2021-01-12T10:54:16-06:00 2020-04-30 470900880 CALIBRE CPA GROUP PLLC 462 SEVENTH AVENUE 16TH FLOOR NEW YORK NY 10018 990 2019-05-01 136129427 HEALTH FUND 917 HEAL 5163263371 22 NORTH TYSON AVENUE NO 1 FL FLORAL PARK NY 11001 RALPH NATALE TRUSTEE 5163263371 2021-01-12 1 JOSEPH MORELLO P02146706 2126951300 2021-01-11 2019 2022-09-23 18:48:47Z 26932346 0 X N/A X 1950 NY TO PROVIDE HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS. 6 3 3 0 0 0 0 0 18193172 18492336 572363 2574261 0 0 18765535 21066597 0 0 17735631 17890993 271590 279238 0 0 0 403281 345495 18410502 18515726 355033 2550871 42587638 44920523 2950752 3141965 39636886 41778558 TO PROVIDE HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS. 0 0 TO PROVIDE HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS. 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 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 98 0 1 3 1 0 0 0 0 0 0 0 0 0 0 X 6 3 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 X BOARD OF TRUSTEES 5163263371 22 NORTH TYSON AVENUE FLORAL PARK NY 11001 DEMOS DEMOPOULOS TRUSTEE 2.00 40.00 X 0 0 0 RALPH NATALE TRUSTEE 2.00 40.00 X 0 124100 37676 ROY KOHN TRUSTEE 2.00 X 0 0 0 KIRK CONAWAY TRUSTEE 2.00 X 0 0 0 JEFFREY ISAACS TRUSTEE 2.00 X 0 0 0 DAVID PEREZ TRUSTEE 2.00 40.00 X 0 121500 37674 JOANN EMMONS FUND ADMINISTRATOR 22.00 18.00 X 140010 0 39200 140010 245600 114550 1 0 1 0 EMPIRE BLUE CROSS AND BLUE SHIELD ONE LIBERTY PLAZA NEW YORK NY 10006 PPO ACCESS 448011 ZENITH AMERICAN SOLUTIONS 140 SYLVAN AVENUE ENGLEWOOD NJ 07632 CLAIMS PROCESSING 311808 2 EMPLOYER CONTRIBUTIONS 525100 18241317 18241317 EMPLOYEE CONTRIBUTIONS 525100 251019 251019 18492336 615316 615316 7824694 5865749 1958945 1958945 1958945 21066597 18492336 0 2574261 17890993 111738 102315 51510 13675 51678 79688 28700 44000 30974 10910 65867 1990 31688 18515726 -26190 -19421 554561 2144501 774603 1175081 14031 12787 82786 82786 519 0 20687195 27018170 20555404 14561890 27515 27515 42587638 44920523 83752 61965 2867000 3080000 2950752 3141965 X 0 0 0 0 39636886 41778558 39636886 41778558 42587638 44920523 2550871 -409199 0 X 0 1 X 0 0 72693 72693 0 10093 10093 0 0 COLLECTIVE TRUST FUND 14561890 F 14561890 POST RETIREMENT BENEFIT OBLIGATIONS 1440000 CLAIMS INCURRED BUT NOT REPORTED 1640000 3080000 X 20628698 -409199 -409199 21037897 28700 28700 21066597 18274026 0 18274026 28700 213000 241700 18515726 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 IT HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE. THE PLAN ADMINISTRATOR HAS ANALYZED THE TAX POSITIONS TAKEN BY THE PLAN, AND HAS CONCLUDED THAT AS OF APRIL 30, 2020, THERE WERE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY (OR ASSET) OR DISCLOSURE IN THE FINANCIAL STATEMENTS. 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: INCREASE IN BENEFIT OBLIGATIONS 0 0 0 RALPH NATALE TRUSTEE 0 111800 0 0 0 12300 0 18930 0 18746 0 161776 0 0 DAVID PEREZ TRUSTEE 0 109200 0 0 0 12300 0 18929 0 18745 0 159174 0 0 JOANN EMMONS FUND ADMINISTRATOR 140010 0 0 0 0 0 19152 0 20048 0 179210 0 0 0 FORM 990, PART VI, SECTION B, LINE 11B LINE 11B EXPLANATION - THE RETURN PREPARER E-MAILS A COPY OF THE FINAL VERSION OF FORM 990 TO THE PLAN ADMINISTRATOR AND TRUSTEES FOR THEIR REVIEW AND APPROVAL. INQUIRIES ARE MADE TO THE PREPARER AS NEEDED. FORM 990, PART VI, SECTION