2017-07-17T19:27:22-05:00 2016-08-31 300702322 HEMMING MORSE CPA'S AND CONSULTANTS 155 BOVET ROAD SUITE 600 SAN MATEO CA 94402 990 2015-09-01 941234856 CARPENTERS HEALTH AND WELFARE TRUST FUND FOR NORTHERN CALIFORNIA CARP 5106330333 265 HEGENBERGER ROAD NO 100 OAKLAND CA 94621 GENE PRICE SECRETARY 5106330333 2017-07-17 1 P00739466 4158364000 2015 2021-01-29 14:40:06Z 265 HEGENBERGER ROAD NO 100 OAKLAND CA 94621 843633329 0 X N/A X 1953 CA SEE PART III LINE 4A 14 14 824 0 0 0 0 0 351935499 397813840 14957283 8239583 12484229 12481667 379377011 418535090 0 0 361574929 385115574 0 0 0 0 0 13523282 13741689 375098211 398857263 4278800 19677827 444509927 499477101 210817015 232496891 233692912 266980210 NONE 0 0 TO PROVIDE HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS COVERED BY COLLECTIVE BARGAINING AGREEMENTS BETWEEN EMPLOYERS AND THE UNION. 0 0 0 0 0 0 0 0 0 0 1 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 1 570 0 824 1 0 0 0 0 0 0 0 0 X 14 14 0 1 0 0 0 0 0 1 0 0 0 1 1 1 0 1 1 0 0 0 X CARPENTERS ADMINISTRATIVE OFFICE 5106330333 265 HEGENBERGER ROAD SUITE 100 OAKLAND CA 94621 X TIMOTHY LIPSCOMB TRUSTEE 5.00 X 0 0 0 RANDY JENCO TRUSTEE 5.00 X 0 0 0 ROY VAN PELT TRUSTEE 5.00 X 0 0 0 FRANK CRIM TRUSTEE 5.00 X 0 0 0 MIKE MENCARINI TRUSTEE 5.00 X 0 0 0 ROBERT ALVARADO TRUSTEE 5.00 X 0 0 0 WILLIAM FEYLING TRUSTEE 5.00 X 0 0 0 TOM MATTIS TRUSTEE 5.00 X 0 0 0 RALPH RUBIO TRUSTEE 5.00 X 0 0 0 CHUCK PALLEY TRUSTEE 5.00 X 0 0 0 DON DOLLY TRUSTEE 5.00 X 0 0 0 JOSEPH R SANTUCCI TRUSTEE 5.00 X 0 0 0 AUGIE BELTRAN TRUSTEE 5.00 X 0 0 0 LARRY NIBBI TRUSTEE 5.00 X 0 0 0 0 0 0 0 0 0 0 CARPENTER FUNDS ADMINISTRATIVE OFFICE OF 265 HEGENBERGER RD SUITE 100 OAKLAND CA 94621 ADMINISTRATION 6620291 BLUE CROSS OF CALIFORNIA PO BOX 70000 VAN NUYS CA 91470 BENEFITS ADMINISTRATOR 2706990 DELTA DENTAL 100 1ST STREET 12TH FLOOR SAN FRANCISCO CA 94105 CLAIMS ADMINISTRATION 1176072 MEDCO HEALTH SOLUTION 100 PARSONS POND DRIVE FRANKLIN LAKES NJ 07417 BENEFITS ADMINISTRATOR 585917 TC3 HEALTH SYSTEMS 3055 LEBANON PIKE NASHVILLE TN 37214 BENEFITS ADMINISTRATOR 342663 5 EMPLOYER CONTRIBUTIONS 900099 373224435 373224435 EMPLOYEE CONTRIBUTIONS 900099 24589405 24589405 397813840 9160044 9160044 424177778 425098239 -920461 -920461 -920461 REBATES AND REFUNDS 900099 11499624 11499624 OTHER INCOME 900099 924651 924651 LIQUIDATED DAMAGES 900099 57392 57392 12481667 418535090 409375046 0 9160044 385115574 11531347 225104 40804 1111594 274617 270289 22838 112030 BANKING EXPENSE 56280 OUTSIDE SERVICES 52412 PATIENT CARE OUTCOMERES 38800 MISCELLANEOUS 5574 398857263 1308268 990557 29219378 37101139 38812426 43985124 212590 337220 181887145 212511089 187519937 199289157 5550183 5262815 444509927 499477101 480480 308636 210336535 232188255 210817015 232496891 X 0 0 0 0 233692912 266980210 233692912 266980210 444509927 499477101 19677827 13609471 0 X X 0 1 X 1 