EMPLOYERS THAT CONTRIBUTE TO THE TRUST. THE ADMINISTRATIVE OFFICE MAINTAINS A DATABASE OF THESE CONTRIBUTING EMPLOYERS, INCLUDING NAMES, ADDRESSES AND OTHER CONTACT INFORMATION. THE FEDERAL TAX CLASSIFICATION (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. ALBERTSON'S LLC ALLIED WASTE INDUSTRIES ALPENROSE DAIRY ALSCO AMERICAN INDUSTRIAL ARAMARK CLEAN ROOM ARAMARK UNIFORM SERVICES B & B LEASING BENTON CO DEPUTY SHERIFFS BIMBO BAKERIES USA, INC BLACK BUTTE RANCH FIRE BLACK BUTTE RANCH POLICE BLISS SANITARY SEVICE INC BROTHERS PIPELINE CORP CALPORTLAND CAPITOL DISPOSAL & RECYLE CARPENTERS UNION L.146 CARPENTERS,UNION,L1503 CHEMTRADE SOLUTIONS LLC CHRISTENSEN ELECTRIC CO CITY OF ASTORIA CITY OF CASTLE ROCK CITY OF CAVE JUNCTION CITY OF CENTRAL POINT CITY OF CLATSKANIE-PUBLIC CITY OF CORVALLIS-POLICE CITY OF EAGLE POINT CITY OF FAIRVIEW CITY OF GRANTS PASS CITY OF INDEPENDENCE CITY OF JACKSONVILLE CITY OF KALAMA CITY OF KELSO CITY OF KLAMATH FALLS CITY OF LEBANON CITY OF MCMINNVILLE CITY OF MOLALLA CITY OF NORTH BEND CITY OF PHOENIX CITY OF RAINIER CITY OF RAINIER PUB WORKS CITY OF RIDGEFIELD CITY OF ROGUE RIVER CITY OF SHADY COVE CITY OF TALENT CITY OF TILLAMOOK-POLICE CITY OF WOODLAND CLACKAMAS GARBAGE CO INC CLATSOP DISTRIBUTING CO CLEAN WATER SERVICES COPELAND PAVING COMPANY COPELAND SAND & GRAVEL COUNTY OF COOS COUNTY OF TILLAMOOK COWLITZ COUNTY AUDITOR CURRY COUNTY ROAD DEPT CURRY COUNTY SHERIFFS DAIMLER TRUCKS N. AMERICA DARLING INTERNATIONAL INC DAY & ZIMMERMANN NPS DHL EXPRESS DOUGLAS COUNTY ECO SERVICES OPERATIONS ECSO EMERALD FRUIT & PRODUCE FARMER BROTHER CO FARMER BROTHERS COMPANY FRED MEYER - DIST TRUCK FRED MEYER PERSONNEL FRED MEYER-BAKERY ENGINEE FRED MEYER-DIVISION KROGE GARBARINO DISPOSAL SERV GREAT WESTERN MALTING CO GRESHAM SANITARY SERVICE HILLSBORO GARB DISP INC INDUSTRIAL EXPORT CO JOHNSON ROCK PROD INC JT COUNCIL TEAMSTERS #37 KELLER DROP BOX INC / KLAMATH CO EMERGENCY COMM KLAMATH COUNTY SERGEANTS L C HALLS TRUCK LINES LAKE COUNTY LAKE DISTRICT HOSPITAL LAKE MERWIN CAMPER HIDEWA LAKESIDE INDUSTRIES LARSENS CREAMERY LEE & EASTES TANK LINES LINDE GAS USA LLC LINDE INC LTM - COAST DIVISION LTM INC LTM INC, WAS BEAVER STATE LYRICAL FOODS II MATHESON TRI-GAS INC. 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