2019-05-21T08:48:33-05:00 2018-07-31 522385296 LINDQUIST LLP 5000 EXECUTIVE PARKWAY SUITE 400 SAN RAMON CA 945834210 990 2017-08-01 946073033 NORTHERN CALIFORNIA GENERAL TEAMSTERS SECURITY FUND NORT 2099405100 PO BOX 2300 STOCKTON CA 95201 MIKE CARNEFIX TRUSTEE 2099405100 2019-05-21 1 JOSEPH M THIERMANN P01066616 9252779100 66.7.226.66 2019-05-21 06:48:22 PD P D85FB602DC4FA66F28A631CB81EF53DF59ECABFA 92C7F91AD246760067C653CBF66B8BF12B4D5FD1 2017 2019-02-21 02:37:17Z DAVE HAWLEY PO BOX 2300 STOCKTON CA 95201 453702093 0 X N/A X 1952 CA TO PROVIDE HEALTH & WELFARE BENEFITS. 6 0 0 0 0 0 0 0 259755238 286478566 5840114 9544701 0 0 265595352 296023267 0 0 200849860 222314649 0 0 0 0 0 25287322 26692391 226137182 249007040 39458170 47016227 267760971 326108078 59727530 69087011 208033441 257021067 TO PROVIDE HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS. 0 0 PROVIDED HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS. 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 X 0 0 0 0 0 0 0 0 0 X 6 0 0 1 0 0 0 0 0 1 0 0 0 1 1 1 1 1 1 0 0 0 X DELTA FUND ADMINISTRATORS 2099405100 1234 W OAK STREET STOCKTON CA 95203 X JEFF BERDION TRUSTEE 1.00 X 0 0 0 PETER NUNEZ TRUSTEE 1.00 X 0 0 0 MIKE CARNEFIX TRUSTEE 1.00 X 0 0 0 DENISE GEORGE TRUSTEE 1.00 X 0 0 0 DAVE HAWLEY TRUSTEE 1.00 X 0 0 0 ROBERT PINA TRUSTEE 1.00 X 0 0 0 SEE SCHEDULE O FOR COMPENSATION PAID BY RELATED ORGANIZATIONS 0.00 X 0 1 0 0 1 0 0 0 0 0 DELTA FUND ADMINISTRATORS LLC 1234 W OAK STREET STOCKTON CA 95207 CONTRACT ADMINISTRATOR 6084365 ANTHEM BLUE CROSS 2121 N CALIFORNIA BLVD WALNUT CREEK CA 94596 NETWORK FEES 2330669 MCMORGAN & COMPANY ONE FRONT STREET STE 500 SAN FRANCISCO CA 94111 INVESTMENT MANAGER 833698 BLUE SHIELD OF CALIFORNIA PO BOX 272540 CHICO CA 95927 NETWORK FEES 498088 DELTA HEALTH SYSTEMS 3244 BROOKSIDE ROAD STOCKTON CA 95219 CONTRACT ADMINISTRATOR 390373 7 EMPLOYER CONTRIBUTIONS 900099 284253094 284253094 PRESCRIPTION REBATES 900099 970212 970212 OTHER REVENUE 900099 904041 904041 PARTICIPANT CONTRIBUTIONS 900099 351219 351219 286478566 7888009 7888009 159335518 157678826 1656692 1656692 1656692 296023267 286478566 0 9544701 222314649 6202251 96113 143237 1025040 4455408 282041 13732 85912 RESERVE SUBSIDIES PAID 10388870 RETIREE SUBSIDIES PAID 3999787 249007040 37861559 38028473 23843917 27437896 12469 18583 206043026 260623126 267760971 326108078 4731417 6527186 54996113 62559825 59727530 69087011 X 0 0 0 0 208033441 257021067 208033441 257021067 267760971 326108078 47016227 1971399 0 X X 0 1 X 1 0 0 CLAIMS PAYABLE AND INBR 42338825 ACCUMULATED ELIGIBILITY CREDITS 20221000 62559825 X 296969626 1971399 1971399 294998227 1025040 1025040 296023267 240188756 0 240188756 1025040 