STRATEGY STUDIO / PUBLIC DATA EXPLORER

PROFESSIONAL AND COMMERCIAL TRADES HEALTH AND WELLNESS FUND: Form 990, tax year 2018

View the entire original 990 at ProPublica ↗

Organization
PROFESSIONAL AND COMMERCIAL TRADES HEALTH AND WELLNESS FUND (EIN 68-0139450)
Tax period
2018-01-01 to 2018-12-31
Filed
2019-11-14
IRS object ID
201943199349300609
Schema version
2018v3.1
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)
Return2019-11-14T23:36:57-06:00ReturnTs
Tax Period End2018-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN450250958PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1EIDE BAILLY LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line13130 CROW CANYON PL STE 300AddressLine1Txt
CitySAN RAMONCityNm
State AbbreviationCAStateAbbreviationCd
ZIP945831386ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2018-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN680139450EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1UFCW NORTHERN CALIFORNIA AND DRUGBusinessNameLine1Txt
Business Name Line2EMPLOYERS HEALTH AND WELFARE TRUST FUNDBusinessNameLine2Txt
FieldValueIRS element (for citing)
Business Name ControlUFCWBusinessNameControlTxt
Phone9257467530PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11000 BURNETT AVENUE NO 200AddressLine1Txt
CityCONCORDCityNm
State AbbreviationCAStateAbbreviationCd
ZIP94520ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonRICK A SILVAPersonNm
Person TitleOFFICERPersonTitleTxt
Phone9257467530PhoneNum
Signature2019-11-14SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonTERRI MONTGOMERYPreparerPersonNm
PTINP00232100PTIN
Phone9254804000PhoneNum

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address24.5.226.27IPv4AddressTxt
FieldValueIRS element (for citing)
IP2019-11-14IPDt
IP Tm23:36:54IPTm
IP TimezonePSIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device IdDA39A3EE5E6B4B0D3255BFEF95601890AFD80709AtSubmissionCreationDeviceId
At Submission Filing Device IdF52D36390EBCF6BF15030359CEDEDEC3AB6B140AAtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2018TaxYr
Build TS2020-03-31 21:24:44ZBuildTS

Form 990 IRS990

US Address USAddress

FieldValueIRS element (for citing)
Address Line11000 BURNETT AVENUE NO 200AddressLine1Txt
CityCONCORDCityNm
State AbbreviationCAStateAbbreviationCd
ZIP94520ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$23,423,559GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501cYes (X)Organization501cInd
Website AddressN/AWebsiteAddressTxt
Type Of Organization TrustYes (X)TypeOfOrganizationTrustInd
Formation1987FormationYr
Legal Domicile StateCALegalDomicileStateCd
Activity Or MissionSEE PART III (4A)ActivityOrMissionDesc
Voting Members Governing Body8VotingMembersGoverningBodyCnt
Voting Members Independent8VotingMembersIndependentCnt
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$20,214,867PYProgramServiceRevenueAmt
CY Program Service Revenue$18,901,482CYProgramServiceRevenueAmt
PY Investment Income$65,891PYInvestmentIncomeAmt
CY Investment Income-$26,487CYInvestmentIncomeAmt
PY Other Revenue$236,636PYOtherRevenueAmt
CY Other Revenue$2,035,442CYOtherRevenueAmt
PY Total Revenue$20,517,394PYTotalRevenueAmt
CY Total Revenue$20,910,437CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$22,096,487PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$19,739,169CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$0PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$0CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$2,106,677PYOtherExpensesAmt
CY Other Expenses$1,967,402CYOtherExpensesAmt
PY Total Expenses$24,203,164PYTotalExpensesAmt
CY Total Expenses$21,706,571CYTotalExpensesAmt
PY Revenues Less Expenses-$3,685,770PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$796,134CYRevenuesLessExpensesAmt
Total Assets BOY$5,727,878TotalAssetsBOYAmt
Total Assets EOY$4,880,566TotalAssetsEOYAmt
Total Liabilities BOY$6,200,761TotalLiabilitiesBOYAmt
Total Liabilities EOY$6,101,899TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY-$472,883NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY-$1,221,333NetAssetsOrFundBalancesEOYAmt
MissionNONEMissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
DescTO PROVIDE HEALTH AND WELFARE BENEFITS TO EMPLOYEES AND OTHER ELIGIBLE PERSONS.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
IRP Document378IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee0EmployeeCnt
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members8GoverningBodyVotingMembersCnt
Independent Voting Member8IndependentVotingMemberCnt
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 CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn0AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc0RegularMonitoringEnfrcInd
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 Line1JESSE GLAVESBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone9257467530PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11000 BURNETT AVENUE NO 200AddressLine1Txt
CityCONCORDCityNm
State AbbreviationCAStateAbbreviationCd
ZIP94520ZIPCd
FieldValueIRS element (for citing)
No Listed Persons CompensatedYes (X)NoListedPersonsCompensatedInd

