2019-01-28T10:27:01-06:00 2018-03-31 410746749 CLIFTONLARSONALLEN LLP 601 W RIVERSIDE AVE SUITE 700 SPOKANE WA 99201 990 2017-04-01 910589283 NORTHWEST SHEET METAL WORKERS WELFARE FUND NORT 5095340600 1322 NORTH POST SPOKANE WA 99201 BARON DERR CHAIRMAN 5095340600 2019-01-28 1 ANN SWINDELL P00060217 5093636300 2019-01-21 67.137.57.251 2019-01-28 08:26:41 PS P 6A821D0B274B5855642737A0F5B4B79E08AAF2E9 4E1019BFE9B9EF55B23EDC930650553A5FF3285A 2017 2019-02-21 02:37:17Z BARON DERR 1322 NORTH POST SPOKANE WA 99201 99277090 0 X N/A X 1952 WA HEALTH AND WELFARE BENEFITS 10 10 149 10 0 0 0 0 82872234 87470033 1569180 1777307 0 0 84441414 89247340 0 0 83181242 70587944 0 0 0 0 0 2238990 1933224 85420232 72521168 -978818 16726172 73314171 93753929 38924666 41216199 34389505 52537730 TO PROVIDE HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS AS SPECIFIED IN THE PLAN. 0 0 TO PROVIDE HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS AS SPECIFIED IN THE PLAN. 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 3948 0 1 149 1 0 0 0 0 0 0 0 0 X 10 10 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 0 0 0 0 0 WA X DAVID KIMMET 5095340600 1322 N POST ST SPOKANE WA 99201 X BARON W DERR CHAIRMAN 1.00 X X 0 0 0 TIM CARTER SECRETARY 1.00 X X 0 0 0 GREG HAYTER TRUSTEE 1.00 X 0 0 0 JOHN CARTER TRUSTEE 1.00 X 0 0 0 JULIE MULLER-NEFF TRUSTEE 1.00 X 0 0 0 LOREN WARD TRUSTEE 1.00 X 0 0 0 JIM REYNOLDS TRUSTEE 1.00 X 0 0 0 LANCE DEYETTE TRUSTEE 1.00 X 0 0 0 KOLBY HANSON TRUSTEE 1.00 X 0 0 0 RANDY GOLDING TRUSTEE 1.00 X 0 0 0 0 0 0 0 0 0 0 AETNA 151 FARMINGTON AVENUE HARTFORD CT 06156 PPO NETWORK 1407718 AW REHN AND ASSOCIATES 1322 N POST ST SPOKANE WA 99201 ADMINISTRATION 1044892 DELTA DENTAL OF WA PO BOX 75983 SEATTLE WA 98175 DENTAL CLAIMS ADMINISTRATOR 255922 ENVISION PHARMACEUTICAL SERVICES 2181 E AURUORA RD STE 201 TWINSBURG OH 44087 RX CLAIMS ADMINISTRATOR 166115 CIGNA PO BOX 644546 PITTSBURGH PA 15264 PPO NETWORK 159489 5 EMPLOYER CONTRIBUTIONS 900099 74998134 74998134 SUPP. BENEFIT CONTRIBS 900099 7008942 7008942 PARTICIPANT CONTRIBUTI 900099 5316491 5316491 LIQUIDATED DAMAGES 900099 146466 146466 87470033 1514522 1514522 10292535 10029750 262785 262785 262785 89247340 87470033 0 1777307 70587944 1211007 92653 126141 70123 123877 150223 47562 45898 46136 AFFORDABLE CARE ACT FEE 19196 ALASKA VACCINE ASSESSME 390 MISCELLANEOUS 18 72521168 4504703 11719574 655555 640674 8386231 8423936 74642 79188 59693040 72890557 73314171 93753929 276196 214095 38648470 41002104 38924666 41216199 X 0 0 0 0 34389505 52537730 34389505 52537730 73314171 93753929 16726172 1422053 0 X X 0 1 X 1 0 0 ACCUMULATED ELIGIBILITY CREDITS 16880119 ESTIMATED LIABILITY FOR INCURRED BUT UNREPORTED CLAIMS 8274000 ESTIMATED LIABILITY FOR EXTENDED MEDICAL COVERAGE 12404108 ESTIMATED LIABILITY FOR SEVERANCE BENEFITS 1084538 ESTIMATED LIABILITY FOR RETIREE SUBSIDY 2359339 41002104 X 90599270 1422053 1422053 89177217 70123 70123 89247340 70097411 0 70097411 70123 2353634 2423757 72521168 PART X, LINE 2: THE TRUST ESTABLISHED UNDER THE PLAN TO HOLD THE PLAN'S ASSETS IS QUALIFIED PURSUANT TO SECTION 501(C)(9) OF THE INTERNAL REVENUE CODE AND, ACCORDINGLY, THE TRUST'S NET INVESTMENT INCOME IS EXEMPT FROM INCOME TAXES. THE PLAN OBTAINED A FAVORABLE DETERMINATION LETTER FROM THE INTERNAL REVENUE SERVICE (IRS) ON JUNE 21, 1988 AND THE PLAN SPONSOR BELIEVES THE PLAN, AS AMENDED, CONTINUES TO QUALIFY AND OPERATE AS DESIGNED. ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE PLAN MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE PLAN AND REECOGNIZE A TAX LIABILITY (OR ASSET) IF THE PLAN AS 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. PART XII, LINE 4B - OTHER ADJUSTMENTS: INCREASE IN ACCUMULATED ELIGIBILITY CREDITS 929,039. DECREASE IN ESTIMATED LIABILITY FOR CLAIMS IBNR -367,000. INCREASE IN ESTIMATED LIABILITY FOR EXTENDED MEDICAL COVERAGE 1,537,954. INCREASE IN ESTIMATED LIABILITY FOR SEVERANCE BENEFITS -23,688. INCREASE IN ESTIMATED LIABILITY FOR RETIREE SUBSIDY 277,329. FORM 990, PART VI, SECTION A, LINE 3 THE DAY TO DAY OPERATIONS OF THE PLAN ARE MANAGED BY AW REHN & ASSOCIATES FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PRESENTED TO THE BOARD OF TRUSTEES AND LEGAL COUNSEL BEFORE SIGNATURE AND FILING FORM 990, PART VI, SECTION B, LINE 12C TRUSTEES ARE ASKED ANNUALLY IN WRITING IF ANY CONFLICTS EXIST. ANY CONFLICTS ARE BROUGHT TO THE BOARD OF TRUSTEES FOR RESOLUTION. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE NOT AVAILABLE TO THE PUBLIC. A SUMMARY ANNUAL REPORT REQUIRED BY ERISA IS SENT TO THE PARTICIPANTS ANNUALLY. ACCORDING TO THE REGULATIONS OF THE EBSA, PARTICIPANTS CAN REQUEST THE FULL ANNUAL REPORT AND FORM 5500 FROM THE PLAN ADMINISTRATOR. FORM XII, LINE 2C THE OVERSIGHT PROCESS AND METHOD FOR CHOOSING THE INDEPENDENT AUDITOR HAS NOT CHANGED FROM PRIOR YEARS. 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