2020-01-29T17:13:16-06:00 2019-03-31 208149084 ANASTASI MOORE & MARTIN PLLC 9 S WASHINGTON ST STE 600 SPOKANE WA 99201 990 2018-04-01 911283260 NORTHWEST LABORERS - EMPLOYERS HEALTH AND SECURITY TRUST FUND NORT 2062824100 11724 NE 195TH STREET NO 300 BOTHELL WA 980118242 ANDREW LEDBETTER TRUSTEE 2062824100 2020-01-29 PAUL ANASTASI P00395796 5093230272 2020-01-29 209.210.95.36 2020-01-29 16:29:45 PS P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 6C9B1A35775087DBDB8A6D25ECA509C7F6C27838 2018 2020-09-23 17:36:50Z DAVE RATZKE 11724 NE 195TH STREET NO 300 BOTHELL WA 980118242 169864113 0 X X 1969 WA TO PROVIDE HEALTH AND WELFARE BENEFITS. 11 11 36 11 0 0 0 0 96885438 102671166 1947077 2136911 3200134 5442721 102032649 110250798 0 0 94036491 91053716 0 0 0 0 0 7896063 7574573 101932554 98628289 100095 11622509 100627840 111796366 40454288 42773232 60173552 69023134 TO PROVIDE HEALTH AND WELFARE BENEFITS. 0 0 98616649 INCOME IS USED TO PROVIDE HEALTH AND SECURITY BENEFITS TO QUALIFIED PARTICIPANTS IN THE PLAN. 98616649 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 36 1 0 0 0 0 0 0 0 0 0 0 X 11 11 0 1 0 0 0 0 0 1 1 0 0 1 0 1 1 0 0 0 X ZENITH AMERICAN SOLUTIONS INC 2062824100 11724 NE 195TH STREET BOTHELL WA 980118242 X DAN KUNEY TRUSTEE 1.00 X 0 0 0 CANDACE MINERICH CHAIRMAN 1.00 X X 0 0 0 ANISSA LINDGREN TRUSTEE 1.00 X 0 0 0 KAYNE SEGURA TRUSTEE 1.00 X 0 0 0 CARL STEWART TRUSTEE 1.00 X 0 0 0 DALE CANNON TRUSTEE 1.00 X 0 0 0 ANDREW LEDBETTER TRUSTEE 1.00 X 0 0 0 JERMAINE SMILEY SECRETARY 1.00 X X 0 0 0 BRIAN BELARDE TRUSTEE 1.00 X 0 0 0 STACY MARTIN TRUSTEE 1.00 X 0 0 0 SHANNON STULL TRUSTEE 1.00 X 0 0 0 0 0 0 0 0 0 0 ZENITH AMERICAN SOLUTIONS 201 QUEEN ANNE AVENUE NORTH 100 SEATTLE WA 98109 ADMINISTRATION 3428351 PREMERA BLUE CROSS 7110 220TH ST SW MOUNTLAKE TERRACE WA 98043 CLAIMS PROCESSING 2291080 CARE ALLIES 1601 CHESTNUT STREET PHILADELPHIA PA 19192 CLAIMS PROCESSING 468846 DELTA DENTAL 9706 FOURTH AVE NE SEATTLE WA 98115 CLAIMS PROCESSING 314629 STOLL LAW GROUP 9101 N HARLAN ST 140 WESTMINSTER CO 80031 LEGAL & PROFESSIONAL 149389 5 EMPLOYER CONTRIBUTIONS 525100 96156094 96156094 EMPLOYEE AND RETIREE 525100 6515072 6515072 102671166 2695963 2695963 59054263 59613315 -559052 -559052 -559052 DRUG REBATES AND SUBSIDY 525100 5382880 5382880 LIQUIDATED DAMAGES 525100 59841 59841 5442721 110250798 110250798 0 0 91053716 91053716 16160 16160 20947 20947 138313 138313 140863 140863 1160 1160 1031 1031 ADMINISTRATIVE FEES 4462264 4462264 PPO ACCESS FEES 2291080 2291080 BANK FEES 188982 188982 SUPPLIES 186106 186106 127667 118218 9449 98628289 98616649 11640 0 7335463 5355138 1361510 8158334 9285816 87114368 93813577 100627840 111796366 355008 359878 40099280 42413354 40454288 42773232 X 0 0 0 0 60173552 69023134 60173552 69023134 100627840 111796366 X 11622509 917634 -3690561 X 0 1 X 0 0 0 BANK OVERDRAFTS 538550 AMOUNTS DUE INSURANCE COMPANIES 251146 BENEFITS PAYABLE 4037670 CLAIMS IBNR 12000000 ACCUMULATED ELIGIBIILITY CREDITS 25585988 42413354 X 111030119 917634 917634 