0 0 REAL ESTATE FUND 54694916 F LIMITED PARTNERSHIP 144594241 F 199289157 PREMIUMS PAYABLE 36395121 CLAIMS PAYABLE AND IBNR 45995933 FUTURE BENEFIT LIABILITY 142368000 RETIREE REFUND PAYABLE 6999600 DUE TO BROKER 429601 232188255 X 432144561 13609471 13609471 418535090 0 418535090 398857263 0 398857263 0 398857263 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. THE TRUST ADMINISTRATOR BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR FISCAL YEARS PRIOR TO AUGUST 31, 2013. FORM 990, PART VI, SECTION A, LINE 3 THE ORGANIZATION HAS DELEGATED CONTROL OVER MANAGEMENT DUTIES CUSTOMARILY PERFORMED BY OR UNDER THE DIRECT SUPERVISION OF OFFICERS, DIRECTORS, TRUSTEES OR KEY EMPLOYEES TO THE ADMINISTRATOR. FORM 990, PART VI, SECTION A, LINE 8B THE ORGANIZATION DOES NOT HAVE ANY SUBCOMMITTEES WITH THE AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11 THE TRUSTEES HAVE DESIGNATED THE ADMINISTRATOR TO REVIEW THE FORM 990 PRIOR TO SIGNING AND FILING. FORM 990, PART VI, SECTION B, LINE 12 IN CONNECTION WITH ANY ACTUAL OR POTENTIAL CONFLICT OF INTEREST, A TRUSTEE SHOULD DISCLOSE TO ALL OTHER TRUSTEES AND FUND COUNSEL THE EXISTENCE AND NATURE OF THE FINANCIAL INTEREST OR BENEFIT INVOLVED INCLUDING DISCLOSURE OF ALL MATERIAL FACTS ATTENDANT TO THE TRANSACTION. 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. FORM 990, PART XII, LINE 2C THE BOARD OF TRUSTEES ASSUMES RESPONSIBILITY FOR THE OVERSIGHT OF THE AUDIT OF THE ORGANIZATION'S FINANCIAL STATEMENTS AND THE SELECTION OF THE INDEPENDENT AUDITOR. CARPENTER FUNDS ADMINSTRATIVE OFFICE OF NORTHERN CALIFORNIA INC 265 HEGENBERGER ROAD SUITE 100 OAKLAND CA 94621 941557079 TO PROVIDE ADMINISTRATIVE SERVICES CA 501(C)(9) N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 FORM 990, PART IV, LINE 34 SCHEDULE R, IDENTIFICATION OF RELATED ORGANIZATIONS: THE FILING ENTITY IS A 501(C)(9) VEBA WHO MUST LIST CONTRIBUTING EMPLOYERS ON SCHEDULE R. THE ADMINISTRATIVE OFFICE MAINTAINS A LIST OF CONTRIBUTIONS EMPLOYERS, HOWEVER, THAT LIST DOES NOT INCLUDE FEDERAL TAX CLASSIFICATION. THEREFORE, THE LIST OF CONTRIBUTING EMPLOYERS IS REPORTED ON PART VII, SUPPLEMENTAL INFORMATION. PACIFIC RACING ASSOC ANDERSON ERIC F INC BALLIET BROS CONSTR CO BOHEMIAN CLUB MANCINI B T COMPANY INC BROWN VANCE INC BRUNSWICK BOWLING & BILLIARDS CAHILL CONTRACTORS INC CALIFORNIA DRYWALL CO CAPPELLETTI CONSTRUCTION CHRISTENSEN H & SONS COLOMBINI CONSTRUCTION COMFORT AIR INC DESIGN WORKSHOPS PERFORMANCE CONTRACTING INC FITZMAURICE J H INC GAEHWILER CONSTRUCTION GHILOTTI BROTHERS INC GILBERT E E CONSTRUCTION INC GRANITE CONSTRUCTION CO HARRIS CONSTRUCTION CO INC WEEKS MARINE INC HERRERO BUILDERS, INC ISACKSON AXEL FLOOR CO SUPERIOR GUNITE LILJA CORPORATION LYLES W M COMPANY MERCER FRASER COMPANY MILL CONSTRUCTION MCGUIRE & HESTER NEW ENGLAND LEAD BURNING NICHOLSON D W CORPORATION OTTO JOHN F INC OVERAA C & COMPANY PACIFIC MECHANICAL COR HARSCO INFRASTRUCTURE AMERICAS PENNEY J C CO RANSOME COMPANY RIDOUT ROOFING CO ROBERTS-OBAYASHI SAN FRANCISCO HOUSING AUTHORITY SBCO INC SHELCO INDUSTRIES STUART FLOOR CO SWINERTON BUILDERS GOLDEN GATE DRYWALL TOMBLESON INC UNGER CONSTRUCTION CO VILA CONSTRUCTION CO NORTHERN CALIFORNIA CARPENTERS CARPENTERS LOCAL # 35 CARPENTERS LOCAL # 217 CARPENTERS LOCAL # 713 PILEDRIVERS UNION 34 CARPENTERS LOCAL # 751 CARPENTERS LOCAL # 405 CARPENTERS LOCAL # 701 CARPENTERS LOCAL # 605 CARPENTERS LOCAL # 152 CARPENTERS LOCAL # 180 CARPENTERS LOCAL #1599 EAST BAY FIXTURE COMPANY ANNING-JOHNSON COMPANY MONTEREY MECHANICAL CO ACME CONSTRUCTION CO INC CARPENTERS LOCAL #1789 CALIFORNIA STATE OF PELETZ C M COMPANY CALIFORNIA STATE OF LAMON CONSTRUCTION CARPENTERS LOCAL # 22 BRANAGH INCORPORATION AMOROSO S J CONSTRUCTION SALINAS STEEL BUILDERS VALHALLA BUILDERS & BOGARD CONSTRUCTION INC EUREKA VALLEY FLOOR CO SAFWAY SERVICES, L.P. EUREKA FLOOR CARPET ONE SACRAMENTO INSULATION RUDOLPH AND SLETTEN INC HEFFLEY AL INC BASCO DRYWALL & PAINTING ROEN C W CONSTRUCTION GLOBAL SPECIALTIES DIRECT INC AUBRY LLOYD W ALCAL SPECIALTY CONTRACTING INC. CODDING CONSTRUCTION C CONCO CEMENT CO GRIFFIN JAMES R INC CARPENTERS TRAINING COMMITTEE CARPENTER FUNDS ADMIN DALEY'S DRYWALL & TAPING INC VILLA AL BUILDER SIGNATURE CONSTRUCTION CO INC ST FRANCIS SQ COOPERATIVE INC P S I MANAGEMENT TEAM INC RAISER CONSTRUCTION CO TURNER CONSTRUCTION CO MAGGIORA & GHILOTTI ROEBBELEN CONTRACTING INC ADERHOLT SPECIALTY CO INC VALENTINE CORPORATION CLARK PACIFIC ROSSI BUILDERS INC NIBBI BROS ASSOCIATES INC KAISER FOUNDATION MARSHALL C L COMPANY DOLAN CONCRETE CONST ARNOLD & EGAN MFG CO ARROW ACOUSTICS INC CALIFORNIA STATE OF SAN JOSE UNIFIED SCHOOL DISTRICT PACE INC ROOF STRUCTURES INC PECK & HILLER COMPANY DEVINCENZI CONCRETE CONSTRUCTION HENSEL PHELPS UNIVERSAL PLASTICS CARPENTERS LOCAL #1109 WESTERN BUILDING MATERIALS COLUMBIA PROPERTIES IN WESTER ACOUSTICS BROWN SHEET METAL & LEWIS NELSON T CONSTRUCTION INC NELSON RONALD R DOME CONSTRUCTION CORP SEQUOIA CONSTRUCTION ANNUZZI CONCRETE SERV OLIVER & COMPANY INC METROPOLITAN BLDRS CARPENTERS HOUSING CORPORATION ROSENDIN ELECTRIC CORP CUSTOM DRYWALL INC ALCAL SPECIALTY CONTRACTING INC. BLACH CONSTRUCTION CO CENTRAL CALIFORNIA MC DONALD ROSS COMPANY MAHER M F INC EXPERT DRYWALL SYSTEM WEBCOR CONSTRUCTION LP ALBANESE JOSEPH J INC HARRIS R M COMPANY GOEBEL FIXTURE CO FOUNDATION CONSTRUCTORS INC COLEMAN BILL VIKING INSULATION SCAFFOLD WORKS INC SMITH NANCY CONSTRUCTION INC SANDERS COY CONSTRUCTION INC SIEMENS GENERATION SERVICES COMPANY DESIGNED BUILDING SYSTEMS INC HALSTEAD DRYWALL INC COLLINS MARVIN CON INC CALIFORNIA ENGINEERING LANDAVAZO CONCRETE INC UNITED ACOUSTICS DBA N R C JOHN DALY BOULEVARD ASSC L P KIE-CON INC ALL FORMS INC BRAY J L & SON INC RECKNAGEL CARL GENERAL BRAYTON C T & SONS INC IRELAND