2017-02-27T12:37:00-06:00 2016-06-30 522385296 LINDQUIST LLP 5000 EXECUTIVE PARKWAY SUITE 400 SAN RAMON CA 94583 990 2015-07-01 943254224 UA LOCAL NO 355 HEALTH AND WELFARE TRUST FUND UALO 4155467800 221 MAIN STREET NO 250 SAN FRANCISCO CA 94105 MIGUEL INIGUEZ TRUSTEE 4155467800 2017-02-27 1 DEBBIE ROESSL DIMERY P01065763 9252779100 2015 2021-01-29 14:40:06Z MIGUEL INIGUEZ 221 MAIN STREET NO 250 SAN FRANCISCO CA 94105 5565021 0 X N/A X 1993 CA TO PROVIDE HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS 4 0 0 0 0 0 0 0 2773713 3387944 114521 52425 508 0 2888742 3440369 0 0 3015268 3179951 0 0 0 0 0 451798 468922 3467066 3648873 -578324 -208504 4366019 4252666 1741197 1907330 2624822 2345336 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 4155467800 221 MAIN STREET 2ND FLOOR SAN FRANCISCO CA 94105 TONY CARYL TRUSTEE 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 SEE SCHEDULE O FOR COMPENSATION PAID BY RELATED ORGANIZATIONS 1.00 X 0 1 0 0 1 0 0 0 0 0 ZENITH AMERICAN SOLUTIONS 221 MAIN STREET SUITE 250 SAN FRANCISCO CA 94105 ADMINISTRATOR 168310 1 EMPLOYER CONTRIBUTIONS 900099 3097709 3097709 STOP LOSS REFUNDS 900099 289799 289799 SELF-PAYS CONT. - SPEC CRAFTS 900099 436 436 3387944 118535 118535 2058542 2124652 -66110 -66110 -66110 3440369 3387944 0 52425 3179951 228520 59040 31279 11389 51933 39580 6051 21621 11367 OTHER EXPENSE 8142 3648873 397897 909761 102299 102401 291455 542043 8283 1113 3566085 2697348 4366019 4252666 21585 23010 1719612 1884320 1741197 1907330 X 0 0 0 0 2624822 2345336 2624822 2345336 4366019 4252666 -208504 -70982 0 X X 0 1 X 1 0 0 CLAIMS PAYABLE AND IBNR 252600 ACCUMULATED ELIGIBILITY CREDITS 1364005 DUE TO RELATED FUNDS 267715 1884320 X 3357998 -70982 -70982 3428980 11389 11389 3440369 3514223 0 3514223 11389 123261 134650 3648873 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, 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 FISCAL YEARS PRIOR TO 2013. 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 11 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 - IDENTIFICATION 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, 2016, THERE ARE APPROXIMATELY 50 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. AQUATECH SOLUTIONS AMERICA ASSOCIATED CONSTRUCTORS, INC. AZTEC SOLAR, INC. BAUMAN LANDSCAPE BEEBE DIVERSIFIED LP BORTOLUSSI & WATKIN CALIFORNIA WATERSCAPE CLYDE COLLISHAW SPRINKLERS,INC COHEN LANDSCAPE SERVICES, INC DAK LANDSCAPE CONSTRUCTION DECKER LANDSCAPING INC ECOLOGICAL CONCERNS, INC. GREEN GROWTH INDUSTRIES EMPIRE LANDSCAPING, INC. FREEDLUN HYDROSEEDING INC HERZER LANDSCAPING, INC. JJ NGUYEN, INC MORI HATSUSHI ASSOC JENSEN CORPORATION KCI ENVIRONMENTAL, INC. LANDSCAPE CONTRACTORS COUNCIL LANDSCAPE VISIONS, INC LAWLER & STANZ, INC LEFEVRE WELDING INC. LEO MANIGLIA ENTERPRISES INC LOCAL 393 MARINA LANDSCAPE INC MARINA LANDSCAPE INC-RESIDENTL MCGUIRE AND HESTER GSL CONSTRUCTION OUTSIDE THE LINES. INC PACIFIC WATER ART, INC PLAYGROUNDS UNLIMITED (M.A.K.) RMT LANDSCAPE CONTRACTORS, INC SHOOTER & BUTTS, INC SHOWTIME CONSTRUCTION SOLANO CONSTRUCTION CO, INC SUNRISE LANDSCAPE TAKEHARA LANDSCAPE, INC TAKEHARA LANDSCAPE/MAINTENANCE TEAM-EES, INC. 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 WHO BUILT CREATIVE BUILDER INC