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NORTHERN CALIFORNIA BAKERY DRIVERS SECURITY FUND: Form 990, tax year 2017

View the entire original 990 at ProPublica ↗

Organization
NORTHERN CALIFORNIA BAKERY DRIVERS SECURITY FUND (EIN 94-6073089)
Tax period
2017-10-01 to 2018-09-30
Filed
2019-07-11
IRS object ID
201931929349300968
Schema version
2017v2.3
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2019-07-11T15:52:40-05:00ReturnTs
Tax Period End2018-09-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN522385296PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1LINDQUIST LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line15000 EXECUTIVE PARKWAY SUITE 400AddressLine1Txt
CitySAN RAMONCityNm
State AbbreviationCAStateAbbreviationCd
ZIP94583ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2017-10-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN946073089EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1NORTHERN CALIFORNIABusinessNameLine1Txt
Business Name Line2BAKERY DRIVERS SECURITY FUNDBusinessNameLine2Txt
FieldValueIRS element (for citing)
Business Name ControlNORTBusinessNameControlTxt
Phone4155467800PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11600 HARBOR BAY PARKWAY NO 200AddressLine1Txt
CityALAMEDACityNm
State AbbreviationCAStateAbbreviationCd
ZIP94502ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonJAMES HAMPersonNm
Person TitleTRUSTEEPersonTitleTxt
Phone4155467800PhoneNum
Signature2019-07-11SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonJESSICA R ROSTERPreparerPersonNm
PTINP01317380PTIN
Phone9252779100PhoneNum

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address66.7.226.66IPv4AddressTxt
FieldValueIRS element (for citing)
IP2019-07-11IPDt
IP Tm13:52:31IPTm
IP TimezonePDIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device Id92C7F91AD246760067C653CBF66B8BF12B4D5FD1AtSubmissionCreationDeviceId
At Submission Filing Device Id92C7F91AD246760067C653CBF66B8BF12B4D5FD1AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2017TaxYr
Build TS2019-02-21 02:37:17ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerJAMES HAMPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line11600 HARBOR BAY PARKWAY NO 200AddressLine1Txt
CityALAMEDACityNm
State AbbreviationCAStateAbbreviationCd
ZIP94502ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$28,872,687GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501cYes (X)Organization501cInd
Website AddressN/AWebsiteAddressTxt
Type Of Organization TrustYes (X)TypeOfOrganizationTrustInd
Formation1952FormationYr
Legal Domicile StateCALegalDomicileStateCd
Activity Or MissionTO PROVIDE HEALTH AND WELFARE BENEFITSActivityOrMissionDesc
Voting Members Governing Body6VotingMembersGoverningBodyCnt
Voting Members Independent0VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$0PYContributionsGrantsAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$19,766,553PYProgramServiceRevenueAmt
CY Program Service Revenue$20,197,424CYProgramServiceRevenueAmt
PY Investment Income-$122,747PYInvestmentIncomeAmt
CY Investment Income$1,047,972CYInvestmentIncomeAmt
PY Other Revenue$11,978PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$19,655,784PYTotalRevenueAmt
CY Total Revenue$21,245,396CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$19,180,586PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$19,536,359CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$4,500PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$4,200CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$1,037,415PYOtherExpensesAmt
CY Other Expenses$996,795CYOtherExpensesAmt
PY Total Expenses$20,222,501PYTotalExpensesAmt
CY Total Expenses$20,537,354CYTotalExpensesAmt
PY Revenues Less Expenses-$566,717PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$708,042CYRevenuesLessExpensesAmt
Total Assets BOY$29,835,919TotalAssetsBOYAmt
Total Assets EOY$30,373,030TotalAssetsEOYAmt
Total Liabilities BOY$3,432,891TotalLiabilitiesBOYAmt
Total Liabilities EOY$3,348,680TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$26,403,028NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$27,024,350NetAssetsOrFundBalancesEOYAmt
MissionTO PROVIDE HEALTH AND WELFARE BENEFITS TO COVERED EMPLOYEES AND THEIR DEPENDENTS.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
DescTHE FUND PROVIDED WELFARE BENEFITS TO COVERED EMPLOYEES AND THEIR DEPENDENTS.Desc
Described In Section501c30DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building Equipment0ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J Required0ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
Info In Schedule O Part VYes (X)InfoInScheduleOPartVInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee0EmployeeCnt
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members6GoverningBodyVotingMembersCnt
Independent Voting Member0IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesYes (1)DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of Committees0MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEO0CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1ZENITH AMERICAN SOLUTIONSBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone4155467800PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11600 HARBOR BAY PARKWAY SUITE 200AddressLine1Txt
CityALAMEDACityNm
State AbbreviationCAStateAbbreviationCd
ZIP94502ZIPCd
FieldValueIRS element (for citing)
Info In Schedule O Part VIIYes (X)InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (7 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
JOHN BOTTALI
TRUSTEE3.00Yes (X)$0$0$0
JAMES HAM
TRUSTEE2.00Yes (X)$0$0$0
LOU VALLETTA
TRUSTEE1.00Yes (X)$0$0$0
MARTY CRANDALL
TRUSTEE1.00Yes (X)$0$0$0
DON HOPKINS
TRUSTEE3.00Yes (X)$3,300$0$0
JOHN ONTIVEROS
TRUSTEE1.00Yes (X)$0$0$0
SEE SCHEDULE O FOR COMPENSATION
PAID BY RELATED ORGANIZATIONS0.00Yes (X)$0$0$0
FieldValueIRS element (for citing)
Total Reportable Comp From Org$3,300TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$0TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K0TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (2 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
ZENITH AMERICAN SOLUTIONS INC
1600 HARBOR BAY PKWY STE 200ALAMEDACA94502FUND ADMINISTRATION$479,670
ANTHEM INC
120 MONUMENT CIRCLEINDIANAPOLISIN46204CLAIMS ADMINISTRATION$113,970
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K2CntrctRcvdGreaterThan100KCnt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
EMPLOYER CONTRIBUTIONS900099$17,048,375$17,048,375
PARTICIPANT CONTRIBUTIONS900099$2,633,138$2,633,138
PRESCRIPTION DRUG REBATES900099$312,362$312,362
STOP LOSS INCOME900099$191,442$191,442
KAISER OVER PAYMENT900099$12,107$12,107
FieldValueIRS element (for citing)
Total Program Service Revenue$20,197,424TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$903,162TotalRevenueColumnAmt
Exclusion$903,162ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$7,772,101SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$7,627,291SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$144,810SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$144,810TotalRevenueColumnAmt
Exclusion$144,810ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$21,245,396TotalRevenueColumnAmt
Related Or Exempt Func Income$20,197,424RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$1,047,972ExclusionAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$19,536,359TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$4,200TotalAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$417,985TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$38,337TotalAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$40,297TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$23,125TotalAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$353,421TotalAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$69,305TotalAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$2,000TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$25,804TotalAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$23,401TotalAmt