7793244 8818284 249007040 PART X, LINE 2: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE THE TAX POSITIONS TAKEN BY THE PLAN AND TO RECOGNIZE A TAX LIABILITY IF THE PLAN HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE. THE PLAN HAS ANALYZED THE TAX POSITIONS TAKEN BY THE PLAN AND HAS CONCLUDED THAT, AS OF JULY 31, 2018, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE FINANCIAL STATEMENTS. THE PLAN IS SUBJECT TO ROUTINE AUDITS BY THE TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. THE PLAN BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR THE FISCAL YEARS PRIOR TO 2015. PART XII, LINE 4B - OTHER ADJUSTMENTS: CHANGE IN BENEFIT OBLIGATIONS FORM 990, PART V, LINE 1A: THE PLAN'S THIRD-PARTY ADMINISTRATOR FILES ONE 1099 ON BEHALF OF ALL THE PLANS THEY ADMINISTER FOR THE VARIOUS "INDEPENDENT CONTRACTORS." THEREFORE, THIS QUESTION HAS BEEN ANSWERED AS ZERO FOR THIS ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 3 THE GOVERNING BODY HAS APPOINTED MANAGEMENT DUTIES TO A THIRD-PARTY ADMINISTRATOR. FORM 990, PART VI, SECTION A, LINE 8B THE ORGANIZATION DOES NOT HAVE A COMMITTEE WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 WAS MADE AVAILABLE TO EACH OF THE TRUSTEES FOR REVIEW BEFORE THE RETURN WAS FILED. THE THIRD-PARTY ADMINISTRATOR REVIEWED THE FORM FOR COMPLETENESS AND ACCURACY PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT-OF-INTEREST POLICY COVERS ALL TRUSTEES AND ANY OTHER INDIVIDUALS WHO EXERCISE DISCRETIONARY AND/OR FIDUCIARY AUTHORITY OVER THE AFFAIRS OF THE TRUST. AT LEAST ONCE ANNUALLY, TRUSTEES AND OTHER FIDUCIARIES ARE REQUIRED TO DISCLOSE IN WRITING ANY RELATIONSHIPS OR INTERESTS THAT COULD GIVE RISE TO A CONFLICT. THE BOARD HAS DISCRETIONARY AUTHORITY TO DETERMINE WHETHER A CONFLICT DOES IN FACT, EXIST AND, IF SO, WHETHER THE CONTEMPLATED TRANSACTION MAY BE AUTHORIZED AS JUST, FAIR AND REASONABLE TO THE TRUST. SUCH DETERMINATIONS ARE MADE WITHOUT THE INPUT OR PARTICIPATION OF THE CONFLICTED INDIVIDUAL. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION DOES NOT COMPENSATE TRUSTEES. 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 VII, SECTION A, LINE 9A: TRUSTEES ARE NOT COMPENSATED BY THE TRUST. 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. IF YOU WOULD LIKE ADDITIONAL INFORMATION, PLEASE CONTACT THE THIRD-PARTY ADMINISTRATOR, DELTA FUND ADMINISTRATORS LLC. FORM 990, PART XII, LINE 2C THE BOARD OF TRUSTEES ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT AND FOR THE SELECTION OF AN INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED. TEAMSTERS RETIREE TRUST PO BOX 2330 STOCKTON CA 95201 686097704 TO PROVIDE HEALTH BENEFITS FOR RETIRED PARTICIPANTS AND THEIR DEPENDENTS. CA 