2016-11-09T15:45:04-06:00 2015-12-31 410746749 CLIFTONLARSONALLEN LLP 220 SOUTH SIXTH STREET SUITE 300 MINNEAPOLIS MN 55402 990 2015-01-01 416024791 CARPENTERS AND JOINERS WELFARE FUND CARP 9528540795 3001 METRO DRIVE NO 500 BLOOMINGTON MN 55425 TIM MCGOUGH CHAIRMAN 9528540795 2016-11-08 1 STACY MEYER P00970625 6123764500 2015 2017-02-10 21:41:12Z TIM MCGOUGH 3001 METRO DRIVE NO 500 BLOOMINGTON MN 55425 287098833 0 X N/A X 1960 MN PROVIDE HEALTH AND WELFARE BENEFITS PURSUANT TO A COLLECTIVE BARGAINING AGREEMENT. 8 0 176 11 0 0 0 0 113208303 122340638 748680 9711410 24840 1044 113981823 132053092 0 0 101180683 118612781 0 0 0 0 0 4192940 4061349 105373623 122674130 8608200 9378962 185347765 184151527 3915239 4399576 181432526 179751951 PROVIDE HEALTH AND WELFARE BENEFITS PURSUANT TO A COLLECTIVE BARGAINING AGREEMENT. 0 0 SELF-FUNDED BENEFITS FOR APPROXIMATELY 11,751 UNION MEMBERS AND THEIR DEPENDENTS. 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 1 0 1 0 0 0 0 0 0 0 0 0 1 0 0 1 3905 0 176 1 0 0 0 0 0 0 X 8 0 0 0 0 0 0 1 0 1 0 0 0 1 1 1 1 0 0 0 0 0 X WILSON-MCSHANE CORPORATION 9528540795 3001 METRO DRIVE SUITE 500 BLOOMINGTON MN 55425 TIM MCGOUGH MGT TRUSTEE/CHAIRMAN 1.00 2.00 X X 0 0 0 DAVE HAMILTON MGT TRUSTEE/ALTERNATE CHAIR 1.00 2.00 X X 0 0 0 JOHN RAINES UNION TRUSTEE/SECRETARY 1.00 4.00 X X 0 250675 46375 PATRICK NILSEN UNION ALTERNATE SECRETARY 1.00 4.00 X X 0 153570 42593 PETER DONNINO MGT TRUSTEE 1.00 2.00 X 0 0 0 MARTHA HENRICKSON MGT ALTERNATE 1.00 2.00 X 0 0 0 CHRIS HILL UNION TRUSTEE/ALTERNATE 1.00 3.00 X 0 106408 38721 BURT JOHNSON UNION TRUSTEE 1.00 3.00 X 0 153542 42510 MATT MARQUIS MGT TRUSTEE ALTERNATE 1.00 2.00 X 0 0 0 JOHN NESSE MGT TRUSTEE 1.00 2.00 X 0 0 0 THOMAS PERRIER UNION TRUSTEE 1.00 3.00 X 0 95845 34848 0 760040 205047 0 0 1 0 WILSON-MCSHANE CORPORATION 3001 METRO DR 500 BLOOMINGTON MN 55425 PLAN ADMINISTRATOR 2602757 BLUE CROSS BLUE SHIELD OF MINNESOTA PO BOX 64560 ST PAUL MN 551640560 CLAIMS PROCESSOR 2305372 TOTAL EMPLOYEE ASSISTANCE MANAGEMENT 700 TRANSFER RD ST PAUL MN 55114 HEALTH MANAGEMENT PROGRAM 270630 DELTA DENTAL 3560 DELTA DENTAL DR EAGAN MN 551223166 CLAIMS PROCESSOR 260054 ANDERSON HELGEN DAVIS & NISSENLLC 150 S 5TH ST 3100 MINNEAPOLIS MN 55402 LEGAL SERVICES 159540 5 CONTRIBUTIONS 525100 122340638 122340638 122340638 2166726 2166726 162590425 155045741 7544684 7544684 7544684 MISCELLANEOUS 525100 1044 1044 1044 132053092 122340638 0 9712454 118612781 183442 394000 99338 69473 44877 7467 21548 CLAIMS PROCESSING FEES 1788000 PCORI TAX 900085 ADMINSTRATIVE FEES 420000 BANK CHARGES 35315 97804 122674130 30209844 12724184 8635793 8987116 378486 274638 75890416 146123642 86275173 185347765 184151527 1844783 1637757 2070456 2761819 