2018-09-18T15:50:29-05:00 2017-11-30 522385296 LINDQUIST LLP 5000 EXECUTIVE PARKWAY SUITE 400 SAN RAMON CA 94583 990 2016-12-01 946072964 BAY AREA AUTOMOTIVE GROUP WELFARE FUND BAYA 9258337300 4160 DUBLIN BOULEVARD NO 400 DUBLIN CA 945687756 MARK GLEASON TRUSTEE 9258337300 2018-09-18 1 DEBBIE ROESSL DIMERY P01065763 9252779100 66.7.226.66 2018-09-18 13:50:17 PD P 6DD8E3D40C39F05221E97E07BD1CB8F36D910CAE 6DD8E3D40C39F05221E97E07BD1CB8F36D910CAE 2016 2018-06-14 16:35:46Z MARK GLEASON 4160 DUBLIN BOULEVARD NO 400 DUBLIN CA 945687756 37606557 0 X N/A X 1954 CA TO PROVIDE HEALTH BENEFITS TO ELIGIBLE PARTICIPANTS AND DEPENDENTS. 4 0 17 0 0 0 0 0 31555692 33346532 145980 284752 371 423 31702043 33631707 0 0 30419202 32641689 26542 23338 0 0 0 1510679 1382672 31956423 34047699 -254380 -415992 14799378 14376398 4244005 4088139 10555373 10288259 TO PROVIDE HEALTH BENEFITS TO ELIGIBLE PARTICIPANTS AND DEPENDENTS. 0 0 PROVIDED HEALTH BENEFITS TO ELIGIBLE PARTICIPANTS AND DEPENDENTS 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 1 504 0 1 17 1 0 0 0 0 0 0 X 4 0 0 1 0 0 0 0 0 1 0 0 0 1 1 1 1 1 1 0 0 0 X HEALTH SERVICES & BENEFIT ADMINISTR 9258337300 4160 DUBLIN BOULEVARD SUITE 400 DUBLIN CA 98568 X MARK GLEASON TRUSTEE 2.00 X 0 0 0 CHUCK ANDREW TRUSTEE 1.00 X 0 0 0 KEN WALKER TRUSTEE 2.00 X 0 0 0 JOSEPH BRAUCHER TRUSTEE 1.00 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 HEALTH SERVICES & BENEFIT ADMIN 4160 DUBLIN BOULEVARD SUITE 400 DUBLIN CA 945687756 ADMINISTRATOR FEE 850623 BEESON TAYER & BODINE 483 9TH STREET SUITE 200 OAKLAND CA 94607 ATTORNEY FEES 135302 LINDQUIST LLP 5000 EXECUTIVE PARKWAY SUITE 400 SAN RAMON CA 945834346 ACCOUNTING FEE 132505 BLUE CROSS OF CALIFORNIA DEPARTMENT 5812 LOS ANGELES CA 900745812 PPO NETWORK FEE 123602 4 EMPLOYER CONTRIBUTIONS 900099 32139687 32139687 STOP LOSS INCOME 900099 890646 890646 PARTICIPANT CONTRIBUTIONS 900099 316199 316199 33346532 173607 173607 4085995 3974850 111145 111145 111145 OTHER INCOME 900099 423 423 423 33631707 33346955 0 284752 32641689 23338 765352 136254 111911 23778 270497 48867 8226 17787 34047699 2314990 2902045 916241 248677 2843038 3562476 13003 13003 8567720 7629492 144386 20705 14799378 14376398 1717005 1325139 2527000 2763000 4244005 4088139 X 0 0 0 0 10555373 10288259 10555373 10288259 14799378 14376398 -415992 148878 0 X X 0 1 X 1 0 0 ACCUMULATED ELIGIBILITY CREDITS 2763000 2763000 X 33756807 148878 148878 33607929 23778 23778 33631707 34166113 0 34166113 23778 -142192 -118414 34047699 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 TAKEN BY THE PLAN, AND HAS CONCLUDED THAT, AS OF NOVEMBER 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 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 -142,192. FORM 990, PART VI, SECTION A, LINE 3 THE TRUST HAS CONTRACTED WITH HEALTH SERVICES & BENEFIT ADMINISTRATORS, INC., TO PROVIDE ADMINISTRATIVE SERVICES FOR THE ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 