501(C)(9) N/A N/A 0 TEAMSTERS LOCAL UNION 948 1933 W CALDWELL VISALIA CA 93277 941310598 LOCAL UNION/SPONSORING ORGANIZATION OF THE FILING ORGANIZATION CA 501C(5) N/A N/A 0 TEAMSTERS LOCAL UNION 137 3540 S MARKET REDDING CA 96001 940577278 LOCAL UNION/SPONSORING ORGANIZATION OF THE FILING ORGANIZATION CA 501C(5) N/A N/A 0 TEAMSTERS LOCAL UNION 150 7120 E PARKWAY SACRAMENTO CA 95823 940380120 LOCAL UNION/SPONSORING ORGANIZATION OF THE FILING ORGANIZATION CA 501C(5) N/A N/A 0 TEAMSTERS LOCAL UNION 386 1225 THIRTEENTH ST MODESTO CA 95354 940577279 LOCAL UNION/SPONSORING ORGANIZATION OF THE FILING ORGANIZATION CA 501C(5) N/A N/A 0 TEAMSTERS LOCAL UNION 431 1140 W OLIVE STREET FRESNO CA 93278 940577293 LOCAL UNION/SPONSORING ORGANIZATION OF THE FILING ORGANIZATION CA 501C(5) N/A N/A 0 TEAMSTERS LOCAL UNION 439 PO BOX 1611 STOCKTON CA 95201 940918920 LOCAL UNION/SPONSORING ORGANIZATION OF THE FILING ORGANIZATION CA 501C(5) N/A N/A 0 TEAMSTERS LOCAL UNION 517 512 W OAK ST VISALIA CA 93291 941069921 LOCAL UNION/SPONSORING ORGANIZATION OF THE FILING ORGANIZATION CA 501C(5) N/A N/A 0 TEAMSTERS LOCAL UNION 533 240 GENTRY WAY RENO NV 89502 880046825 LOCAL UNION/SPONSORING ORGANIZATION OF THE FILING ORGANIZATION NV 501C(5) N/A N/A 0 TEAMSTERS LOCAL UNION 87 2531 G STREET BAKERSFIELD CA 93301 950865989 LOCAL UNION/SPONSORING ORGANIZATION OF THE FILING ORGANIZATION CA 501C(5) N/A N/A 0 TEAMSTERS LOCAL UNION 601 745 EAST MINER AVENUE STOCKTON CA 95202 940366146 LOCAL UNION/SPONSORING ORGANIZATION OF THE FILING ORGANIZATION CA 501C(5) N/A N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 SCHEDULE R, IDENTIFICATION OF RELATED ORGANIZATIONS: THE FILING ORGANIZATION IS A TAFT-HARTLEY MULTIEMPLOYER TRUST THAT PROVIDES HEALTH AND WELFARE BENEFITS TO ELIGIBLE EMPLOYEES AND THEIR DEPENDENTS. AS OF JULY 31, 2018, THERE ARE APPROXIMATELY 176 EMPLOYERS THAT CONTRIBUTE TO THE TRUST. THE ADMINISTRATIVE OFFICE MAINTAINS A DATABASE OF THESE CONTRIBUTING EMPLOYERS, INCLUDING NAMES, ADDRESSES AND OTHER CONTACT INFORMATION. THE FEDERAL TAX CLASSIFICATION (DISREGARDED ENTITY, TAX-EXEMPT ORGANIZATION, PARTNERSHIP, TAXABLE CORPORATION OR TRUST) FOR EACH CONTRIBUTING EMPLOYER IS NOT ON FILE WITH THE ADMINISTRATIVE OFFICE AND IT COULD NOT BE REASONABLY OBTAINED. AS A RESULT, THE NAMES OF THE CONTRIBUTING EMPLOYERS ARE LISTED ON PART VII BELOW AND NOT ON PARTS II THROUGH IV BY FEDERAL TAX CLASSIFICATION. ORLAND UNIT WATER USERS ASSOC AGGREGATE PRODUCTS FOSTER FARMS - FRESNO ADVANCED FOOD PRODUCTS ALLIDED/ REPUBLIC WASTE STKN ALLIDED/ REPUBLIC WASTE STKN ALLIDED/ REPUBLIC WASTE STKN SYSCO FOOD SERVICE OF SAC GRANITE CONSTRUCTION WILBUR-ELLIS CO GRANITE ROCK GREIF INDUSTRIAL GEORGE KISHIDA INC