2020-07-03T17:03:03-05:00 2019-08-31 450250958 EIDE BAILLY LLP 3130 CROW CANYON PL STE 300 SAN RAMON CA 945831386 990 2018-09-01 941234856 CARPENTERS HEALTH AND WELFARE TRUST FUND FOR NORTHERN CALIFORNIA CARP 5106330333 265 HEGENBERGER ROAD NO 100 OAKLAND CA 94621 RANDY JENCO TRUSTEE 5106330333 2020-06-23 1 THERESA MONTGOMERY P00232100 9254804000 2020-06-23 99.110.55.147 2020-06-23 19:03:57 PD P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 327E456370A643C83A1BB4325D39191A230D016A 2018 2021-09-10 13:11:23Z RANDY JENCO 265 HEGENBERGER ROAD NO 100 OAKLAND CA 94621 1760562379 0 X N/A X 1953 CA HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS COVERED BY COLLECTIVE BARGAINING AGREEMENTS 16 16 1129 0 0 0 0 0 490550861 506042516 15348380 14730974 11949681 17794745 517848922 538568235 0 0 466106997 507937065 0 0 0 0 0 14840387 14755474 480947384 522692539 36901538 15875696 664262908 728182133 291888202 331464541 372374706 396717592 NONE 0 0 TO PROVIDE HEALTH AND WELFARE BENEFITS TO APPROXIMATELY 30,000 ELIGIBLE PARTICIPANTS COVERED BY COLLECTIVE BARGAINING AGREEMENTS BETWEEN EMPLOYERS AND THE UNION. 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 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 574 0 1 1129 1 0 0 0 0 0 0 0 0 X 16 16 0 1 0 0 0 0 0 1 0 0 0 0 1 1 0 1 1 0 0 0 X CARPENTER FUNDS ADMINISTRATIVE OFFICE 5106330333 265 HEGENBERGER ROAD NO 100 OAKLAND CA 94621 X GENE PRICE TRUSTEE 5.00 X 0 0 0 RANDY JENCO TRUSTEE 5.00 X 0 0 0 ROY VAN PELT TRUSTEE 5.00 X 0 0 0 FRANK CRIM TRUSTEE 5.00 X 0 0 0 MIKE MENCARINI TRUSTEE 5.00 X 0 0 0 ROBERT ALVARADO TRUSTEE 5.00 X 0 0 0 JAY BRADSHAW TRUSTEE 5.00 X 0 0 0 TOM MATTIS TRUSTEE 5.00 X 0 0 0 CURTIS KELLY TRUSTEE 5.00 X 0 0 0 CHUCK PALLEY TRUSTEE 5.00 X 0 0 0 DON DOLLY TRUSTEE 5.00 X 0 0 0 AUGIE BELTRAN TRUSTEE 5.00 X 0 0 0 LARRY NIBBI TRUSTEE 5.00 X 0 0 0 SCOTT SMITH TRUSTEE 5.00 X 0 0 0 ANTHONY CANALES TRUSTEE 5.00 X 0 0 0 TIMOTHY LITTON TRUSTEE 5.00 X 0 0 0 0 0 0 0 0 0 0 CARPENTER FUNDS ADMINISTRATIVE OFFICE OF 265 HEGENBERGER RD SUITE 100 OAKLAND CA 94621 ADMINISTRATION 5915959 BLUE CROSS OF CALIFORNIA 21555 OXNARD ST WOODLAND HILLS CA 91367 BENEFITS ADMINISTRATOR 3084449 DELTA DENTAL 100 1ST STREET 12TH FLOOR SAN FRANCISCO CA 94105 CLAIMS ADMINISTRATION 1396483 HSTECHNOLOGY 23382 MILL CREEK DR SUITE 200 LAGUNA HILLS CA 92653 BENEFITS ADMINISTRATOR 789912 MEDCO HEALTH SOLUTION 100 PARSONS POND DRIVE FRANKLIN LAKES NJ 07417 BENEFITS ADMINISTRATOR 663115 9 EMPLOYER CONTRIBUTIONS 900099 473925952 473925952 EMPLOYEE CONTRIBUTIONS 900099 32116564 32116564 506042516 10596568 10596568 1226128550 1221994144 4134406 4134406 4134406 REBATES AND REFUNDS 900099 15974298 15974298 OTHER INCOME 900099 1779474 1779474 LIQUIDATED DAMAGES 900099 40973 40973 17794745 538568235 523837261 0 14730974 507937065 11936022 301009 33883 1547997 261894 303473 62293 116411 BANKING EXPENSE 92828 PATIENT CARE OUTCOME RE 54365 OUTSIDE SERVICES 33304 MISCELLANEOUS 11995 522692539 439749 80887531 51772097 45988614 51171557 56473867 143610 53903 265983141 239879461 290072718 301245837 4680036 3652920 664262908 728182133 628128 310052 291260074 331154489 291888202 331464541 X 0 0 0 0 372374706 396717592 372374706 396717592 664262908 728182133 15875696 8467190 0 X X 0 1 X 1 0 0 REAL ESTATE FUND 97577427 F LIMITED PARTNERSHIP 