110112485 138313 138313 110250798 99799561 0 99799561 138313 -1309585 -1171272 98628289 PART X, LINE 2: THE TRUST ESTABLISHED UNDER THE PLAN TO HOLD THE PLANS ASSETS IS QUALIFIED PURSUANT TO THE APPROPRIATE SECTION OF THE INTERNAL REVENUE CODE (IRC), AND, ACCORDINGLY, THE TRUSTS NET INVESTMENT INCOME IS EXEMPT FROM INCOME TAXES. THE PLAN HAS OBTAINED A FAVORABLE DETERMINATION LETTER FROM THE INTERNAL REVENUE SERVICE (IRS), BUT HAS SINCE BEEN AMENDED. HOWEVER, THE PLAN ADMINISTRATOR BELIEVES THAT THE PLAN IS CURRENTLY DESIGNED AND BEING OPERATED IN COMPLIANCE WITH THE APPLICABLE REQUIREMENTS OF THE IRC. THEREFORE, THEY BELIEVE THAT THE PLAN IS QUALIFIED AND THE RELATED TRUST IS TAX-EXEMPT AS OF THE FINANCIAL STATEMENT DATES. ACCORDINGLY, NO PROVISION FOR INCOME TAXES HAS BEEN INCLUDED IN THE PLANS FINANCIAL STATEMENTS. 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 ADMINISTRATOR HAS ANALYZED THE TAX POSITIONS TAKEN BY THE PLAN AND HAS CONCLUDED THAT AS OF MARCH 31, 2018, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF THE LIABILITY (OR ASSET) OR DISCLOSURE IN THE FINANCIAL STATEMENTS. THE PLAN IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS AND THE PLAN COULD BE SUBJECT TO INCOME TAX IF CERTAIN ISSUES WERE FOUND BY THE IRS THAT COULD RESULT IN THE DISQUALIFICATION OF THE PLANS TAX-EXEMPT STATUS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. PART XII, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN CURRENT BENEFIT OBLIGATIONS PART XII, LINE 4B - OTHER ADJUSTMENTS: CHANGE IN CURRENT BENEFIT OBLIGATIONS FORM 990, PART VI, SECTION A, LINE 3 LINE 3 EXPLANATION - THE DAY TO DAY MANAGEMENT AND OPERATIONS OF THE PLAN ARE HANDLED BY A THIRD PARTY ADMINISTRATOR, ZENITH AMERICAN SOLUTIONS, INC. FORM 990, PART VI, SECTION B, LINE 11B LINE 11B EXPLANATION - THE FORM 990 IS REVIEWED BY THE CHAIRMAN OF THE BOARD OF TRUSTEES AS WELL AS THE PLAN ADMINISTRATOR PRIOR TO ITS FILING. FORM 990, PART VI, SECTION C, LINE 19 THE PLAN PROVIDES FOR PARTICIPANT INSPECTION OF DOCUMENTS AND FINANCIAL STATEMENTS UPON REQUEST THROUGH THE PLAN ADMINISTRATORS. FORM 990, PART XI, LINE 9: CHANGE IN CURRENT BENEFIT OBLIGATIONS -3,690,561. ASSOCIATED GENERAL CONTRACTORS INLAND NORTHWEST AGC JEFFERSON COUNTY PUD LABORERS 348 LABORERS 348W LABORERS LOCAL 238 LABORERS LOCAL 335 LOCAL 1239 LABORERS LOCAL 242 DAY WORKERS LOCAL 242 LABORERS LOCAL 242 OFFICE WORKERS LOCAL 292 LABORERS LOCAL 335 LABORERS LOCAL UNION 252 NW LAB-EMPLOYERS TRAINING PORT OF LONGVIEW PORT OF SEATTLE PORT OF SEATTLEPCS PUBLIC UTILITY DISTRICT #1 SEATTLE HOUSING AUTHORITY SEATTLE SCHOOL DIST 1 SEATTLE SCHOOL DISTRICT SUNNYSIDE VALLEY IRR TACOMA HOUSING AUTHORITY TACOMA SCHOOL DISTRICT WASH & NO IDAHO DIST COUNCIL YAKIMA-TIETON IRRIGATION DIST B & G MASONRY 3464 A&A PROFESSIONAL CLEAINING SVC 8382 SEATTLE TUNNEL PARTNERS 493195 A&D ENTERPRISES LLC 4030 AA CONTRACTOR SERVICES LLC 42624 ADVANCED TRAFFIC CONTROL LLC 576071 ALCANTAR & ASSOCIATES LLC 1485 ALUMA SYSTEMS CC LLC 9643 ANDERSEN STRUCTURES LLC 616067 ARNOLD'S