2020-10-12T12:16:15-05:00 2019-12-31 410746749 CLIFTONLARSONALLEN LLP 220 S 6TH STREET SUITE 300 MINNEAPOLIS MN 55402 990 2019-01-01 416023461 MINNESOTA & NORTH DAKOTA BRICKLAYERS & ALLIED CRAFTWORKERS HEALTH FUND MINN 6512561801 2520 PILOT KNOB ROAD NO 325 MENDOTA HEIGHTS MN 55120 DOUGLAS SCHROEDER CHAIRMAN 6512561801 2020-10-10 1 DOUG BERTOSSI P00637990 6123764500 67.137.57.251 2020-10-10 13:02:41 CD P 9C1DED54EE6A56468881F41BE7A7DD662CF8FCB7 3EFF34B2914DC3C2E596050BA4BD51260E209E38 2019 2021-04-22 16:20:28Z DOUGLAS SCHROEDER 2520 PILOT KNOB ROAD NO 325 MENDOTA HEIGHTS MN 55120 62518073 0 X N/A X 1961 MN PROVIDE HEALTH & WELFARE BENEFITS TO UNION MEMBERS AND THEIR DEPENDENTS. 7 1 13 10 0 0 0 0 23800862 24479901 5972107 3999047 0 0 29772969 28478948 0 0 21889127 22560127 0 0 0 0 0 1371123 1282125 23260250 23842252 6512719 4636696 74484003 86609284 81433 47993 74402570 86561291 PROVIDE HEALTH AND WELFARE BENEFITS TO UNION MEMBERS AND THEIR DEPENDENTS. 0 0 PAYMENT OF HOSPITAL, MEDICAL, DENTAL, DISABILITY, DEATH, AND VISION BENEFITS FOR 2,405 UNION 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 0 0 1 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 13 1 0 0 0 0 0 0 0 0 X 7 1 0 0 0 0 0 1 0 1 0 0 0 1 1 1 1 0 1 0 0 0 X ZENITH AMERICAN SOLUTIONS 6512561900 2520 PILOT KNOB ROAD 325 MENDOTA HEIGHTS MN 55120 X X DOUGLAS SCHROEDER SEE SCHEDULE O 1.00 50.00 X X 0 0 0 PAUL WIESE MANAGEMENT TRUSTEE - SECRE 1.00 41.00 X X 0 0 0 DARRIN DROSKY MANAGEMENT - ALTERNATE TRU 1.00 42.00 X 0 0 0 MICHAEL GANZ SEE SCHEDULE O 1.00 44.00 X 0 0 0 FRANK GRAZZINI II MANAGEMENT TRUSTEE 1.00 41.00 X 0 0 0 AMY THOMPSON MANAGEMENT TRUSTEE 1.00 41.00 X 0 0 0 MICHAEL LAPENSKY MANAGEMENT - ALTERNATE TRU 1.00 42.00 X 0 0 0 STAN PACZYNSKI SEE SCHEDULE O 1.00 41.00 X 0 0 0 RON RASLEY MANAGEMENT TRUSTEE 1.00 41.00 X 0 0 0 TERRY WONG SEE SCHEDULE O 1.00 49.00 X 0 0 0 REBECCA NOHAVA UNION TRUSTEE - ALTERNATE 1.00 40.00 X 0 0 0 0 0 0 0 0 0 0 HEALTH PARTNERS 8170 33RD AVE S BLOOMINGTON MN 55425 PPO 1098271 ZENITH AMERICAN SOLUTIONS 2520 PILOT KNOB ROAD 325 MENDOTA HEIGHTS MN 55120 PLAN ADMINISTRATOR 763681 BAC SERVICE CORPORATION 2520 PILOT KNOB ROAD 325 MENDOTA HEIGHTS MN 55120 SERVICE CORPORATION 112075 3 CONTRIBUTIONS 525100 24479901 24479901 24479901 2131277 2131277 35906895 34039125 1867770 1867770 1867770 28478948 26347671 0 2131277 22560127 851783 107649 28650 126599 82857 60461 249 15709 AFFORDABLE CARE ACT FEE 8168 23842252 3047300 2449019 8096749 14466868 1974031 1685935 5969 65 97746 20705 53125639 59609095 7513904 7815731 622665 561866 74484003 86609284 70793 44582 10640 3411 81433 47993 X 0 0 0 0 74402570 86561291 74402570 86561291 74484003 86609284 4636696 7522025 0 X 0 1 X 1 0 0 LIMITED