2018-11-13T15:16:11-06:00 2017-12-31 952648289 VAVRINEK TRINE DAY & CO LLP 1900 S NORFOLK STREET SUITE 225 SAN MATEO CA 94403 990 2017-01-01 941229312 HOTEL AND RESTAURANT EMPLOYEES HEALTH AND WELFARE TRUST HOTE 2067263271 2323 EASTLAKE AVE E SEATTLE WA 98102 TRUSTEE TRUSTEE TRUSTEE 2067263271 2018-11-13 1 JENNIFER SNOW P01882015 9094664410 65.60.100.226 2018-11-13 13:10:06 PS P C8485762D0A103083B9EABF22E0AFFE603142D80 A8923EACCE2D6A4F1290DCBC04922AB836540ED7 2017 2019-02-21 02:37:17Z 2323 EASTLAKE AVE E SEATTLE WA 98102 25916546 0 X N/A X 1963 CA TO PROVIDE HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS 7 7 0 0 0 0 0 0 22073675 22745185 303220 407374 115808 9730 22492703 23162289 0 0 18424281 18069946 0 0 0 0 0 470308 547336 18894589 18617282 3598114 4545007 12833406 18114267 3399128 3465648 9434278 14648619 NONE 0 0 TO PROVIDE HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS COVERED BY COLLECTIVE BARGAINING AGREEMENTS BETWEEN THE UNIONS AND THE EMPLOYERS. 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 4 0 0 0 0 0 0 0 0 0 0 0 0 X 7 7 0 1 0 0 0 0 0 1 0 0 0 1 1 0 0 1 1 0 0 0 X NORTHWEST ADMINISTRATORS INC 2067263271 2323 EASTLAKE AVE E SEATTLE WA 98102 YULISA ELENES TRUSTEE 5.00 X 0 0 0 BILL BACIGALUPI TRUSTEE 5.00 X 0 0 0 JIM DUPONT TRUSTEE 5.00 X 0 0 0 WEI-LING HUBER TRUSTEE 5.00 X 0 0 0 DOUGLAS CORNFORD TRUSTEE 5.00 X 250 0 0 LIAN ALAN TRUSTEE 5.00 X 0 0 0 LISA KERSHNER TRUSTEE 5.00 X 0 0 0 250 0 0 0 0 0 0 NORTHWEST ADMINISTRATORS INC 1182 MARKET ST SUITE 320 SAN FRANCISCO CA 94102 ADMINISTRATOR 171576 1 EMPLOYER CONTRIBUTIONS 900099 22726325 22726325 PARTICIPANT CONTRIB 900099 18860 18860 22745185 427379 427379 2734252 2754257 -20005 -20005 -20005 LIQUIDATED DAMAGES 900099 9730 9730 9730 23162289 22734910 0 427379 18069946 224932 33669 76704 42313 70250 5425 4389 MEDICAL REVIEW 45563 AD HOC GROUP EXPENSES 25072 PRINTING, POSTAGE AND S 17399 BANK CHARGES 1620 18617282 2531462 5047632 391225 1725771 2129822 1558015 28597 2352 7752300 9780497 12833406 18114267 66601 47813 3332527 3417835 3399128 3465648 X 0 0 0 0 9434278 14648619 9434278 14648619 12833406 18114267 4545007 669334 0 X X 0 1 X 0 0 0 INSURANCE PREMIUMS PAYABLE 3417835 3417835 X 23831623 669334 669334 23162289 0 23162289 18617282 0 18617282 0 18617282 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. FORM 990, PART VI, SECTION A, LINE 3 THE ORGANIZATION DELEGATES CONTROL OVER MANAGEMENT DUTIES CUSTOMARILY PERFORMED BY OR UNDER THE DIRECT SUPERVISON OF OFFICERS, DIRECTORS, TRUSTEES, OR KEY EMPLOYEES TO THE CONTRACT ADMINISTRATOR. FORM 990, PART VI, SECTION A, LINE 8B THE ORGANIZATION DOES NOT HAVE ANY COMMITTEES WITH THE AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11B TRUSTEES ARE MAILED THE FORM AND ASKED TO REMARK IF THEY HAVE CHANGES. 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 XI LINE 2C THE BOARD OF TRUSTEES ASSUMES RESPONSIBILITY FOR OVERSEEING THE AUDIT OF THE ORGANIZATION'S FINANCIAL STATEMENTS AND FOR SELECTING THE INDEPENDENT AUDITOR. EAST BAY RESTAURANT AND TAVERN RETIREMENT PLAN 2323 EASTLAKE AVE E SEATTLE WA 98102 946076428 TO PROVIDE PENSION BENEFITS TO ELIGIBLE PARTICIPANTS CA 401A N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 PARTS II, III, AND IV - IDENTIFICATION OF RELATED TAX ORGANIZATIONS IN 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.