2020-11-16T14:03:59-06:00 2019-12-31 450250958 EIDE BAILLY LLP 3130 CROW CANYON PL STE 300 SAN RAMON CA 945831386 990 2019-01-01 941229312 HOTEL AND RESTAURANT EMPLOYEES HEALTH AND WELFARE TRUST HOTE 2067263271 2323 EASTLAKE AVE E SEATTLE WA 98102 SENIOR DIRECTOR LABOR SENIOR DIRECTOR, LABOR 2067263271 2020-11-16 1 THERESA MONTGOMERY CPA P00232100 9254804000 2020-11-16 99.110.55.147 2020-11-16 14:01:42 PS P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 327E456370A643C83A1BB4325D39191A230D016A 2019 2022-01-07 14:23:13Z KEVIN GLEASON 2323 EASTLAKE AVE E SEATTLE WA 98102 35950256 0 X N/A X 1963 CA TO PROVIDE HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS 6 6 0 6 0 0 0 0 23505747 25780888 497561 844225 223295 73960 24226603 26699073 0 0 21091213 26010747 0 0 0 0 0 497860 504232 21589073 26514979 2637530 184094 18273619 21679151 2036330 4308401 16237289 17370750 TO PROVIDE HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS 0 0 TO PROVIDE HEALTH AND WELFARE BENEFITS TO APPROXIMATELY 1,400 ELIGIBLE PARTICIPANTS COVERED BY COLLECTIVE BARGAINING AGREEMENTS BETWEEN THE UNIONS AND THE EMPLOYERS. 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 6 0 1 0 0 0 0 0 0 0 0 0 X 6 6 0 1 0 0 0 0 0 1 0 0 0 1 1 0 0 1 1 0 0 0 X NORTHWEST ADMINISTRATORS INC 2067263271 2323 EASTLAKE AVE E SEATTLE WA 98102 X KEVIN GLEASON SENIOR DIRECTOR, LABOR 5.00 X X 0 0 0 WEI-LING HUBER CO-CHAIR 5.00 X X 0 0 0 DOUGLAS CORNFORD TRUSTEE 5.00 X 0 0 0 JOSE ZARATE TRUSTEE 5.00 X 0 0 0 LIAN ALAN TRUSTEE 5.00 X 0 0 0 YULISA ELENES TRUSTEE 5.00 X 0 0 0 0 0 0 0 0 0 0 NORTHWEST ADMINISTRATORS INC 1182 MARKET ST STE 320 SAN FRANCISCO CA 94102 ADMINISTRATIVE SERVICES 201971 1 EMPLOYER CONTRIBUTIONS 900099 25753707 25753707 PARTICIPANT CONTRIB 900099 27181 27181 25780888 489508 489508 9605900 9251183 354717 354717 354717 LIQUIDATED DAMAGES 900099 73960 73960 73960 26699073 26209565 0 489508 26010747 201971 27299 79928 46136 117988 8486 6171 PRINTING, POSTAGE AND S 14585 BANK CHARGES 1620 AD HOC GROUP EXPENSES 48 26514979 6133510 3466929 836199 4830946 1675386 3048512 1304142 2931 8324382 10329833 18273619 21679151 30520 21328 2005810 4287073 2036330 4308401 X 0 0 0 0 16237289 17370750 16237289 17370750 18273619 21679151 184094 949367 0 X X 0 1 X 1 0 0 INSURANCE PREMIUMS PAYABLE 4002022 DUE TO OTHER TRUSTS 101604 DUE TO BROKER 183447 4287073 X 27602304 949367 949367 26652937 46136 46136 26699073 24471101 -1997742 -1997742 26468843 46136 46136 26514979 PART X, LINE 2: THE PLAN HAS ADOPTED GUIDANCE ON ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES ISSUED BY THE FINANCIAL ACCOUNTING STANDARDS BOARD. THE PLAN BELIEVES THAT THE PLAN 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 2D - OTHER ADJUSTMENTS: NET CHANGE IN BENEFIT OBLIGATIONS -1,997,742. FORM 990, PART VI, SECTION A, LINE 3 THE ORGANIZATION DELEGATES CONTROL OVER MANAGEMENT DUTIES CUSTOMARILY PERFORMED BY OR UNDER THE DIRECT SUPERVISON OF OFFICERS, DIRECTORS, TRUSTEES, OR KEY EMPLOYEES TO THE CONTRACT ADMINISTRATOR, NORTHWEST ADMINISTRATORS, INC. FORM 990, PART VI, SECTION A, LINE 8B THE ORGANIZATION DOES NOT HAVE ANY COMMITTEES WITH THE AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11B TRUSTEES ARE MAILED THE FORM AND ASKED TO REMARK IF THEY HAVE CHANGES. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC, UPON REQUEST. FORM 990, PART XI LINE 2C THE BOARD OF TRUSTEES ASSUMES RESPONSIBILITY FOR OVERSEEING THE AUDIT OF THE ORGANIZATION'S FINANCIAL STATEMENTS AND FOR SELECTING THE INDEPENDENT AUDITOR. EAST BAY RESTAURANT AND TAVERN RETIREMENT PLAN 1182 MARKET STREET SAN FRANCISCO CA 94120 946076428 TO PROVIDE PENSION BENEFITS TO ELIGIBLE PARTICIPANTS CA 401A 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.