INTERIOR SYSTEMS INC YOLO MACHINERY ERECTOR DE MELLO ROOFING INC DUTRA CONSTRUCTION CO MC FALL WILLIAM W SWISHER WAYNE E CEMENT CONTR INC BEALS - MARTIN & ASSOC THOMAS W A CO INC WALTERS K G CONSTRUCTI MAI INDUSTRIES NORTHERN SUN ASSOCIATION KULLBERG G A & SON INC GES EXPOSITION SERVICES INC FISHER DEVELOPMENT INC KENT LATHING CO PETERSON HYDRAULICS CASEY-FOGLI CONCRETE C G & S DRYWALL INC CONDON-JOHNSON & ASSOCIATES INC FIELD CONST R N INC SKANSKA USA BLDG INC-WA DIV JOHNSTON FLOYD CONSTR CO INC R & W CONCRETE INC SWANSON GARY CARPENTERS LOCAL #2236 ANNING-JOHNSON COMPANY NORTHERN SUN ASSOCIATE WESTERN STATES DRYWALL/LATHING DEVCON CONSTRUCTION INC MERLO LEWIS M INC SWIRIDOFF CONSTRUCTION COMMERCIAL CASEWORK INC GALLINO DONALD F INC CALIFORNIA STATE OF SUTTI & ASSOCIATES INC C. C. MYERS, INC. CONTRACTORS SCAFFOLD SUPPLY BERKELEY CEMENT INC ELLJAY ACOUSTICS INC RADOS STEVE P INC AD-IN INC PERFORMANCE DRYWALL INC CARPENTERS 46 COUNTIES SPACETONE ACOUSTICS INC CONCO WEST INC PLANT CONSTRUCTION CO LP C S MARINE CONSTRUCTORS INC M C M CONSTRUCTION INC COON JOHN H CONSTRUCTION SPECIALTIES JARRETT E P DRILLING C BENSON R C & SONS INC ALGER ART DBA PENINSULA CRANE & RIGG VILLASENOR RAYMOND CITY BUILDING INC PETERSEN BUILDERS INC COAST INSULATION CO DIVISION JOHNSON A A & SONS INC T C B BUILDERS INC WALTERS & WOLF INTERIORS PEACOCK CONSTRUCTION INC LANKFORD CONSTRUCTION MOUNTAIN CONSTRUCTION INC HARDER MECHANICAL CONS STROER & GRAFF BRADY CO./CENTRAL CA, INC. COMPU-TECH WESTERN ADDITION DRYWALL SWEETWATER CONSTRUCTION MARLEY COOLING TOWER CO UNISTRUT INTERNATIONAL CORP F & H CONSTRUCTION ATLANTIC PLANT MAINTENANCE T S M CONTRACTOR RES-COM INSULATION INC SERVICE WEST COULTER CONSTRUCTION ESCOBAR & WILLIAMS DRYWALL PEREZ M COMPANY INC DBA MANSON CONSTRUCTION CO ARB INC CLARK & SULLIVAN CONSTRUCTION STACY AND WITBECK INC DILBECK & SONS INC KIEWIT INFRASTRUCTURE WEST CO. PACIFIC DOOR PRODUCTS INC R M R CONSTRUCTION CO SERVICE METAL PRODUCTS CAVALLINI CONSTRUCTION C. C. MYERS, INC. K K CONSTRUCTION O'NEILL J M INC RUTHERFORD INC SAN JOSE CONSTRUCTION BAYSIDE INTERIORS INC WJJ - D & H, INC. WRIGHT CONTRACTING INC HANCOCK RICHARD INC MC CARTHY BUILDING COMPANIES INC URATA AND SONS CEMENT K C INDUSTRIAL CONSTRUCTORS INC SCHNABEL FOUNDATION CO MC NELY CONSTRUCTION CO GOLDEN BAY CONST INC BENICIA INDUSTRIES INC CONSOLIDATED PARTITION D R S MARINE MURATORE INC R F J INC FALCO CONSTRUCTION J & J ACOUSTICS INC SIMONS INSTALLATION R R CONSTRUCTION ROLDAN CONSTRUCTION IN FLOSTOR INSTALLATION & SERVICE CO HINDS BROS CO INC J & J PLASTERING PERFORMANCE MECHANICAL INC CHERNE CONTRACTING COR HORTON C W GENERAL CON JACKSON THOMAS R ETHOSENERGY FIELD SVCS LLC ANGOTTI & REILLY INC MURGA, STRANGE & CHALMERS INC MORTENSON M A CO R B DRYWALL INC DEVEL CONSTRUCTION INC QUALITY SYSTEMS INSTALLATIONS DASCO CONSTRUCTION BAY AREA CONCRETES INC R M R CONSTRUCTION CO