3915239 4399576 X 0 0 0 0 181432526 179751951 181432526 179751951 185347765 184151527 9378962 -11059537 0 X 0 1 X 1 0 0 SSGA IMTERM. GOV CREDIT BD INDEX CM NL 45670558 F NTGI QM COM DAILY S&P 500 TAX EXEMPT 40604615 F 86275173 VACATION DOLLARS DUE TO CREDIT UNION 1379928 DUE TO OTHER FUNDS 1381891 2761819 X 120894217 -11059537 -11059537 131953754 99338 99338 132053092 122574792 0 122574792 99338 99338 122674130 PART X, LINE 2: THE VEBA TRUST FUNDING CERTAIN BENEFITS OF THE PLAN RECEIVED AN EXEMPTION LETTER FROM THE IRS DATED AUGUST, 29, 1967, STATING THAT THE TRUST IS TAX-EXEMPT UNDER THE PROVISIONS OF SECTION 501(C)9 OF THE IRC. HOWEVER, AS A RESULT OF THE PLAN'S FUNDING POLICY, FROM TIME TO TIME THE TRUST MAY BE SUBJECT TO INCOME TAXES. NO FEDERAL OR STATE INCOME TAXES HAVE BEEN RECORDED IN 2015 FOR UNRELATED BUSINESS TAXABLE INCOME. IN ADDITION, THE PLAN AND THE TRUST ARE REQUIRED TO OPERATE IN CONFORMITY WITH THE IRC TO MAINTAIN THE TAX-EXEMPT STATUS OF THE TRUST. THE PLAN ADMINISTRATOR BELIEVES THAT THE PLAN IS BEING OPERATED IN COMPLIANCE WITH THE APPLICABLE REQUIREMENTS OF THE IRC AND, THEREFORE, BELIEVES THAT THE RELATED TRUST IS TAX-EXEMPT. 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 IT HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE. THE PLAN IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. THE PLAN ADMINISTRATOR BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO 2012. 0 0 0 JOHN RAINES UNION TRUSTEE/SECRETARY 0 250675 0 0 0 0 0 0 0 46375 0 297050 0 0 PATRICK NILSEN UNION ALTERNATE SECRETARY 0 153570 0 0 0 0 0 0 0 42593 0 196163 0 0 BURT JOHNSON UNION TRUSTEE 0 153542 0 0 0 0 0 0 0 42510 0 196052 0 0 FORM 990 PART VII THE FILING ORGANIZATION RELIED ON A RELATED ORGANIZATION TO ESTABLISH COMPENSATION FOR THE OFFICERS AND DIRECTORS LISTED IN FORM 990, PART VII AND SCHEDULE J, PART II. OFFICERS AND DIRECTORS SERVE IN A VOLUNTEER CAPACITY FOR THE FILING ORGANIZATION AND RECEIVE THE COMPENSATION REPORTED FOR SERVICES RENDERED TO THE RELATED ORGANIZATIONS. THE RELATED ORGANIZATIONS USED THE FOLLOWING METHOD TO DETERMINE THE COMPENSATION: APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. J&K BUILDERS INC CONTRIBUTING EMPLOYER CONTRIBUTIONS X 10709 10709 0 0 0 CITYWIDE WOOD FLOORS CONTRIBUTING EMPLOYER CONTRIBUTIONS X 25747 25747 0 0 0 NORTHSTAR INSTALLATIONS LLC CONTRIBUTING EMPLOYER CONTRIBUTIONS X 1564 1564 0 0 0 MINORITY OWNED INS & DRYWALL CONTRIBUTING EMPLOYER CONTRIBUTIONS X 4380 4380 0 0 0 JR JONES FIXTURE CO CONTRIBUTING EMPLOYER CONTRIBUTIONS X 23254 23254 0 0 0 NORTHSTAR INSTALLATIONS LLC CONTRIBUTING EMPLOYER CONTRIBUTIONS X 5209 5209 0 0 0 DORAN CONSTRUCTION CONTRIBUTING EMPLOYER CONTRIBUTIONS X 108518 108518 0 0 0 DOW ACOUSTICS