2018-03-09T14:37:10-06:00 2017-06-30 522385296 LINDQUIST LLP 5000 EXECUTIVE PARKWAY SUITE 400 SAN RAMON CA 94583 990 2016-07-01 943254224 UA LOCAL NO 355 HEALTH AND WELFARE TRUST FUND UALO 4155467800 1600 HARBOR BAY PARKWAY NO 200 ALAMEDA CA 94502 MIGUEL INIGUEZ TRUSTEE 4155467800 2018-03-09 1 DEBBIE ROESSL DIMERY P01065763 9252779100 66.7.226.66 2018-03-09 12:36:52 PS P 6DD8E3D40C39F05221E97E07BD1CB8F36D910CAE AF0F784E429982BC93A0FAF5EDF9664BBECC31B5 2016 2021-01-29 14:40:06Z X MIGUEL INIGUEZ 1600 HARBOR BAY PARKWAY NO 200 ALAMEDA CA 94502 5001403 0 X N/A X 1993 CA TO PROVIDE HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS 4 0 0 0 0 0 0 0 3387944 4947981 52425 53422 0 0 3440369 5001403 0 0 3179951 3739587 0 0 0 0 0 468922 402835 3648873 4142422 -208504 858981 4252666 5815141 1907330 2468365 2345336 3346776 PROVIDE HEALTH AND WELFARE BENEFITS TO ELIGIBLEPARTICIPANTS. 0 0 PROVIDED HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS. 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 0 0 1 0 0 0 0 0 0 0 X 4 0 0 1 0 0 0 0 0 1 0 0 0 1 0 0 1 0 0 0 X ZENITH ADMINISTRATORS 2062824100 201 QUEEN ANNE AVE N SUITE 100 SEATTLE WA 98109 TONY CARYL TRUSTEE - PAST 0.20 X 0 0 0 MIGUEL INIGUEZ TRUSTEE 0.20 X 0 0 0 LINDA ROSSMAN TRUSTEE 0.20 X 0 0 0 GARY ANDREWS TRUSTEE 0.20 X 0 0 0 FELIPE HERNANDEZ TRUSTEE 0.20 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 ZENITH AMERICAN SOLUTIONS 201 QUEEN ANNE AVE N SUITE 100 SEATTLE WA 98109 ADMINISTRATOR 150319 1 EMPLOYER CONTRIBUTIONS 900099 3873703 3873703 STOP LOSS REFUNDS 900099 1073290 1073290 SELF-PAYS CONT. - SPEC 900099 988 988 4947981 53422 53422 5001403 4947981 0 53422 3739587 221786 40578 28057 3655 52000 35301 4209 12421 OTHER EXPENSE 4828 4142422 909761 1991028 102401 102504 542043 825766 1113 3014 2697348 2892829 4252666 5815141 23010 18929 1884320 2449436 1907330 2468365 X 0 0 0 0 2345336 3346776 2345336 3346776 4252666 5815141 858981 142459 0 X X 0 1 X 1 0 0 CLAIMS PAYABLE AND IBNR 525991 ACCUMULATED ELIGIBILITY CREDITS 1208980 DUE TO RELATED FUNDS 232465 PAYABLE TO INSURANCE CO. 482000 2449436 X 5140207 142459 142459 4997748 3655 3655 5001403 4020401 0 4020401 3655 118366 122021 4142422 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'S ADMINISTRATOR HAS ANALYZED THE TAX POSITIONS AND HAS CONCLUDED THAT, AS OF JUNE 30, 2017, 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 FISCAL YEARS PRIOR TO 2014. PART XII, LINE 4B - OTHER ADJUSTMENTS: CHANGE IN BENEFIT OBLIGATIONS FORM 990, PART VI, SECTION A, LINE 3 THE TRUST CONTRACTED WITH ZENITH AMERICAN SOLUTIONS, INC. TO PROVIDE ADMINISTRATIVE SERVICES TO THE PLAN. FORM 990, PART VI, SECTION A, LINE 8B THERE ARE NO COMMITTEES THAT HAVE AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11B A COPY OF THE FORM 990 WAS PROVIDED TO THE BOARD OF TRUSTEES FOR REVIEW BEFORE IT WAS FILED. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC, UPON REQUEST. PART XII, LINE 2C THE BOARD OF TRUSTEES ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDITED FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED. FORM 990, PART V, LINE 1A THE 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 ZERO FOR THIS ORGANIZATION. FORM 990, PART VII, SECTION A, LINE 1A 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, ZENITH AMERICAN SOLUTIONS, INC. NO CALIFORNIANO NEVADA LANDSCAPE & UNDERGROUND UTILITY JATC 13 TENNESSEE STREET VALLEJO CA 94590 686091014 EDUCATING AND TRAINING JOURNEYMEN AND APPRENTICES CA 501(C)(5) N/A N/A 0 LOCAL UNION 355 UA PLUMBING & PIPEFITTING IND OF THE US & CANADA 13 TENNESSEE STREET VALLEJO CA 94590 680189344 PLAN SPONSOR CA 501(C)(5) N/A N/A 0 UA LOCAL NO355 HIRING HALL ADMINISTRATION TRUST FUND 13 TENNESSEE STREET VALLEJO CA 94590 686095525 PROVIDE JOBS FOR THEIR MEMBERS CA N/A T 0 UA LOCAL 355 JOINT-LABOR MGMT COOPERTION CTTEE TRUST FUND 13 TENNESSEE STREET VALLEJO CA 94590 943201019 FOSTER RELATIONS BETWEEN LABOR AND MANAGEMENT CA N/A T 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 SCHEDULE R - INDETIFICATION OF RELATED ORGANIZATIONS: THE FILING ORGANIZATION IS A TAFT-HARTLEY MULTI-EMPLOYER TRUST THAT PROVIDES HEALTH AND WELFARE BENEFITS TO ELIGIBLE EMPLOYEES AND THEIR DEPENDENTS. AS OF JUNE 30, 2017, THERE ARE APPROXIMATELY 56 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. ASSOCIATED CONSTRUCTORS, INC. AZTEC SOLAR, INC. BAUMAN LANDSCAPE BEEBE DIVERSIFIED LP BLANCHARD CONSTRUCTION BORTOLUSSI & WATKIN CALIFORNIA WATERSCAPE CLYDE COLLISHAW SPRINKLERS,INC COHEN LANDSCAPE SERVICES, INC DAK LANDSCAPE CONSTRUCTION DECKER LANDSCAPING INC DGS-DIRECT CONSTRUCTION UNIT ECOLOGICAL CONCERNS, INC. EMPIRE LANDSCAPING INC FREEDLUN HYDROSEEDING INC GSL CONSTRUCTION GREEN GROWTH INDUSTRIES GREENSCAPE HERZER LANDSCAPING, INC. JENSEN CORPORATION JJ NGUYEN, INC KCI ENVIRONMENTAL, INC. LANDSCAPE CONTRACTORS COUNCIL LANDSCAPE VISIONS LAWLER & STANZ. INC. LEMINGS IRRIGATION, INC. LEFEVRE WELDING INC. LEO MANIGLIA ENTERPRISES INC MARINA LANDSCAPE INC MARINA LANDSCAPE INC-RESIDENTL MCGUIRE AND HESTER MORI HATSUSHI ASSOC MULCH MASTER OUTSIDE THE LINES PACIFIC PARKS LANDSCAPING PACIFIC WATER ART, INC PLAYGROUNDS UNLIMITED (M.A.K.) RMT LANDSCAPE CONTRACTORS, INC SEAPORT LANDSCAPE NO AGID SANTA FE LANDSCAPERS INC SHOOTER & BUTTS, INC SIERRA LUMBER & FENCE COMPANY SHOWTIME CONSTRUCTION SOLANO CONSTRUCTION CO, INC SUNRISE LANDSCAPE TAKEHARA LANDSCAPE, INC TAKEHARA LANDSCAPE/MAINTENANCE TEAM-EES TRUXELL & VALENTINO LANDSCAPE TRUXELL & VALENTINO UNDERGROUND UTILITY/LANDSCAPE WABO LANDSCAPE & CONSTRUCTION WATERWORKS INDUSTRIES, INC WATERWORKS INDUSTRIES,INC S/A WEST VALLEY CONSTRUCTION CO WESTERN WATER FEATURES, INC