AMERIPRIDE UNIFORM SER - FRESNO AMERIPRIDE UNIFORM SER - SAC WESTWAY FEED PRODUCTS RUAN - T321 TRUCKLOAD RUAN - T317 RUAN - T309 TANK ANDERSON / COTTONWOOD A-C IRRIGATION DISTRICT CA DAIRIES - TURLOCK VULCAN MATERIALS (PREV CALMAT) ARAMARK ASTA CONSTRUCTION SAPUTO DAIRY FOODS BAKER COMMODITIES. INC BALL METAL FOOD CONTAINERS BARRETO & SILVEIRA DAIRY LAND O LAKES LAND O LAKES, INC. LAS ANIMAS CONCRETE INLAND BIG 4 TIRE SERVICE BERKELEY FARMS BLACK BUTTE SCHOOL DIST ORGANIZED LABOR CREDIT UNION ALLIED WASTE / FRESNO ALLIED WASTE / RICE RD BUCHWALD'S CA COLD STORAGE CALAVERAS TRANSIT MIX RUAN - T305 C.A.S.E. 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RIDER & SONS HAPPY VALLEY SCHOOL DIST JIM HYATT PRODUCE FOSTER FARMS / HUMBOLDT LEEP/TESCHER/HELFMAN/ZANZE KNAUF INSULATION SOUTHERN WINE & SPIRITS LEPRINO FOODS - TRACY LEPRINO FOODS - LEMOORE LOCAL 948 LOCAL 137 LOCAL 150 / OFFICE T&T TRUCK AND CRANE LOCAL 386 LOCAL 431 LOCAL 439 LOCAL 533 LOCAL 601 LOCAL 517 LEWISTON ELEM SCHOOL DIST CEMEX CEMEX CEMEX / MERCED PLANT CEMEX CEMEX / MODESTO, NEWMAN, TURLOCK CA DAIRIES - LOS BANOS S. MARTINELLI & CO FOSTER FARMS - REDDING CHARLES MCMURRAY AMERICOLD (PREV VERSACOLD) MERCER FRASER READY MIX MODEL DAIRY WASTE MANAGEMENT / MODESTO WASTE MANAGEMENT / REDDING MODOC JT UNIFIED SCHOOL DIST MONTEREY BAY CENTRAL LBR CNCL MONTEREY CITY DISPOSAL MOUNTAIN UNION SCHOOL DIST MYOVICH TRUCKING NATURIPE BERRY GROWERS MONDELEZ GLOBAL (NABISCO) MV TRANSPORTATION, INC ALSCO, INC - AMERICAN LINEN DIV ALSCO HUTTIG BUILDING PRODUCTS DARLING INGREDIENTS DARLING DELAWARE CA DAIRIES - FRESNO PYRENEES FRENCH BAKERY DEFENSE BASE SERVICES PAJARO DUNES SOUTH ASSOC PDM STEEL SERVICE CENTERS PAJARO VALLEY COLD STORAGE SERVICE WEST DEL MAR COLD STORAGE DEL MAR FOOD PROD DEL MONTE FOODS AMERICAN METALS CORP CEMEX / RENO SPARKS READYMIX ARAMARK - RENO RILITE AGGREGATES MISSION LINEN SACRAMENTO RENDERING CO DRISCOLL'S BERRIES QUALITY MANPOWER SCANNAVINO TRUCKING SAN BENITO FOODS SANTA CLARA NUT CO CANTEEN VENDING SENECA DISTRICT HOSPITAL SHASTA CO/ DEPT OF PUBLIC WORKS SHASTA LAKE FIRE SHASTA REDI MIX SHELDON'S PEST MGMT SERVICE INC STKN SCAVENGERS STURDY OIL CO DYNCORP INTERNATIONAL SILGAN CAN CO SILGAN CAN CO / RIVERSIDE SILGAN CONTAINERS SUGAR TRANSPORT CALAVERAS MATERIALS SURPRISE VALLEY SCHOOL / CERTIFIED TAHOE TRANSIT DISTRICT T.A.R.P. SVENHARDS SWEDISH BAKERY SUNSWEET GROWERS TEICHERT AGGREGATES TIN MAN DENTAL SUPPLY TRANSDEV CHICO TRANSDEV REDDING RAIL TERMINAL SERVICES US COLD STORAGE VALLEY FIG - UNION AMERIPRIDE UNIFORM SER -FRESNO WAYSIDE LUMBER WILLIAMS BAKERY/ US BAKERY WESTERN BUILDING MATERIALS VARCITY ICE CREAM DISTRICT VEGETABLE GROWERS SUPPLY INC LOCAL 87 UPS - VARIOUS LOCATIONS