2020-02-20T11:59:49-06:00 2019-05-31 470900880 CALIBRE CPA GROUP PLLC 230 W MONROE ST SUITE 310 CHICAGO IL 60606 990 2018-06-01 366147408 FOX VALLEY & VICIN CONSTRUCTION WEL FUND FOXV 8475191880 953 AMERICAN LANE NO 100 SCHAUMBURG IL 60173 ART STURMS TRUSTEE 8475191880 2020-02-20 1 COREY BILKEY P00499751 3126550037 38.100.43.100 2020-02-20 11:59:30 CS P 099BB351ED5C43DB8E4A0DD96B056B1430213725 099BB351ED5C43DB8E4A0DD96B056B1430213725 2018 2020-11-19 02:30:22Z X ART STURMS 953 AMERICAN LANE NO 100 SCHAUMBURG IL 60173 9737715 0 X N/A X 1961 WI TO PROVIDE MEDICAL, DENTAL, VISION, TEMPORARY DISABILITY, AND DEATH BENEFITS. 10 5 0 0 0 0 0 0 7399872 8039186 819037 690047 0 0 8218909 8729233 0 0 7380344 8498071 0 0 0 0 0 767640 763249 8147984 9261320 70925 -532087 24448471 24322155 3814720 3978846 20633751 20343309 X TO PROVIDE MEDICAL, DENTAL, VISION, TEMPORARY DISABILITY, AND DEATH BENEFITS 0 0 TO PROVIDE MEDICAL, DENTAL, VISION, TEMPORARY DISABILITY, AND DEATH BENEFITS TO ELIGIBLE MEMBERS TO PROVIDE MEDICAL, DENTAL, VISION, TEMPORARY DISABILITY, AND DEATH BENEFITS TO ELIGIBLE MEMBERS AND THEIR DEPENDENTS. 0 0 0 0 0 0 0 0 0 0 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 0 0 0 0 0 0 0 0 0 0 0 X 10 5 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 0 0 0 X GROUP ADMINISTRATORS LTD 8475191880 953 AMERICAN LANE SCHAUMBURG IL 60173 DAN AUSSEM CHAIRMAN 2.00 X 0 0 0 KENNETH SANDENO TRUSTEE 2.00 X 0 0 0 ART STURMS SECRETARY 2.00 40.00 X 0 121407 81616 ANTHONY FRESCURA JR TRUSTEE 2.00 40.00 X 0 104832 95212 PETE NIELSEN TRUSTEE 2.00 X 0 0 0 RICHARD LANGE TRUSTEE 2.00 40.00 X 0 113404 89470 DAVID HENDERSON TRUSTEE 2.00 X 0 0 0 TROY COX TRUSTEE 2.00 40.00 X 0 113050 89612 BOB MORREALE TRUSTEE 2.00 X 0 0 0 ERIC MROWICKI TRUSTEE 2.00 40.00 X 0 74750 61319 0 527443 417229 0 0 1 0 BCBS 300 EAST RANDOLPH ST CHICAGO IL 60601 PPO CLAIMS PROVIDER 248523 GROUP ADMINISTRATORS LTD 953 AMERICAN LANE SCHAUMBURG IL 60173 ADMINISTRATOR 232081 SEGAL COMPANY 101 N WACKER DR CHICAGO IL 60606 CONSULTANT 108655 3 EMPLOYER CONTRIBUTIONS 525100 7634349 7634349 EMPLOYEE CONTRIBUTIONS 525100 404837 404837 8039186 698522 698522 1000007 1008482 -8475 -8475 -8475 8729233 8039186 0 690047 8498071 232081 53185 39901 38388 363732 22975 1688 11299 9261320 395893 587359 834092 853864 8878 12125 20893536 20387202 2294388 2456576 21684 25029 24448471 24322155 13748 3274 3800972 3975572 3814720 3978846 X 0 0 0 0 20633751 20343309 20633751 20343309 24448471 24322155 -532087 241645 0 X X 0 1 X 1 0 0 LIMITED PARTNERSHIPS 2456576 F 2456576 EXTENDED ELIGIBILITY 3334900 EST LIAB FUT CLMS INCRRD NOT REPRTD 507300 CLAIMS PAYABLE 126800 DUE TO ASSOCIATED FUNDS 6572 3975572 X 8932490 241645 241645 8690845 38388 38388 8729233 9048332 0 9048332 38388 174600 212988 9261320 PART X, LINE 2: AS OF MAY 31, 2019, 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 THE TAXING JURISDICTIONS; HOWEVER THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIOD IN PROGRESS. AT MAY 31, 2019 THE PLAN IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO THE FISCAL YEAR ENDED MAY 31, 2016. PART XII, LINE 4B - OTHER ADJUSTMENTS: CHANGE IN CURRENT BENEFIT OBLIGATIONS 174,600. 0 0 0 ART STURMS SECRETARY 0 121407 0 0 0 0 0 81616 0 0 0 203023 0 0 ANTHONY FRESCURA JR TRUSTEE 0 104832 0 0 0 0 0 95212 0 0 0 200044 0 0 RICHARD LANGE TRUSTEE 0 113404 0 0 0 0 0 89470 0 0 0 202874 0 0 TROY COX TRUSTEE 0 113050 0 0 0 0 0 89612 0 0 0 202662 0 0 FORM 990, PART VI, SECTION B, LINE 11B THE TRUSTEES AUTHORIZE THE FUND'S THIRD-PARTY ADMINISTRATOR AND A DESIGNATED TRUSTEE TO REVIEW THE FORM 990 BEFORE IT IS FILED. FORM 990, PART VI, SECTION B, LINE 12C THE TRUSTEES ARE GOVERNED BY THE TRUST DOCUMENT AND HAVE A FIDUCIARY RESPONSIBILITY UNDER ERISA TO ADMINISTER THE PLAN IN THE BEST INTEREST OF THE MEMBERSHIP. THE US DEPARTMENT OF LABOR REQUIRES ALL LABOR TRUSTEES TO REPORT ON FORM LM-30 POTENTIAL SITUATIONS WHERE THERE MAY BE CONFLICTS OF INTEREST. THIS INFORMATION IS OPEN TO THE PUBLIC. FORM 990, PART VI, SECTION C, LINE 19 A SUMMARY ANNUAL REPORT IS DISTRIBUTED TO ALL PARTICIPANTS. PARTICIPANTS ARE ABLE TO REQUEST THE AUDITOR'S REPORT AND OTHER FINANCIAL INFORMATION FROM THE PLAN ADMINISTRATOR AND/OR THE US DEPARTMENT OF LABOR. ALSO, FORM 5500 IS OPEN TO PUBLIC INSPECTION THROUGH THE US DEPARTMENT OF LABOR. FORM 990, PART XII, LINE 2C: THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. 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