Form990 Part VII Section A Form990PartVIISectionAGrp (8 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
JACK LANDES
TRUSTEE5.00Yes (X)$0$0$0
MARLA DONATI
TRUSTEE5.00Yes (X)$0$0$0
MIKE FRENNA
TRUSTEE5.00Yes (X)$0$0$0
RICK GLAZER
TRUSTEE5.00Yes (X)$0$0$0
JOHN HEISE
TRUSTEE5.00Yes (X)$0$0$0
BRET SLUSSER
TRUSTEE5.00Yes (X)$0$0$0
ROGER CEBALLOS
TRUSTEE5.00Yes (X)$0$0$0
ALLISON FULLER
TRUSTEE5.00Yes (X)$0$0$0
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
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 (4 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
UFCW ADMIN LLC
1000 BURNETT AVE 110CONCORDCA94520ADMINISTRATOR$949,444
BLUE SHIELD
3401 N CENTRE LAKE DR 400ONTARIOCA91761ADMINISTRATOR$364,144
JOHN H COHENOUR
225 WATT AVE 335SACRAMENTOCA95825LEGAL$157,780
THE SEGAL COMPANY
100 MONTGOMERY ST STE 500SAN FRANCISCOCA94104ACTUARY/CONSULTANT$105,514
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K4CntrctRcvdGreaterThan100KCnt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
EMPLOYER CONTRIBUTIONS900099$17,756,401$17,756,401
PARTICIPANT CONTRIBUTIONS900099$1,145,081$1,145,081
FieldValueIRS element (for citing)
Total Program Service Revenue$18,901,482TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$50,635TotalRevenueColumnAmt
Exclusion$50,635ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$2,436,000SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$2,513,122SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities-$77,122SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$77,122TotalRevenueColumnAmt
Related Or Exempt Func Income-$77,122RelatedOrExemptFuncIncomeAmt

Other Revenue Misc OtherRevenueMiscGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
STOP LOSS REIMBURSEMENT900099$1,837,364$1,837,364
RETIREE DRUG SUBSIDY900099$198,078$198,078
FieldValueIRS element (for citing)
Other Revenue Total$2,035,442OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$20,910,437TotalRevenueColumnAmt
Related Or Exempt Func Income$20,859,802RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$50,635ExclusionAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$19,739,169TotalAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$945,318TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$157,780TotalAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$31,108TotalAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$66,178TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$5,056TotalAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$12,535TotalAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmt
HEALTHCARE ADMIN AND ME$494,785
CONSULTING SERVICES$105,514
MEDEXPERT$62,400
UNION LOCAL ADMIN SUPPO$44,805

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$41,923TotalAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$21,706,571TotalAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$936,290BOYAmt
EOY$1,647,889EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$157,289BOYAmt
EOY$16,790EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$1,698,504BOYAmt
EOY$2,733,955EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$2,935,795BOYAmt
EOY$481,932EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$5,727,878BOYAmt
EOY$4,880,566EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$29,408BOYAmt
EOY$43,948EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$6,171,353BOYAmt
EOY$6,057,951EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$6,200,761BOYAmt
EOY$6,101,899EOYAmt
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-$472,883BOYAmt
EOY-$1,221,333EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY-$472,883BOYAmt
EOY-$1,221,333EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$5,727,878BOYAmt
EOY$4,880,566EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$796,134ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$47,684NetUnrlzdGainsLossesInvstAmt
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 (4 entries)

DescDescAmtAmt
DUE TO BROKER$1,490
CLAIMS PAYABLE AND PREMIUMS PAYABLE$3,430,000
CLAIMS INCURRED BY NOT REPORTED$2,525,000
DUE TO UFCW LLC$101,461
FieldValueIRS element (for citing)
Total Liability$6,057,951TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$20,958,121TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$47,684NetUnrealizedGainsInvstAmt
Revenue Not Reported$47,684RevenueNotReportedAmt
Revenue Subtotal$20,910,437RevenueSubtotalAmt
Revenue Not Reported Fincl Stmt$0RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$20,910,437TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$21,917,571TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included$211,000OtherExpensesIncludedAmt
Expenses Not Reported$211,000ExpensesNotReportedAmt
Expenses Subtotal$21,706,571ExpensesSubtotalAmt
Expenses Not Rpt Fincl Stmt$0ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$21,706,571TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART X, LINE 2:THE TRUST HAS ADOPTED GUIDANCE ON ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES ISSUED BY THE FINANCIAL ACCOUNTING STANDARDS BOARD. THE TRUST ADMINISTRATOR BELIEVES THAT THE TRUST HAS NOT TAKEN UNCERTAIN TAX POSITIONS THAT REQUIRE ADJUSTMENT TO THE FINANCIAL STATEMENTS AS A TAX LIABILITY.
PART XII, LINE 2D - OTHER ADJUSTMENTS:CHANGE IN BENEFIT OBLIGATIONS 211,000.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 3THE ORGANIZATION DELEGATES CONTROL OVER MANAGEMENT DUTIES CUSTOMARILY PERFORMED BY OR UNDER THE DIRECT SUPERVISION OF OFFICERS, DIRECTORS, TRUSTEES, OR KEY EMPLOYEES TO THE CONTRACT ADMINISTRATOR.
FORM 990, PART VI, SECTION B, LINE 11BTHE TRUSTEES GIVE AUTHORITY TO THE CHAIR AND SECRETARY TO REVIEW THE FORM, AND THE TRUSTEES REVIEW AFTER SUBMISSION.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON WRITTEN REQUEST.
FORM 990, PART XI, LINE 2C:THE BOARD OF TRUSTEES ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF THE PLAN'S FINANCIAL STATEMENTS AND SELECTION OF THE INDEPENDENT AUDITOR.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1UFCW PHARMACISTS CLERKS AND DRUG EMPLOYER'S PENSION TRUSTBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11000 BURNETT AVE STE 200AddressLine1Txt
CityCONCORDCityNm
State AbbreviationCAStateAbbreviationCd
ZIP94520ZIPCd
FieldValueIRS element (for citing)
EIN942518312EIN
Primary ActivitiesDEFINED BENEFIT PENSION PLANPrimaryActivitiesTxt
Legal Domicile StateCALegalDomicileStateCd
Exempt Code Section401(A)ExemptCodeSectionTxt
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 ReferencePARTS II,III, IV - IDENTIFICATION OF RELATED TAX ORGANIZATIONSFormAndLineReferenceDesc
ExplanationIN 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.ExplanationTxt