PARTNERSHIPS 7815731 F 7815731 ADVANCE CONTRIBUTIONS FROM EMPLOYEES FOR FUTURE COVERAGE 3411 3411 X 35874374 7522025 7522025 28352349 126599 126599 28478948 23715653 0 23715653 126599 126599 23842252 PART X, LINE 2: THE VEBA TRUST FUNDING BENEFITS OF THE PLAN RECEIVED AN EXEMPTION LETTER FROM THE INTERNAL REVENUE SERVICES (IRS) DATED FEBRUARY 27, 1963, STATING THAT THE TRUST IS TAX-EXEMPT UNDER THE PROVISIONS OF SECTION 501(C)(9) OF THE INTERNAL REVENUE CODE (IRC). HOWEVER, AS A RESULT OF THE PLAN'S FUNDING POLICY, FROM TIME TO TIME THE TRUST MAY BE SUBJECT TO INCOME TAXES. NO FEDERAL OR STATE INCOME TAXES HAVE BEEN RECORDED IN 2019 OR 2018 FOR UNRELATED BUSINESS TAXABLE INCOME. IN ADDITION, THE PLAN AND TRUST ARE REQUIRED TO OPERATE IN CONFORMITY WITH THE IRC TO MAINTAIN THE TAX-EXEMPT STATUS OF THE TRUST. THE PLAN ADMINISTRATOR BELIEVES THAT THE PLAN IS BEING OPERATED IN COMPLIANCE WITH THE APPLICABLE REQUIREMENTS OF THE IRC AND, THEREFORE, BELIEVES THAT THE RELATED TRUST IS TAX-EXEMPT. 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 THE PLAN HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE IRS. THE PLAN IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. TWIN CITY TILE & MARBLE CONTRIBUTING EMPLOYER LATE CONTRIBUTIONS X 65 65 0 0 0 65 FORM 990, PART VI, SECTION A, LINE 7A THE BRICKLAYERS AND ALLIED CRAFTWORKERS LOCAL UNION 1 MINNESOTA/NORTH DAKOTA AND THE ASSOCIATED GENERAL CONTRACTORS OF MINNESOTA EACH APPOINT 50% OF THE BOARD OF TRUSTEES. FORM 990, PART VI, SECTION A, LINE 8B THERE ARE NO COMMITTEES WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BOARD. FORM 990, PART VI, SECTION B, LINE 11B FORM 990 WAS REVIEWED BY THE BOARD OF TRUSTEES IN CONJUNCTION WITH THE REVIEW OF THE ANNUAL AUDIT. FORM 990, PART VI, SECTION B, LINE 12C THE POLICY IS DISCUSSED ANNUALLY BY THE BOARD OF TRUSTEES TO ENSURE THE TRUSTEES UNDERSTAND THE CONFLICT OF INTEREST POLICY AND UNDERSTANDS THE FUND IS A TAX-EXEMPT ORGANIZATION THAT MUST ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX EXEMPT PURPOSES. PER THE POLICY, ANY PERSON DISCOVERING A CONFLICT SHOULD DISCLOSE IT IMMEDIATELY TO THE CHAIRMAN OF THE BOARD OF TRUSTEES. THE BOARD OF TRUSTEES DETERMINES IF A CONFLICT EXISTS AND MAY PLACE APPROPRIATE RESTRICTIONS ON THE INDIVIDUAL OR TRANSACTIONS AFFECTED AT THEIR DISCRETION. ANY CONFLICTS ARE DOCUMENTED IN MEETING MINUTES. NO SUCH CONFLICTS AROSE DURING THE YEAR. FORM 990, PART VI, SECTION C, LINE 19 THE FUND'S GOVERNING DOCUMENTS, FINANCIAL STATEMENTS, AND CONFLICT OF INTEREST POLICY ARE NOT MADE AVAILABLE TO THE GENERAL PUBLIC. FORM 990 PART VII, SECTION A, LINE 1A TRUSTEES ARE NOT COMPENSATED BY THE FUND. 