CUSTOM SEEDING LLC 2283 ASCENDENT LLC 533252 BAKER UNDERGROUND & CONST LLC 4811 BARCOTT CONSTRUCTION LLC 48338 BAYSHORE CONCRETE LLC 125 BC 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CONSTRUCTION INC 458124 NOVOTNY CONSTRUCTION -775 NPL CONSTRUCTION COMPANY 540485 NUSSBAUM GROUP INC 17661 NW COOPERATION FUND 42789 NW REGION ORGANIZING COMPANY 156324 NW SCAFFOLD SERVICE INC 1193 NWE CONSTRUCTION COMPANY 1087 OHNO CONSTRUCTION CO 89455 OJEDA BUSINESS VENTURES 164126 OLD SCHOOL CONCRETE 1280 OLSON BROS EXCAVATING INC 81162 OLSON BROTHERS PRO VAC 10140 OLYMPIC CONCRETE FINISHING INC 24303 OLYMPIC PAVING INC 23770 OLYMPIC PENINSULA CONSTRUCTION 30167 OMA CONSTRUCTION INC 33961 OMEGA GENERAL INC 21817 OUT WEST LANDSCAPE& IRRIGATION 5792 OUTLOOK EXTERIOR MAINT INC 1334 PACIFIC COAST CONCRETE 1439 PACIFIC EARTH WORKS INC 31 PACIFIC FISHRMEN SHIPYARD ELEC 115005 PACIFIC FOUNDATION INC 4515 PACIFIC INTERNATIONAL 8071 PACIFIC MOBILE STRUCTURES 11700 PACIFIC NORTHERN ENVIRONMENTAL 1423 PACIFIC PILE AND MARINE 8186 PACIFIC RIM SERVCONST CO INC 26593 PACIFIC SHIP REP & FABRI 232927 PAVEMENT SURFACE CONTROL 35164 PCL CONSTR SERVINC 319088 PEASE & SONS INC 62872 PEASE CONSTRUCTION INC 269027 PELLCO CONSTRUCTION INC 276092 PENCEKELLY CONST INC 8807 PENHALL COMPANY 233938 PENINSULATORS NW INC 50 PENTAGON TECHNOLOGIES GROUP -390 PERFORMANCE ABATEMENT SVC 1622267 PERFORMANCE CONTRACTING 298042 PETERSEN BROTHERS INC 287804 PETROCHEM INSULATION INC 24622 PHILLIPS & JORDAN INC 3077 PILE CONTRACTORS INC 1293 PIPELINE CONSTRUCTION CO 13363 PIVETTA BROTHERS CONST INC 347904 PLATINUM INDUSTRIAL INC 24593 PLATINUM SCAFFOLDING SVCS 4299 PLATS PLUS INC 26979 POE ASPHALT PAVING INC 307397 PORT MADISON ENTER CONST CORP 11495 PORT OF VANCOUVER 129307 POTTLE & SONS CONST INC 14907 POWER MAINTENANCE RESOUCES 35213 PRECISION CONCRETE CUTTING 86684 PRECISION PIPELINE 53173 PRICE GREGORY 30682 PRICE GREGORY INTL 101965 PROPEL CONSTRUCTION 15405 PROSPECT CONSTRUCTION 127347 PUGET SOUND TAPPING SERVICES 33051 Q3 CONTRACTING INC 2125 QUANTUM CONSTRUCTION 473 R & D MASONRY 282784 R & R CONSTRUCTION INC 640 RRA CO INC 1770 RAGTIME PDX 248 RAILWORKS TRACK SYSTEMS INC 17125 RDF BUILDERS CO 6864 RESOURCE MANAGEMENT ASSOCIATES 94515 RETIREE HEALTH RX & DENTAL 6574285 REV DRILLING INC 51169 RG CONSTRUCTION 19383 RHINO EXCAVATING &TRUCKING INC 25351 RISING RIVER INC 6414 RIVIERA COMMUNITY CLUB INC 127570 ROADRUNNER CONCRETE CUTTING 31573 ROCKFORD CORPORATION 23293 ROGER HICKEL CONTRACTING INC 7958 ROGNLINS INC 310769 ROZA IRRIGATION 565530 RV & ASSOCIATES 272594 SABEY CONSTRUCTION INC 35898 SAK & ASSOCIATES 344201 SALINAS CONSTRUCTION INC 300457 SALINAS SAWING & SEALING 288956 SALISBURY & ASSOCIATES INC 521 SCARSELLA BROTHERS INC 479185 SCHERER TRUCKING & EXCAVATION 1146 SCHOCK & COMPANY INC 24531 SCHWIESOW CONST INC 34971 SCOBORIA CONSTRUCTION INC 14925 SDB INC 1149 SECURE A SITE 11765 SELLEN CONSTRUCTION CO INC 1098073 SHAMROCK PAVING INC 618808 SHIMMICK CONSTRUCTION COMPANY 279281 SHORELINE CONSTRUCTION CO 193666 