Other Expenses OtherExpensesGrp

FieldValueIRS element (for citing)
DescPCORI FEESDesc
Total$3,120TotalAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$20,537,354TotalAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$1,300,556BOYAmt
EOY$518,818EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$1,522,754BOYAmt
EOY$1,557,607EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$24,416BOYAmt
EOY$847,160EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$26,988,193BOYAmt
EOY$27,449,445EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$29,835,919BOYAmt
EOY$30,373,030EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$1,835,593BOYAmt
EOY$1,632,986EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$23,498BOYAmt
EOY$22,294EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$1,573,800BOYAmt
EOY$1,693,400EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$3,432,891BOYAmt
EOY$3,348,680EOYAmt
FieldValueIRS element (for citing)
Org Does Not Follow SFAS117Yes (X)OrgDoesNotFollowSFAS117Ind

Cap Stk Tr Prin Current Funds CapStkTrPrinCurrentFundsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Pd In Cap Srpls Land Bldg Eqp Fund PdInCapSrplsLandBldgEqpFundGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rtn Earn Endowment Incm Oth Fnds RtnEarnEndowmentIncmOthFndsGrp

FieldValueIRS element (for citing)
BOY$26,403,028BOYAmt
EOY$27,024,350EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$26,403,028BOYAmt
EOY$27,024,350EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$29,835,919BOYAmt
EOY$30,373,030EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$708,042ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$86,720NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Total Book Value Land Buildings$0TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescACCUMULATED ELIGIBILITY CREDITSDesc
Amt$1,693,400Amt
FieldValueIRS element (for citing)
Total Liability$1,693,400TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$21,135,551TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst-$86,720NetUnrealizedGainsInvstAmt
Revenue Not Reported-$86,720RevenueNotReportedAmt
Revenue Subtotal$21,222,271RevenueSubtotalAmt
Investment Expenses Not Incld$23,125InvestmentExpensesNotIncldAmt
Revenue Not Reported Fincl Stmt$23,125RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$21,245,396TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$20,673,366TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$20,673,366ExpensesSubtotalAmt
Investment Expenses Not Incld2$23,125InvestmentExpensesNotIncld2Amt
Other Expenses Not Included-$159,137OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt-$136,012ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$20,537,354TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART X, LINE 2:THE PLAN'S ADMINISTRATOR HAS ANALYZED THE TAX POSITIONS TAKEN BY THE PLAN AND HAS CONCLUDED THAT, AS OF SEPTEMBER 30, 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'S ADMINISTRATOR BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR THE YEARS PRIOR TO 2015.
PART XII, LINE 4B - OTHER ADJUSTMENTS:CHANGE IN BENEFIT OBLIGATIONS

