2020-10-27T12:07:21-05:00 2019-12-31 721088864 LAPORTE APAC 5100 VILLAGE WALK SUITE 300 COVINGTON LA 70433 990 2019-01-01 720945796 COMMUNITY COFFEE COMPANY LLC EMPLOYEE HEALTH & LIFE BENEFITS PLAN COMM 2253683900 3332 PARTRIDGE LANE BUIDING A BATON ROUGE LA 70809 ANNETTE VACCARO SENIOR VP, TREASURER & SECRETARY 2253683900 2020-10-20 1 BRUCE S PRENDERGAST MS CPA P00151746 9858925850 64.88.174.3 2020-10-20 07:53:30 CD P 6A6F4B9032D351B0824C90F61A0A44658A5FFD92 2A8A6564BED8805A9A60C76B49ACE93BC0DCFD2B 2019 2021-04-22 16:20:28Z ANTOINETTE VACCARO 3332 PARTRIDGE LANE BUIDING A BATON ROUGE LA 70809 9358722 0 X N/A X 1997 LA PROVIDE TAX SHELTERED HEALTH AND LIFE BENEFITS TO EMPLOYEES OF COMMUNITY COFFEE COMPANY, LLC. 1 0 0 0 0 0 0 0 9058570 9358722 0 0 0 0 9058570 9358722 0 0 8606176 8883531 0 0 0 0 0 452394 446191 9058570 9329722 0 29000 715000 744000 2408231 2475825 -1693231 -1731825 TO PROVIDE THE EMPLOYEES OF COMMUNITY COFFEE COMPANY, LLC TAX SHELTERED HEALTH AND LIFE BENEFITS. 0 0 9329722 9358722 PROVIDE HEALTH AND LIFE BENEFITS TO EMPLOYEES OF COMMUNITY COFFEE COMPANY, LLC. 9329722 0 0 0 0 0 0 0 0 0 0 0 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 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 X ANTOINETTE VACCARO 2253683900 3332 PARTRIDGE LANE BLDG A BATON ROUGE LA 70809 X COMMUNITY COFFEE COMPANY LLC TRUSTEE 1.00 X 0 0 0 0 0 0 0 0 0 0 UMR 115 W WAUSAU AVE WAUSAU WI 54401 CLAIMS PROCESSOR 266406 1 EMPLOYER CONTRIBUTIONS 900099 5707903 5707903 PARTICIPANT CONTRIBUTI 900099 3650819 3650819 9358722 9358722 9358722 0 0 8883531 446191 9329722 715000 744000 715000 744000 711000 836000 1697231 1639825 2408231 2475825 X 0 0 0 0 -1693231 -1731825 -1693231 -1731825 715000 744000 X 29000 -67594 X 0 1 X 1 0 0 POST-RETIREMENT BENEFIT OBLIGATIONS 1639825 1639825 X 9358722 0 9358722 0 9358722 9329722 0 9329722 0 9329722 PART X, LINE 2: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA PROVIDE ACCOUNTING AND DISCLOSURE GUIDANCE ABOUT POSITIONS TAKEN BY A PLAN IN ITS TAX RETURNS THAT MIGHT BE UNCERTAIN. THE PLAN ADMINISTRATOR BELIEVES THAT IT HAS APPROPRIATE SUPPORT FOR ANY TAX POSITIONS TAKEN AND, AS SUCH, DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS THAT ARE MATERIAL TO THE FINANCIAL STATEMENTS. FORM 990, PART VI, SECTION B, LINE 11B A DRAFT OF THE FORM 990 IS PROVIDED TO THE SENIOR DIRECTOR OF ACCOUNTING AND REPORTING. IT IS REVIEWED FOR ACCURACY AND PROPRIETY. THE RETURN IS THEN REVIEWED BY THE CFO, WHO PROVIDES THE FINAL APPROVAL. FORM 990, PART VI, SECTION B, LINE 12 COMMUNITY COFFEE COMPANY, LLC EMPLOYEE HEALTH & LIFE BENEFITS PLAN DOES NOT HAVE THE POLICIES AND PROCEDURES AS NOTED ON PAGE 6, PART VI BECAUSE: 1. IT HAS NO EMPLOYEES OR BOARD OF DIRECTORS SO THERE IS NO ONE THE POLICIES WOULD APPLY TO. 2. IT IS A TRUST WHICH MERELY HOLDS FUNDS FOR EMPLOYEE AND RETIREE INSURANCE PAYMENTS. 3. COMMUNITY COFFEE COMPANY, LLC SERVES AS ITS TRUSTEE, WHICH HAS AN OUTSIDE FINANCIAL INSTITUTION TO MONITOR ITS INVESTMENTS AND AN OUTSIDE BOARD TO MONITOR COMPANY ACTIVITIES, POLICIES, AND PROCEDURES. 4. IT IS THE HEALTH AND LIFE BENEFITS PLAN OF COMMUNITY COFFEE COMPANY, LLC, WHICH HAS A CONFLICT OF INTEREST POLICY, A DOCUMENT RETENTION POLICY, A WHISTLEBLOWER POLICY, AND A COMPENSATION POLICY. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, FINANCIAL STATEMENTS AND TAX RETURNS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. HOWEVER, THE ORGANIZATION DOES NOT HAVE A CONFLICT OF INTEREST POLICY. FORM 990, PART XI, LINE 9: CHANGE IN ACTUARIAL COMPUTATION -67,594. COMMUNITY COFFEE LLC PO BOX 791 BATON ROUGE LA 70821 720478429 SALES/DISTRIBUTION LA N/A C 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 COMMUNITY COFFEE LLC S 5707903 FAIR MARKET VALUE