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. THE FOLLOWING RELATED ORGANIZATIONS REPORTED COMPENSATION FOR A TRUSTEE LISTED ON THE MINNESOTA & NORTH DAKOTA BRICKLAYERS & ALLIED CRAFTWORKERS HEALTH FUND: DOUGLAS SCHROEDER, CHAIRMAN BRICKLAYERS AND ALLIED CRAFTWORKERS LOCAL UNION NO. 1 MINNESOTA/NORTH DAKOTA EIN: 41-1716458 STAN PACZYNSKI, UNION - ALTERNATE TRUSTEE BRICKLAYERS AND ALLIED CRAFTWORKERS LOCAL UNION NO. 1 MINNESOTA/NORTH DAKOTA EIN: 41-1716458 MICHAEL GANZ, UNION TRUSTEE BRICKLAYERS AND ALLIED CRAFTWORKERS LOCAL UNION NO. 1 MINNESOTA/NORTH DAKOTA EIN: 41-1716458 TERRY WONG, UNION TRUSTEE BRICKLAYERS AND ALLIED CRAFTWORKERS LOCAL UNION NO. 1 MINNESOTA/NORTH DAKOTA EIN: 41-1716458 MN & ND BRICKLAYERS AND ALLIED CRAFTSWORKERS PENSION FUND 2520 PILOT KNOB RD MENDOTA HEIGHTS MN 55120 516029930 PROVIDE RETIREMENT BENEFITS TO UNION MEMBERS MN 401(A) N/A N/A 0 MN & ND BRICKLAYERS AND ALLIED CRAFTSWORKERS VACATION FUND 2520 PILOT KNOB RD MENDOTA HEIGHTS MN 55120 237068471 PROVIDE VACATION BENEFITS TO UNION MEMBERS. MN 501(C)(9) N/A N/A 0 BRICKLAYERS LOCAL NO 1 APPREN 35420 INTERNATIONAL PARKWAY NEW HOPE MN 55428 416319702 PROVIDE TRAINING AND RETRAINING TO CURRENT AND PROSPECTIVE UNION MEMBERS MN 501(C)(5) N/A N/A 0 BRICKLAYERS AND ALLIED CRAFTWORKERS LOCAL UNION NO 1 MINNESOTANORTH DAKOTA 312 CENTRAL AVE SUITE 328 MINNEAPOLIS MN 55414 411716458 PROTECT AND IMPROVE THE GENERAL WELFARE OF ITS MEMBERS AND EMPLOYEES MN 501(C)(5) N/A N/A 0 MINNESOTA CERAMIC TILE AND ALLIED TRADES RETIREMENT FUND 2520 PILOT KNOB RD MENDOTA HEIGHTS MN 55120 416059404 TO PROVIDE RETIREMENT BENEFITS TO UNION MEMBERS MN 401(A) N/A N/A 0 ASSOCIATED GENERAL CONTRACTORS OF MINNESOTA INC 525 PARK STREET NO 110 ST PAUL MN 55103 410132580 REPRESENTING MEMBERS INVOLVED IN MINNESOTA'S CONSTRUCTION INDUSTRY MN 501(C)(6) N/A N/A 0 CITY OF MINNEAPOLIS CITY OF ST PAUL HEALTH REIMBURSEMENT ARANGEMEN INTERNAT'L MASONRY INSTITUTE IOWA LABORERS DISTRICT COUNCIL MASONRY INSTITUTE MASONRY INDUSTRY TRUST ADMIN SPECIAL SCHOOL DISTRICT #1 ST PAUL PUBLIC SCHOOLS UNIVERSITY OF MINNESOTA SELF PAYS D R FRANTZ CONCRETE CONST RAM CONSTRUCTION SERVICES BRICKLAYERS AND ALLIED CRAFTWORKERS SERVICE CORPORATION 2520 PILOT KNOB ROAD MENDOTA HEIGHTS MN 55120 811520819 ADMINISTRATIVE SERVICES TO RELATED FUND MN N/A C 0.20000 0 A J SPANJERS CO A-Z CONSTRUCTION MAS DBA B&D ACME TUCKPOINTING & RESTOR ACOUSTICS ASSOCIATES INC ADVANCE TERRAZZO & TILE CO ADVANCED MASONRY RESTORATION ALBERT INSTALLATIONS INC ALVIN BENIKE INC AMERICAN MAS RESTORATION CORP ANCHOR GLASS CONTAINER INC ANDERSON MAS & CONCRETE INC ARCHITHORITY UNITED LLC AXEL H OHMAN INC B & D ASSOCIATES LLC B & M MASONRY INC B & W MASONRY BEDROCK-FLINT INC BOB'S SPARKLE WASH BRATRUD CONSTRUCTION BROWN REFRACTORY SERVICE