C, LINE 19 FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC THROUGH THE ORGANIZATION'S ANNUAL FORM 5500 FILING. NO OTHER DOCUMENTS ARE AVAILABLE TO THE PUBLIC. LOCAL UNION 917 IBT 24 N TYSON AVENUE FLORAL PARK NY 11001 135279293 LABOR UNION NY 501(C)(5) 0 LOCAL 917 PENSION FUND 22 NORTH TYSON AVENUE FLORAL PARK NY 11001 BENEFIT FUND NY 0 LOCAL 868 I B OF T PENSION FUND 22 NORTH TYSON AVENUE FLORAL PARK NY 11001 BENEFIT FUND NY 0 LOCAL 816 LABOR & MGMT PENSION TR FUND 22 NORTH TYSON AVENUE FLORAL PARK NY 11001 BENEFIT FUND NY 0 19-20 INDUSTRY CITY CONTRIBUTING EMPLOYER 0 A F KAUFMAN CONTRIBUTING EMPLOYER 0 A F ROCKLAND PLUMBING CONTRIBUTING EMPLOYER 0 A F SUPPLY CORP CONTRIBUTING EMPLOYER 0 ABM INDUSTRIES CONTRIBUTING EMPLOYER 0 ALLIED AVIATION CONTRIBUTING EMPLOYER 0 AMBRO OPERATING CORP CONTRIBUTING EMPLOYER 0 APPROVED OIL CONTRIBUTING EMPLOYER 0 BAKERY DRIVERS LOCAL CONTRIBUTING EMPLOYER 0 BARNEY'S SERVICE STATION CONTRIBUTING EMPLOYER 0 BAYSIDE FUEL CONTRIBUTING EMPLOYER 0 BLUE DIAMOND CONTRIBUTING EMPLOYER 0 BORO FUEL CONTRIBUTING EMPLOYER 0 BRONX AUTOMOTIVE CONTRIBUTING EMPLOYER 0 BRONX FORD CONTRIBUTING EMPLOYER 0 BUCKEYE PIPELINE CONTRIBUTING EMPLOYER 0 CARMEL GARAGE INC CONTRIBUTING EMPLOYER 0 CENTRAL PARKING CONTRIBUTING EMPLOYER 0 CENTURY MOTORS INC CONTRIBUTING EMPLOYER 0 COHLER FUEL CONTRIBUTING EMPLOYER 0 DEBRAGGA & SPITLER CONTRIBUTING EMPLOYER 0 DORCHESTER HEATING CONTRIBUTING EMPLOYER 0 EAST COAST MECHANICAL CONTRIBUTING EMPLOYER 0 EAST COAST PETROLEUM CONTRIBUTING EMPLOYER 0 FANCY FOODS INC CONTRIBUTING EMPLOYER 0 FRED SCHILDWACHTER CONTRIBUTING EMPLOYER 0 GROCERY HAULERS CONTRIBUTING EMPLOYER 0 HALL ST COLD STORAGE CONTRIBUTING EMPLOYER 0 HEMSTEAD LINCOLN MERCURY CONTRIBUTING EMPLOYER 0 INTERSTATE FOODS INC CONTRIBUTING EMPLOYER 0 JM HUNTINGTON MOTORS CONTRIBUTING EMPLOYER 0 KARP VOLVO INC CONTRIBUTING EMPLOYER 0 L&M BUS CORP CONTRIBUTING EMPLOYER 0 LAB CORP CONTRIBUTING EMPLOYER 0 LAZ PARKING CONTRIBUTING EMPLOYER 0 LOCAL 553 PENSION FUND CONTRIBUTING EMPLOYER 0 MAJOR CHEVROLET INC CONTRIBUTING EMPLOYER 0 MAJOR WORLD CDJR LLC CONTRIBUTING EMPLOYER 0 MANHATTAN AMC JEEP CONTRIBUTING EMPLOYER 0 MERRICK DODGE INC CONTRIBUTING EMPLOYER 0 MISSION OF THE IMMAC CONTRIBUTING EMPLOYER 0 MONTEBELLO COAL CONTRIBUTING EMPLOYER 0 NEW UTRECHT CONTRIBUTING EMPLOYER 0 PACIFIC PETROLEUM CONTRIBUTING EMPLOYER 0 PETRO CONTRIBUTING EMPLOYER 0 PLAZA OLDSMOBILE CONTRIBUTING EMPLOYER 0 PLAZA TOYOTA CONTRIBUTING EMPLOYER 0 PRIDE BUS CORP CONTRIBUTING EMPLOYER 0 PRIDE CORPORATION CONTRIBUTING EMPLOYER 0 PRIDE TRANSPORTATION CONTRIBUTING EMPLOYER 0 PROPARK AMERICA CONTRIBUTING EMPLOYER 0 PULLUM FUEL CONTRIBUTING EMPLOYER 0 ROCKWAY FUEL CONTRIBUTING EMPLOYER 0 RSTR MOTORS CONTRIBUTING EMPLOYER 0 SJ FUEL CONTRIBUTING EMPLOYER 0 SKAGGS & WALSH CONTRIBUTING EMPLOYER 0 SPEEDWAY CONTRIBUTING EMPLOYER 0 STANDARD PARKING CONTRIBUTING EMPLOYER 0 STATEWIDE OIL CONTRIBUTING EMPLOYER 0 THE CAR PARK CONTRIBUTING EMPLOYER 0 UNITED APOLLO PETROLEUM CONTRIBUTING EMPLOYER 0 UNITED JEWISH APPEAL CONTRIBUTING EMPLOYER 0 WELCOME PARKING CONTRIBUTING EMPLOYER 0 WILCO ENERGY CONTRIBUTING EMPLOYER 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 1 0 0 LOCAL 917 PENSION FUND Q 86250 TIME STUDY LOCAL 868 I B T PENSION FUND Q 48435 TIME STUDY LOCAL 816 LABOR & MGMT PENSION FUND Q 127545 TIME STUDY