8B THERE IS NO COMMITTEE WITH 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. REVIEW OF THE FORM 990 WAS CONDUCTED BY THE BOARD PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C AT LEAST ONCE A YEAR, TRUSTEES AND OTHER INDIVIDUALS WHO ARE SUBJECT TO THE CONFLICT OF INTEREST POLICY WILL BE ASKED TO DISCLOSE IN WRITING ANY RELATIONSHIP OR INTERESTS THAT COULD GIVE RISE TO A CONFLICT. SHOULD ANY INDIVIDUAL COVERED BY THE POLICY DETERMINE OR SUSPECT THAT HE OR SHE POSSESSES AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST, SUCH INDIVIDUAL MUST DISCLOSE THE EXISTENCE OF THE FINANCIAL INTEREST OR RELATIONSHIP GIVING RISE TO THE CONFLICT AND DISCLOSE ALL RELEVANT FACTS PRIOR TO PARTICIPATING IN ANY DECISION TO ENTER INTO ANY PROPOSED TRANSACTION OR ARRANGEMENT OR, IF LATER, AS SOON AS THE ACTUAL OR POTENTIAL CONFLICT IS RECOGNIZED. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. UPON REQUEST, THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL INFORMATION AVAILABLE TO THE PARTICIPANTS. 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, HEALTH SERVICES & BENEFIT ADMINISTRATORS, INC. FORM 990 PART XII, LINE 2C THE BOARD OF TRUSTEES ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT AUDITOR. THIS PROCESS HAS NOT CHANGED. TEAMSTERS AUTOMOTIVE & ALLIED WORKERS LOCAL UNION NO 665 1500 FRANKLIN STREET 3RD FLR SAN FRANCISCO CA 94109 LABOR UNION CA 501(C)(5) N/A N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 SCHEDULE R, PART VII, IDENTIFICATION OF RELATED ORGANIZATIONS: THE FILING ORGANIZATION IS A TAFT-HARTLEY MULTIEMPLOYER TRUST THAT PROVIDES HEALTH AND WELFARE BENEFITS TO ELIGIBLE EMPLOYEES AND THEIR DEPENDENTS. AS OF NOVEMBER 30, 2017, THERE ARE APPROXIMATELY 60 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. ACE PARKING MGMT AMERICAN PARKING MGMT. AMPCO SYS PARKING AUTORETURN BABBITT BEARING COMPANY BRANNON EQUIPMENT CABLE CAR PARKING SERVICE CITY OF SF PORT - S. PLAZA COAST C. TRUCK/EQUIP. CO COMM PROPERTIES OF SJ COOKS AUTOMOTIVE D & J GARAGE DOUGLAS PARKING ENCORE HOSPITALITY SERVICE FIRST STUDENT FRONTIER FORD GOSSETT-RADERMAN, LINDA GUIDOTTI, SHARRON HERTZ RENT-A-CAR HS&BA HILTON SF FINANCIAL DIST. IMPERIAL PARKING INC. CHARIOT GLENCORE RECYCLING, INC. JOCKEY CLUB ONE PARKING KROGH, MICHELLE SERRAMONTE FORD LAZ PARKING LEVENE, CARRIE LOCAL 665 PL34 LOOMIS ARMORED US INC. LOZANO, PAULINA LUXOR CAB CO. MISSION VALLEY FORD TRUCK MOORE BUICK CO. NEW SO PARKING SECURITY NORMANDIN CHRYSLER JEEP PALACE GARAGE. PARKING CONCEPTS INC PCAM, LLC PEARSON AUTOMOBILE(MACHINISTS) PROPARK AMERICA WEST (B) RECTOR MOTOR CAR COMPANY SERCO, INC. ROSAS, KIMI RYDER TRANSPORT SERVICES S. ROBERSON TRUCKING SAVOY CORPORATION SF PARKING/SFIA EMPLOYEE PARK RECOLOGY SONOMA/MARIN STEVENS CREEK TOYOTA STEWART CHEVROLET T M INDUSTRIES INC TOYOTA OF PALO ALTO TRANSDEV SERVICES INC UNION PACIFIC PARKING INC UNIPART/JAGUAR CARS INC IMPARK YMCA OF SILICON VALLEY