SIERRA PACIFIC CONSTRUCTION 23776 SITE DEVELOPMENT INC 24218 SKAAR CONSTRUCTION 7510 SKANSKA USA BUILDING INC 1309107 SKANSKA USA CIVIL CA DISTRICT 259801 SLEAD CONSTRUCTION INC 27194 SNELSON COMPANIES INC 281265 SNOHOMISH COUNTY LABOR COUNCIL 22020 SOLDATA INC 13124 SOUND ALLIANCE 8782 SOUND EARTH WORKS INC 60772 SPARTAN CONSTRUCTION 230 SPECIALIZED LANDSCAPING INC 18304 SPILKER MASONRY CO 100989 SPOKANE ALLIANCE 18384 SPOKANE CONCRETE CUT INC 55710 SPOKANE TRAFFIC CONTROL 395705 SRIPE RITE INC 1366 SS LANDSCAPING SERVICES INC 41048 ST JOSEPHS PRECISION PRECAST 3178 STACY AND WITBECK INC 739262 STARCH CONCRETE INC 8867 STATON COMPANY 2222 STEBBINS ENGRG CORP 6304 STELLAR J CORPORATION 4979 STERLING BREEN CRUSHING INC 46185 STETNER ELECTRIC 18659 STORIE BARRIERS CORP 54 STRICKLAND & SONS EXCAVATION 23341 STRIPE RITE INC 54744 SUMMIT FENCE COMPANY 97981 SUMMIT SEALANTS INC 17522 SUPERIOR GUNITE 168452 SWIDECKI TRUCKING & EXCAVATION 14255 SWINERTON BUILDERS 6573 T YOROZU GARDENING CO INC 973 TERRA DYNAMICS INC 9280 TERRY LEE EXCAVATING INC 11845 TEUFEL NURSERY INC 66446 THE BAG LADY INC 1317 THE BRICKMAN GROUP 136 THE CONCO COMPANIES 1163526 THE HDD 2598 THE HENSON CO INC 129298 THE POOL COMPANY INC 6107 TIGER NORTHWEST INC 5719 TODD SHIPYARDS 455890 TOKITA CONSTRUCTION INC 20187 TOTEM ELECTRIC OF TACOMA INC 53467 TOWN & COUNTRY FENCE CO OF OR 119 TOWN OF WILKESON 21164 TRAFFIC MANAGEMENT INC 250168 TRANSPORTATION SYSTEMS INC 7864 TRENCHLESS CONSTRUCTION SVC 569 TSD FLAGGING 6739 TUCCI & SONS INC 605996 TURNER CONSTRUCTION CO 528553 TYEE CONCRETE CONSTRUCTION INC 28090 US PIPELINE INC 4375 UNIMARK CONST CO 140982 UNION SQUARE TENANT SERVICES 10202 UNIPRO 58597 UNIVERSITY MECH CONTR INC 1259 US TRINITY ENERGY LABOR SVC 54970 VAN LOM CONCRETE 9035 VECA ELECTRIC INC 12658 VENTILATION POWER CLEANING INC 843 VERSATILE DRILLING 35273 VIKING ENGINEER & CONSTRUCTION 3548 VOITH HYDRO INC 2939 WA ST BLDG&CONST TRADE COUNCIL 6522 WA-ID DIST COUN LAB 19095 WALECET 2673 WALKER SPECIALTY CONST 522629 WALSH CONST DBA WALSH PACIFIC 400960 WAPATO POINT MANAGEMENT CO 125930 WARD-HENSHAW CONST CO INC 12078 WARDS MASONRY INC 74482 WASTE TREATMENT COMPLETION CO 2272154 WATER TECTONICS INC 248 WATSON ASPHALT PAVING CO INC 178025 WATTS CONSTRUCTION INC 276443 WAUNCH CONSTRUCTION & TRUCKING 134682 WELDED CONSTRUCTION CO 27016 WEST COAST CONCRETE RESTORE 93948 WESTERN MODERN ARTS INC 2418 WESTERN PARTITIONS INC 32191 WESTERN REFINERY SERVICES 5998 WESTERN WATERPROOFING CO INC 13573 WHITAKERELLIS 14649 WHITWORTH EXCAVATING INC 1800 WILCOX CONSTRUCTION INC 258750 WILDISH STANDARD PAVING CO 172 WILDLANDS INC 17090 WILLIAM WINKLER CO 974792 WILSON CONCRETE CONT INC 338001 WINTERBOURNE LANDSCAPE 2307 WISKO AMERICA INC 17495 WORK JE INC 34029 WORKER OWNER COUNCIL OF WASH 10017 YORK BUILDING SERVICES 11373 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 SEE ATTACHED LIST - EXEMPT ORGANIZATIONS S 4762362 CASH SEE ATTACHED LIST - PARTNERSHIPS S 11725571 CASH SEE ATTACHED LIST - CORPORATIONS S 86094566 CASH