CONTRIBUTING EMPLOYER CONTRIBUTIONS X 27278 27278 0 0 0 NEAL HALONEN CONST CONTRIBUTING EMPLOYER CONTRIBUTIONS X 5589 5589 0 0 0 NEAL HALONEN CONST CONTRIBUTING EMPLOYER CONTRIBUTIONS X 10671 10671 0 0 0 INITIATIVE CONSTRUCTION INC CONTRIBUTING EMPLOYER CONTRIBUTIONS X 9129 9129 0 0 0 INTEGRITY ACOUSTICS INC CONTRIBUTING EMPLOYER CONTRIBUTIONS X 1353 1353 0 0 0 STOIC DRYWALL LLC CONTRIBUTING EMPLOYER CONTRIBUTIONS X 1061 1061 0 0 0 SALEM LLC CONTRIBUTING EMPLOYER CONTRIBUTIONS X 927 927 0 0 0 BOR-SON CONSTRUCTION LLC CONTRIBUTING EMPLOYER CONTRIBUTIONS X 18 18 0 0 0 HICK'S CONCRETE CONSTRUCTION CONTRIBUTING EMPLOYER CONTRIBUTIONS X 1002 1002 0 0 0 J EIDEN CONSTRUCTION INC CONTRIBUTING EMPLOYER CONTRIBUTIONS X 6886 6886 0 0 0 DURESKY FLOOR COVERING CONTRIBUTING EMPLOYER CONTRIBUTIONS X 4936 4936 0 0 0 HICK'S CONCRETE CONSTRUCTION CONTRIBUTING EMPLOYER CONTRIBUTIONS X 1826 1826 0 0 0 STELLAR EXTERIORS OF MN CONTRIBUTING EMPLOYER CONTRIBUTIONS X 289 289 0 0 0 RYAN JAY CARPENTRY LLC CONTRIBUTING EMPLOYER CONTRIBUTIONS X 235 235 0 0 0 TWIN CITIES DRYWALL INC CONTRIBUTING EMPLOYER CONTRIBUTIONS X 822 822 0 0 0 TM SKULSKI DBA ALL-STAR CONTRIBUTING EMPLOYER CONTRIBUTIONS X 1295 1295 0 0 0 FLOORWORKSLLC CONTRIBUTING EMPLOYER CONTRIBUTIONS X 3634 3634 0 0 0 SHOTLEY CONSTRUCTION CONTRIBUTING EMPLOYER CONTRIBUTIONS X 706 706 0 0 0 INITIATIVE CONSTRUCTION INC CONTRIBUTING EMPLOYER CONTRIBUTIONS X 9442 9442 0 0 0 MARLOW FLOOR COVERING INC CONTRIBUTING EMPLOYER CONTRIBUTIONS X 2723 2723 0 0 0 OW CONSTRUCTION CONTRIBUTING EMPLOYER CONTRIBUTIONS X 2384 2384 0 0 0 INTEGRITY ACOUSTIC SOLUTIONS CONTRIBUTING EMPLOYER CONTRIBUTIONS X 3051 3051 0 0 0 274638 FORM 990, PART VI, SECTION A, LINE 7A THE BARGAINING ORGANIZATION, THE EMPLOYER AND UNION, BOTH APPOINT 50% OF THE BOARD. FORM 990, PART VI, SECTION A, LINE 8B THE ORGANIZATION DOES NOT HAVE ANY COMMITTEES THAT HAVE AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 IS REVIEWED IN CONJUNCTION WITH REVIEW OF ANNUAL AUDIT BY THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 12C THE POLICY REQUIRES PERSONS COVERED BY IT TO MONITOR AND REPORT TO THE PLAN ANY ACTUAL OR POTENTIAL CONFLICTS OF INTEREST. THE PLAN THEN INVESTIGATES TO DETERMINE IF A CONFLICT OF INTEREST, IN FACT, EXISTS, WHETHER IT IS MATERIAL, AND WHETHER CORRECTIVE ACTION IS REQUIRED. COVERED PERSONS ARE ALSO OBLIGATED TO REPORT ANY CONFLICT OF INTEREST OF WHICH THEY ARE AWARE INVOLVING OTHER COVERED PERSONS. PERSONS COVERED BY THE POLICY ALSO ANNUALLY CERTIFY IN WRITING THAT THEY HAVE NOT BEEN INVOLVED IN ANY CONFLICT OF INTEREST WHICH HAS NOT BEEN REPORTED TO THE PLAN. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. 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