2021-07-13T12:57:52-05:00 2020-12-31 131577780 SCHULTHEIS & PANETTIERI LLP 450 WIRELESS BLVD HAUPPAUGE NY 11788 990 2020-01-01 136121369 DERRICKMEN'S WELFARE FUND LOCAL 197 DERR 2125055050 253 W 35TH ST - 12TH FL NEW YORK CITY NY 100011970 WILLIAM HAYES UNION TRUSTEE 2125055050 2021-07-13 1 WILLIAM HAYES 999009999 CAROL WESTFALL P00539069 6312734778 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z WILLIAM HAYES 253 W 35TH ST - 12TH FL NEW YORK CITY NY 100011970 4466447 0 X N/A X 1950 NY TO PROVIDE MEDICAL, VACATION, DEATH BENEFITS, PRESCRIPTION DRUG,OPTICAL, DISABILITY AND PAID FAMILY LEAVE TO ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS. 7 7 0 0 0 0 0 0 6866396 4379199 98403 87248 0 0 6964799 4466447 0 0 5974807 4936803 0 0 0 0 0 235452 250563 6210259 5187366 754540 -720919 6915844 6337256 828235 730572 6087609 5606684 TO PROVIDE MEDICAL, VACATION, DEATH BENEFITS, PRESCRIPTION DRUG,OPTICAL, DISABILITY AND PAID FAMILY LEAVE TO ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS. 0 0 TO PROVIDE MEDICAL, VACATION, DEATH BENEFITS, PRESCRIPTION DRUG,OPTICAL, DISABILITY AND PAID FAMILY LEAVE TO ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS. 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 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 37 0 1 0 0 0 0 0 0 0 0 0 X 7 7 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X DANIEL H COOK ASSOC 2125055050 253 W 35TH ST - 12TH FL NEW YORK NY 100011970 X WILLIAM HAYES UNION TRUSTEE 1.00 3.00 X 0 0 0 CAROLE RAFTREY UNION TRUSTEE 1.00 3.00 X 0 0 0 THOMAS WILSON UNION TRUSTEE 1.00 3.00 X 0 0 0 DAVID CARRUA - EFF 092020 UNION TRUSTEE 1.00 3.00 X 0 0 0 CHRIS GORMAN - THRU 082020 UNION TRUSTEE 1.00 3.00 X 0 0 0 MARCO BERARDI EMPLYR TRUSTEE 1.00 3.00 X 0 0 0 ANTHONY VESPA EMPLYR TRUSTEE 1.00 3.00 X 0 0 0 ROBERT WEISS EMPLYR TRUSTEE 1.00 3.00 X 0 0 0 0 0 0 0 0 0 0 SCHULTHEIS & PANETTIERI LLP 450 WIRELESS BOULEVARD HAUPPAUGE NY 11788 ACCOUNTING AND AUDIT 103874 1 PARTICIPANTS' CONTRIB 238900 2522398 2522398 EMPLOYERS' CONTRIB 238900 1820208 1820208 INSURANCE REIMB 900090 36593 36593 4379199 87248 87248 4466447 4379199 0 87248 4936803 56036 67118 6000 24482 8294 3043 3051 THIRD PARTY ADMINISTRAT 65238 REIMB ADMIN EXP-LOCAL 1 17301 5187366 2477326 1340485 23303 109544 628885 860903 3786330 4026324 6915844 6337256 97904 134726 730331 595846 828235 730572 X 0 0 0 0 6087609 5606684 6087609 5606684 6915844 6337256 -720919 239994 0 X 0 1 X 1 0 0 CHNG IN CLAIMS PAY & INCUR NOT RPTD 595846 595846 4700441 239994 239994 4460447 6000 6000 4466447 5315851 0 5315851 6000 -134485 -128485 5187366 PART XII, LINE 4B - OTHER ADJUSTMENTS: CHNG IN CLAIMS PAY & INCUR NOT RPTD -134,485. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 WAS PREPARED IN COORDINATION WITH THE FUND ADMINISTRATOR. ONCE COMPLETE, THE FORM WAS PROVIDED TO AND REVIEWED BY THE BOARD OF TRUSTEES PRIOR TO SUBMISSION. FORM 990, PART VI, SECTION B, LINE 12C AS REQUIRED BY THE FUND'S POLICY AND BY ERISA, OFFICERS, DIRECTORS, AND KEY EMPLOYEES HAVE A CONTINUOUS OBLIGATION TO REPORT POTENTIAL CONFLICTS OF INTEREST. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICTS OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO ALL PARTICIPANTS UPON REQUEST. DOCUMENTS ARE AVAILABLE TO THE GENERAL PUBLIC UPON REQUEST TO THE EXTENT REQUIRED BY LAW. DERRICKMEN'S ANNUITY FUND LCL 197 253 WEST 35TH STREET 12TH FLOOR NEW YORK CITY NY 100011970 516112621 PROVIDE RET BENEFITS TO ELIG PARTICIPANTS NY 501(A) N/A N/A 0 DERRICKMEN'S APPRENTICE EDU FUND 253 WEST 35TH STREET 12TH FLOOR NEW YORK CITY NY 100011970 136221668 PROVIDE APP TRAINING, SKILL IMROV & SAFETY ED TO ELIG PARTICIPANTS NY 501(C)(3) LINE_2_SCHOOL_DESCRI N/A 0 DERRICKMEN'S PENSION FUND LCL 197 253 WEST 35TH STREET 12TH FLOOR NEW YORK CITY NY 100011970 136121370 TO PROVIDE RET BENEFITS TO ELIG PARTICIPANTS NY 501(A) N/A N/A 0 LOCAL 197 INT'L ASSOC OF IRONWORKERS 25-19 43RD AVE LONG ISLAND CITY NY 11101 135591951 LABOR ORGANIZATION NY 501(C)(5) N/A N/A 0 SEE SCHEDULE R SUPPLEMENTAL INFORMATION 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 SCHEDULE R, PART II AND IV: CERTAIN TRUSTEES LISTED ON FORM 990 PART VII SECTION A, SERVE AS VOLUNTEERS AND DO NOT RECEIVE COMPENSATION FROM THIS ORGANIZATION OR RELATED ORGANIZATIONS IN THEIR CAPACITY AS TRUSTEES OF THIS ORGANIZATION. CERTAIN TRUSTEES LISTED ON FORM 990 PART VII, SECTION A, SERVE AS VOLUNTEERS AND DO NOT RECEIVE COMPENSATION FROM THIS ORGANIZATION BUT DO RECEIVE COMPENSATION FROM LOCAL 197 INT'L ASSOC. OF BRIDGE STRUCTURAL & ORNAMENTAL IRONWORKERS (THE UNION") IN THEIR CAPACITY AS EMPLOYEES/OFFICERS OF THE UNION. THEIR COMPENSATION IS REPORTED ON THE FORM 990 OF THE UNION. 2020 FORM 990, SCHEDULE R ATTACHMENT, RELATED ORGANIZATIONS PART IV, IDENTIFICATION OF RELATED ORGANIZATIONS TAXABLE AS A CORPORATION OR TRUST (A) NAME A. OTTAVINO CORP. A.J. MCNULTY & CO., INC. ARTEX SYSTEMS INC. ATLANTIC EXT. WALL SYSTEMS AWL INDUSTRIES, INC. BERARDI STONE SETTING DEERPATH CONSTRUCTION CORP. DMB CONSTRUCTION CORP EAGLE ONE ROOFING CONTRACTORS INC. ENCLOS CORP. JEMCO ERECTORS, INC. JMC STONE CORP KOEHLER MASONRY CORP. MIDWEST STEEL MILLER DRUCK SPECIALTY CONT. ONOFRIO'S PRECAST SERVICES , INC. PANSINI STONE SETTING INC. PETRONE ERECTORS, INC. PETRONE STONE INC. PLAZA CONSTRUCTION LLC PRECAST SERVICES INC. PRESTIGE STONE & PAVERS CORP. STONE TRUSS SYSTEMS INC. UNITED STRUCTURAL WORKS, INC. VESPA STONE LLC. WILKSTONE, L.L.C. WOLKOW BRAKER ROOFING