2016-10-17T08:53:30-05:00 2014-11-30 043508036 MANZI & ASSOCIATES LLC 855 TURNPIKE STREET NORTH ANDOVER MA 01845 990 2013-12-01 042088633 SHEET METAL WORKERS LOCAL UNION NO 17 INSURANCE FUND SHEE 6174265646 1157 ADAMS STREET 1ST FLOOR DORCHESTER MA 02124 ROBERT KEOGH FUNDS ADMINISTRATOR 6174265646 2015-08-28 1 JEANNIE MICKEL P01058630 9789751099 2013 2017-02-10 21:41:12Z X ROBERT KEOGH 1157 ADAMS STREET 1ST FLOOR DORCHESTER MA 02124 39991731 0 X X 1950 MA TO PROVIDE HEALTH BENEFITS FOR ELIGIBLE PARTICIPANTS 6 6 44 0 0 0 0 0 25396665 24220303 1487828 3104189 430397 466612 27314890 27791104 0 0 24522078 27373150 610617 630387 0 0 0 448059 397796 25580754 28401333 1734136 -610229 54590713 54892611 4646150 5032748 49944563 49859863 TO PROVIDE HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS 0 0 TO PROVIDE HEALTH AND OTHER SPECIFIED BENEFITS TO ELIGIBLE MEMBERS/DEPENDANTS THROUGH A COLLECTIVELY BARGAINED MULTIEMPLOYER PLAN. 0 0 0 0 0 0 0 0 0 1 1 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 1 0 1 44 1 0 0 0 0 0 0 0 0 X 6 6 0 0 0 0 1 0 0 1 1 0 0 1 0 0 1 0 1 0 X ROBERT KEOGH 6174265646 1157 ADAMS STREET 1ST FLOOR DORCHESTER MA 02124 JAMES WOOL TRUSTEE 10.00 X X 0 0 0 FRED CREAGER TRUSTEE 10.00 X X 0 0 0 KEVIN GILL TRUSTEE 10.00 X X 0 0 0 FESTUS JOYCE TRUSTEE 10.00 X X 0 0 0 JOSEPH CULLEN TRUSTEE 10.00 X X 0 0 0 JACK DESMOND TRUSTEE 10.00 X X 0 0 0 ROBERT KEOGH ADMINISTRATOR 40.00 X 205006 0 76436 205006 0 76436 1 0 1 0 BLUE CROSS BLUE SHIELD 401 PARK DRIVE BOSTON MA 02215 HEALTH CLAIMS ADMINISTRATION 1024138 1 EMPLOYER CONTRIBUTIONS 561000 22745181 22745181 MEMBER CONTRIBUTIONS 561000 845784 845784 SASMI CONTRIBUTIONS 561000 629338 629338 24220303 868200 868200 14436616 12200627 2235989 2235989 2235989 ADMIN ASSESSMENTS 900099 466612 466612 466612 27791104 26922904 0 868200 27373150 191390 219753 190100 29144 22028 19450 147862 36800 7287 28476 39438 5115 42551 20814 POSTAGE 10472 TELEPHONE 8815 ADMINISTRATIVE EXPENSE 5393 PRINTING 2120 1175 28401333 2824525 1058371 4270631 4870570 20141 32540 1153092 472362 723281 680730 30580187 23535537 14288375 22658406 1883573 2056457 54590713 54892611 626079 512895 4020071 4519853 4646150 5032748 X 0 0 0 0 49944563 49859863 49944563 49859863 54590713 54892611 -610229 525529 0 X X 0 1 X 1 0 807660 148376 659284 345432 323986 21446 680730 SSGA INDEX PLUS FUND 7451253 F INSTITUTIONAL SENIOR LOAN FUND 2583757 F MESIROW MULTISTRATEGY 3920644 F DPT CORE PLUS 8702752 F 22658406 INCURRED BUT NOT REPORTED CLAIMS 4177409 BENEFITS PAYABLE 342444 4519853 X 28168771 525529 525529 27643242 147862 147862 27791104 27753689 0 27753689 147862 499782 647644 28401333 PART X, LINE 2: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE PLAN MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE PLAN AND RECOGNIZE A TAX LIABILITY (OR ASSET) IF THE PLAN HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE DEPARTMENT OF LABOR AND INTERNAL REVENUE SERVICE. THE PLAN ADMINISTRATOR HAS ANALYZED THE TAX POSITIONS TAKEN BY THE PLAN, AND HAS CONCLUDED THAT AS OF NOVEMBER 30, 2014, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY (OR ASSET) OR DISCLOSURE IN THE FINANCIAL STATEMENTS. PART XII, LINE 4B - OTHER ADJUSTMENTS: NET CHANGE IN BENEFIT OBLIGATIONS 499,782. X 0 0 0 ROBERT KEOGH ADMINISTRATOR 205006 0 0 0 0 0 76436 0 0 0 281442 0 0 0 FORM 990, PART VI, SECTION A, LINE 6 COLLECTIVELY BARGAINED MULTIEMPLOYER PLAN FOR MEMBERS AND RETIREES OF LOCAL 17 SMW FORM 990, PART VI, SECTION B, LINE 11 BOARD OF TRUSTEES HAS GIVEN AUTHORITY TO THE FUND ADMINISTRATOR TO REVIEW ALL TAX DOCUMENTATION BEFORE FILING. FORM 990, PART VI, SECTION B, LINE 12 AS AN EMPLOYEE BENEFIT PLAN WE ARE SUBJECT TO THE CONFLICTS OF INTEREST REQUIREMENTS OF ERISA. FORM 990, PART VI, SECTION B, LINE 15B COMPENSATION IS REVIEWED ANNUALLY BY THE BOARD OF TRUSTEES. FORM 990, PART VI, SECTION C, LINE 19 AVAILABLE UPON REQUEST FORM 990, PART XII, LINE 2C PROCESS HAS NOT CHANGED FROM PRIOR YEAR. FORM 990, PAGE 1, SECTION B THE ORGANIZATION IS AMENDING THIS RETURN TO CORRECT AND PROPERLY REPORT PROGRAM SERVICE REVENUE AS RELATED OR EXEMPT FUNCTION REVENUE THAT WAS ORIGINALLY INCORRECTLY REPORTED AS UNRELATED BUSINESS REVENUE. IN ADDITION, TO CORRECT AND PROPERLY REPORT OTHER REVENUE, INVESTMENT INCOME (INCLUDING DIVIDENDS, INTEREST AND OTHER SIMILAR AMOUNTS), AS REVENUE EXCLUDED FROM TAX UNDER SECTIONS 512-514 THAT WAS ORIGINALLY INCORRECTLY REPORTED AS RELATED OR EXEMPT FUNCTION REVENUE. 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