C R MEYER & SONS COMPANY CAMCO CONSTRUCTION INC CARCIOFINI COMPANY INC CD TILE & STONE INC COMMERCIAL FLOORING INSTALL CON'S MASONRY INC CONTRACT CAULKING CONTRACT TILE & CARPET INC CROSSTOWN MASONRY INC D & D STONE LLC D J KRANZ CO INC DAROLD BERGER MASONRY INC DAYCO CONCRETE DEL'S CONSTRUCTION CO INC DZIEDZIC CAULKING INC EICHOLTZ MASONRY INC EXTERIOR BUILDING SERVICES INC FABCON INC FLEMMING TILE INC FOWLER & HAMMER INC FOWLER AND HAMMER FRANDRUP MASONRY INC GAGE BROTHERS CAULKING GAGNON INCORPORATED GEORGE SIEGFRIED CONST CO GOFF MASONRY LLC GORDON CONST OF MAHNOMEN INC GRANITE-TOPS INSTALLATION INC GRAZZINI BROTHERS CO GRESSER COMPANIES INC HANSON MASONRY & CONCRETE LLC HARBOR CITY MASONRY INC HARLAN FALCK & SON INC HARRISON TILE CO INC HAUGEN MASONRY CONTRACTORS INC HOLLENBACK & NELSON INC HOVLAND INC HUESMAN SCHREIBER MASONRY ICE COLD EVENTS LLC INCOR INSTALLATION INC INSTALLATION CONCEPTS INC J E DUNN CONSTRUCTION COMPANY J STAY TILE LLC JOHN FOLEY MASONRY JOHNSON & NELSON JOHNSON CARPET JOHNSON TERRAZZO CO INC KASELLA CONCRETE INC KIFFMEYER INC KNUTSON CONSTRUCTION SERVICES LAKEHEAD CONSTRUCTORS INC LANGER CONSTR CO LEE'S CERAMICS INC LOUHI & KIVELA MASONRY INC M A MORTENSON CO M C MAGNEY CONST MAERTENS-BRENNY CONSTRUCTION MARKET & JOHNSON INC MAVO SYSTEMS INC MCGOUGH CONSTRUCTION CO INC METROPOLITAN TILE & MARBLE MICHIGAN BAC BENEFIT FUNDS MIDWEST PRECAST SERVICES LLC MIDWESTERN MASONRY INC MINNESOTA CEMENT MASONS MN CONCRETE SPECIALTIES INC MN STATE BUILDING TRADES MOLIN CONCRETE PRODUCTS MOSAICA LLC NIKKEL TILE INC NORTHLAND CONCRETE & MASONRY NORTHWEST ADMINISTRATORS INC OHIO BRICKLAYERSSTONER ASSOC PARAMOUNT CONCRETE & MAS INC PATZOLDT CONCRETE & MASONRY LL PROJECT RESTORATIONS INC PULLMAN POWER LLC REFRACTORY SERVICE INC RESCH'S TILE INC RESTORATION & CONSTRUCTION SER RESTORATION SYSTEMS INC RICE LAKE CONSTRUCTION GROUP RIGHTWAY CAULKING ROYL MASONRY SCHLEIS FLOOR COVERING INC SERVAIS TILE & STONE INC SHEEHY CONSTRUCTION CO SMITH-SHARPE FIRE BRICK SUPPLY STEBBINS ENGINEERING STEENBERG - WATRUD CONST INC STONE CONSTRUCTION INC STRETAR MASONRY & CONCRETE INC SUMMIT CONCRETE & MAS CONST SUNRISE SPECIALTY CONTR TCR ENTERPRISES DBA J&K MASON TED KENNE CONSTRUCTION TERRAZZO DESIGNS LLC THE CAULKERS COMPANY INC TIM'S CONSTRUCTION GROUP TOTAL CONSTRUCTION & EQUIPMENT TWIN CITY TILE & MARBLE CO UNITED MASONRY INC UNITED REFACTORIES INC VAN MINSEL BROS CONSTRUCTION WEISE MASONRY INC WELLS CONCRETE PRODUCTS CO WENDT MASONRY INC WESTERN SPECIALTY CONTRACTORS WILLIAMS REFRACTORY SERVICES WISCONSIN MASONS FRINGE FUNDS WISCONSIN TERRAZZO & TILE INC WTG TERRAZZO & TILE INC WYSAN PRECAST SERVICES LLC ZACHMAN PRECAST INC 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1