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (8 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART V, LINE 1ATHE PLAN'S THIRD PARTY ADMINISTRATOR FILES ONE 1099 ON BEHALF OF ALL THE PLANS THEY ADMINISTER FOR THE VARIOUS "INDEPENDENT CONTRACTORS." THEREFORE, LINE 1A HAS BEEN ANSWERED ZERO. ADDITIONALLY, THE THIRD PARTY ADMINISTRATOR ENSURES THAT THE PLAN IS IN COMPLIANCE WITH THE BACKUP WITHHOLDING RULES.
FORM 990, PART VI, SECTION A, LINE 3THE PLAN HAS CONTRACTED WITH ZENITH AMERICAN SOLUTIONS, INC., TO PROVIDE ADMINISTRATIVE SERVICES FOR THE ORGANIZATION.
FORM 990, PART VI, SECTION A, LINE 8BTHERE ARE NO COMMITTEES WITH THE AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY.
FORM 990, PART VI, SECTION B, LINE 11BA COPY OF THE FORM 990 WAS PROVIDED TO THE BOARD OF TRUSTEES FOR REVIEW BEFORE IT WAS FILED.
FORM 990, PART VI, SECTION B, LINE 12CTRUSTEES ARE REQUIRED, ON AN ANNUAL BASIS, TO DISCLOSE ANY RELATIONSHIPS OR INTERESTS THAT COULD GIVE RISE TO A CONFLICT. IF THERE IS A CONFLICT OF INTEREST, THE PERSON INVOLVED IS EXCLUDED FROM THE DISCUSSION AND APPROVAL OF SUCH TRANSACTION.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION MAKES IT GOVERNING DOCUMENTS, CONFLICT-OF-INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART VII, LINE 1AONLY ONE TRUSTEE IS COMPENSATED BY THE TRUST. COMPENSATION PAID TO TRUSTEES BY OTHER ORGANIZATIONS IS REPORTED ON THE FORM 990 FILED WITH THE INTERNAL REVENUE SERVICE BY THE RELATED TAX EXEMPT ORGANIZATION. IF YOU WOULD LIKE MORE INFORMATION, PLEASE CONTACT THE THIRD-PARTY ADMINISTRATOR, ZENITH AMERICAN SOLUTIONS, INC.
FORM 990, PART XII, LINE 2CTHE BOARD ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDITED FINANCIAL STATEMENTS AND FOR SELECTION OF THE INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED.

Schedule R IRS990ScheduleR

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1SEE EXPLANATION AT PART VIIBusinessNameLine1Txt
FieldValueIRS element (for citing)
Primary ActivitiesVARIOUSPrimaryActivitiesTxt
Legal Domicile StateCALegalDomicileStateCd
Controlled Organization0ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE R, IDENTIFICATION OF RELATED ORGANIZATIONSFormAndLineReferenceDesc
ExplanationTHE FILING ORGANIZATION IS A TAFT-HARTLEY MULITIEMPLOYER TRUST THAT PROVIDES HEALTH BENEFITS TO ELIGIBLE EMPLOYEES AND THEIR DEPENDENTS. AS OF SEPTEMBER 30, 2018, THERE ARE APPROXIMATELY 4 EMPLOYERS THAT CONTRIBUTE TO THE TRUST AND 13 SPONSORING ORGANIZATIONS. THE ADMINISTRATIVE OFFICE MAINTAINS A DATABASE OF THESE CONTRIBUTING EMPLOYERS AND SPONSORING ORGANIZATIONS, 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 AND SPONSORING ORGANIZATION IS NOT ON FILE WITH THE ADMINISTRATIVE OFFICE AND IT COULD NOT BE REASONABLY OBTAINED. AS A RESULT, THE NAMES OF THE CONTRIBUTING EMPLOYERS AND SPONSORING ORGANIZATIONS ARE LISTED ON PART VII BELOW AND NOT ON PARTS II THROUGH IV BY FEDERAL TAX CLASSIFICATION. BIMBO BAKERIES USA ROMA BAKERY, INC. SAFEWAY SVENHARDS SWEDISH BAKERY TEAMSTERS LOCAL 87 TEAMSTERS LOCAL 137 TEAMSTERS LOCAL 150 TEAMSTERS LOCAL 186 TEAMSTERS LOCAL 315 TEAMSTERS LOCAL 386 TEAMSTERS LOCAL 431 TEAMSTERS LOCAL 439 TEAMSTERS LOCAL 853 TEAMSTERS LOCAL 890 TEAMSTERS LOCAL 912 TEAMSTERS LOCAL 948 TEAMSTERS LOCAL 986ExplanationTxt