STRATEGY STUDIO / PUBLIC DATA EXPLORER

NORTHERN CALIFORNIA BAKERY DRIVERS SECURITY FUND: Form 990, tax year 2015

View the entire original 990 at ProPublica ↗

Organization
NORTHERN CALIFORNIA BAKERY DRIVERS SECURITY FUND (EIN 94-6073089)
Tax period
2015-10-01 to 2016-09-30
Filed
2017-06-28
IRS object ID
201701799349301100
Schema version
2015v3.0
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)
Return2017-06-28T14:20:15-05:00ReturnTs
Tax Period End2016-09-30TaxPeriodEndDt

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 Begin2015-10-01TaxPeriodBeginDt

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 Line1221 MAIN STREET NO 250AddressLine1Txt
CitySAN FRANCISCOCityNm
State AbbreviationCAStateAbbreviationCd
ZIP94105ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonJAMES HAMPersonNm
Person TitleTRUSTEEPersonTitleTxt
Phone4155467800PhoneNum
Signature2017-06-28SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonJESSICA R ROSTERPreparerPersonNm
PTINP01317380PTIN
Phone9252779100PhoneNum
FieldValueIRS element (for citing)
Tax2015TaxYr
Build TS2021-01-29 14:40:06ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerJAMES HAMPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1221 MAIN STREET NO 250AddressLine1Txt
CitySAN FRANCISCOCityNm
State AbbreviationCAStateAbbreviationCd
ZIP94105ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$41,750,682GrossReceiptsAmt
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$19,928,304PYProgramServiceRevenueAmt
CY Program Service Revenue$19,224,612CYProgramServiceRevenueAmt
PY Investment Income$1,960,570PYInvestmentIncomeAmt
CY Investment Income$1,248,955CYInvestmentIncomeAmt
PY Other Revenue$9,906PYOtherRevenueAmt
CY Other Revenue$40,951CYOtherRevenueAmt
PY Total Revenue$21,898,780PYTotalRevenueAmt
CY Total Revenue$20,514,518CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$19,622,518PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$19,064,747CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$0PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$4,500CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$1,078,707PYOtherExpensesAmt
CY Other Expenses$1,055,689CYOtherExpensesAmt
PY Total Expenses$20,701,225PYTotalExpensesAmt
CY Total Expenses$20,124,936CYTotalExpensesAmt
PY Revenues Less Expenses$1,197,555PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$389,582CYRevenuesLessExpensesAmt
Total Assets BOY$28,585,400TotalAssetsBOYAmt
Total Assets EOY$28,592,311TotalAssetsEOYAmt
Total Liabilities BOY$3,443,914TotalLiabilitiesBOYAmt
Total Liabilities EOY$3,118,041TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$25,141,486NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$25,474,270NetAssetsOrFundBalancesEOYAmt
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
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 SOLUTIONS INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone4155467800PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1221 MAIN STREET SUITE 250AddressLine1Txt
CitySAN FRANCISCOCityNm
State AbbreviationCAStateAbbreviationCd
ZIP94105ZIPCd
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)$3,000$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$3,000TotalReportableCompFromOrgAmt
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

Contractor Name ContractorName

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1ZENITH AMERICAN SOLUTIONS INCBusinessNameLine1Txt

Contractor Address ContractorAddress

US Address USAddress

FieldValueIRS element (for citing)
Address Line1221 MAIN STREET SUITE 250AddressLine1Txt
CitySAN FRANCISCOCityNm
State AbbreviationCAStateAbbreviationCd
ZIP94105ZIPCd
FieldValueIRS element (for citing)
ServicesFUND ADMINISTRATIONServicesDesc
Compensation$429,967CompensationAmt
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K1CntrctRcvdGreaterThan100KCnt

Program Service Revenue ProgramServiceRevenueGrp (4 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
EMPLOYER CONTRIBUTIONS900099$15,867,991$15,867,991
PARTICIPANT CONTRIBUTIONS900099$2,953,053$2,953,053
STOP LOSS INCOME900099$276,416$276,416
PRESCRIPTION DRUG REBATES900099$127,152$127,152
FieldValueIRS element (for citing)
Total Program Service Revenue$19,224,612TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,592,255TotalRevenueColumnAmt
Exclusion$1,592,255ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$20,892,864SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$21,236,164SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities-$343,300SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$343,300TotalRevenueColumnAmt
Exclusion-$343,300ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
LITIGATION INCOME900099$22,500$22,500
TPL SUBROGATION REFUND900099$17,281$17,281
OTHER INCOME900099$1,170$1,170
FieldValueIRS element (for citing)
Other Revenue Total$40,951OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$20,514,518TotalRevenueColumnAmt
Related Or Exempt Func Income$19,265,563RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$1,248,955ExclusionAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$19,064,747TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$4,500TotalAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$413,635TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$79,933TotalAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$33,427TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$20,000TotalAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$341,532TotalAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$85,794TotalAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$6,000TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$31,764TotalAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$20,176TotalAmt

Other Expenses OtherExpensesGrp (3 entries)

DescDescTotalTotalAmt
ACA TRANSITIONAL REINSU$18,304
PCORI FEES$4,629
MISCELLANEOUS EXPENSE$495

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$20,124,936TotalAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$2,755,250BOYAmt
EOY$1,259,568EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$1,385,449BOYAmt
EOY$1,695,139EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$21,319BOYAmt
EOY$22,065EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$24,423,382BOYAmt
EOY$25,615,539EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$28,585,400BOYAmt
EOY$28,592,311EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$1,963,141BOYAmt
EOY$1,544,778EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$54,373BOYAmt
EOY$36,563EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$1,426,400BOYAmt
EOY$1,536,700EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$3,443,914BOYAmt
EOY$3,118,041EOYAmt
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$25,141,486BOYAmt
EOY$25,474,270EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$25,141,486BOYAmt
EOY$25,474,270EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$28,585,400BOYAmt
EOY$28,592,311EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$389,582ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$56,798NetUnrlzdGainsLossesInvstAmt
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$1,536,700Amt
FieldValueIRS element (for citing)
Total Liability$1,536,700TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$20,437,720TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst-$56,798NetUnrealizedGainsInvstAmt
Revenue Not Reported-$56,798RevenueNotReportedAmt
Revenue Subtotal$20,494,518RevenueSubtotalAmt
Investment Expenses Not Incld$20,000InvestmentExpensesNotIncldAmt
Revenue Not Reported Fincl Stmt$20,000RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$20,514,518TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$20,330,467TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$20,330,467ExpensesSubtotalAmt
Investment Expenses Not Incld2$20,000InvestmentExpensesNotIncld2Amt
Other Expenses Not Included-$225,531OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt-$205,531ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$20,124,936TotalExpensesPerForm990Amt

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, 2016, 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 2013.
PART XII, LINE 4B - OTHER ADJUSTMENTS:CHANGE IN BENEFIT OBLIGATION

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (8 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
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 11A 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 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 IFNORMATION, 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.
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.

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-HARLEY MULTIEMPLOYER TRUST THAT PROVIDES HEALTH BENEFITS TO ELIGIBLE EMPLOYEES AND THEIR DEPENDENTS. AS OF SEPTEMBER 30, 2016, 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 RESONABLY OBTAIEND. 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