203668410 F 301245837 PREMIUMS PAYABLE 48083175 CLAIMS PAYABLE AND IBNR 75069433 FUTURE BENEFIT LIABILITY 190361000 RETIREE REFUND PAYABLE 7318000 DUE TO BROKER 7861933 CONTRIBUTIONS IN TRANSIT 2460948 331154489 X 545487428 8467190 8467190 537020238 1547997 1547997 538568235 489789853 0 489789853 1547997 31354689 32902686 522692539 PART X, LINE 2: THE TRUST HAS ADOPTED GUIDANCE ON ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES ISSUED BY THE FINANCIAL ACCOUNTING STANDARDS BOARD. THE TRUST ADMINISTRATOR BELIEVES THAT THE TRUST HAS NOT TAKEN UNCERTAIN TAX POSITIONS THAT REQUIRE ADJUSTMENT TO THE FINANCIAL STATEMENTS AS A TAX LIABILITY. INFORMATIONAL TAX RETURNS, FOR TAX YEARS FOR WHICH THE APPLICABLE STATUTES OF LIMITATIONS HAVE NOT EXPIRED, ARE SUBJECT TO EXAMINATION BY AUTHORITIES. PART XII, LINE 4B - OTHER ADJUSTMENTS: CHANGE IN NET BENEFIT OBLIGATIONS 31,354,689. FORM 990, PART VI, SECTION A, LINE 3 THE ORGANIZATION HAS DELEGATED CONTROL OVER MANAGEMENT DUTIES CUSTOMARILY PERFORMED BY OR UNDER THE DIRECT SUPERVISION OF OFFICERS, DIRECTORS, TRUSTEES OR KEY EMPLOYEES TO THE ADMINISTRATOR, THE CARPENTER FUNDS ADMINISTRATIVE OFFICE. FORM 990, PART VI, SECTION A, LINE 8B THE ORGANIZATION DOES NOT HAVE ANY SUBCOMMITTEES WITH THE AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11B THE TRUSTEES HAVE DESIGNATED THE ADMINISTRATOR TO REVIEW THE FORM 990 PRIOR TO SIGNING AND FILING. FORM 990, PART VI, SECTION B, LINE 12 IN CONNECTION WITH ANY ACTUAL OR POTENTIAL CONFLICT OF INTEREST, A TRUSTEE SHOULD DISCLOSE TO ALL OTHER TRUSTEES AND FUND COUNSEL THE EXISTENCE AND NATURE OF THE FINANCIAL INTEREST OR BENEFIT INVOLVED INCLUDING DISCLOSURE OF ALL MATERIAL FACTS ATTENDANT TO THE TRANSACTION. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. FORM 990, PART XII, LINE 2C THE BOARD OF TRUSTEES ASSUMES RESPONSIBILITY FOR THE OVERSIGHT OF THE AUDIT OF THE ORGANIZATION'S FINANCIAL STATEMENTS AND THE SELECTION OF THE INDEPENDENT AUDITOR. CARPENTER FUNDS ADMINISTRATIVE OFFICE OF NORTHERN CALIFORNIA INC 265 HEGENBERGER ROAD SUITE 100 OAKLAND CA 94621 941557079 TO PROVIDE ADMINISTRATIVE SERVICES FOR VARIOUS RELATED CARPENTER TRUST FUNDS CA 501(C)(9) N/A 0 BASIC CRAFTS WORKERS' COMPENSATION BENEFITS TRUST FUND 265 HEGENBERGER ROAD SUITE 100 OAKLAND CA 94621 810650114 TO PROVIDE A VEHICLE THROUGH WHICH WORKERS' COMPENSATION BENEFITS ARE PROVID CA 501(C)(9) N/A 0 CARPENTERS PENSION TRUST FUND FOR NORTHERN CALFORNIA 265 HEGENBERGER ROAD SUITE 100 OAKLAND CA 94621 946050970 TO PROVIDE PENSION BENEFITS FOR ELIGIBLE PARTICIPANTS. CA 401(A) N/A 0 CARPENTERS ANNUITY TRUST FUND FOR NORTHERN CALFORNIA 265 HEGENBERGER ROAD SUITE 100 OAKLAND CA 94621 946534591 TO PROVIDE ANNUITY BENEFITS FOR ELIGIBLE PARTICIPANTS. CA 401(A) N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 PARTS II, III, AND IV - IDENTIFICATION OF RELATED TAX ORGANIZATIONS IN A MULTIEMPLOYER PLAN, A CONTRIBUTING EMPLOYER IS CONSIDERED A RELATED ORGANIZATION BECAUSE THEY ARE OBLIGATED TO CONTRIBUTE TO THE PLAN PURSUANT TO THE TERMS IN THE COLLECTIVE BARGAINING OR PARTICIPATION AGREEMENT. THE ADMINISTRATIVE OFFICE ONLY MAINTAINS THE DATA NECESSARY TO FULFILL THE OBLIGATION TO CONTRIBUTE, IT DOES NOT MAINTAIN SPECIFIC BUSINESS DATA REGARDING THE EMPLOYERS, SUCH AS ENTITY TYPE OR TAX INFORMATION.