2016-07-12T17:54:09-05:00 2015-08-31 942723629 HEMMING MORSE CPA'S AND CONSULTANTS 155 BOVET ROAD SUITE 600 SAN MATEO CA 94402 990 2014-09-01 941291152 CEMENT MASONS HEALTH & WELFARE FUND FOR NORTHERN CALIFORNIA CEME 7078643300 220 CAMPUS LANE FAIRFIELD CA 945341499 BRYON LONEY SECRETARY 7078643300 2016-07-12 1 P01781096 4158364000 2014 2016-09-27 15:27:22Z 220 CAMPUS LANE FAIRFIELD CA 945341499 43486323 0 X N/A X 1953 CA SEE PART III LINE 4A 8 8 0 0 0 0 0 0 26838864 30856715 497122 450960 392575 546650 27728561 31854325 0 0 19689605 28174490 0 0 0 0 0 2069135 2137179 21758740 30311669 5969821 1542656 35650845 40887821 9379862 13314196 26270983 27573625 NONE 0 0 TO PROVIDE HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS ACCORDING TO THE TERMS OF THE COLLECTIVE BARGAINING AGREEMENTS BETWEEN THE EMPLOYERS AND THE UNION 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 23 0 0 0 0 0 0 0 0 0 0 X 8 8 0 1 0 0 0 0 0 1 0 0 0 0 1 0 0 1 1 0 0 0 X BRYON LONEY 7078643300 220 CAMPUS LANE FAIRFIELD CA 945341499 X SHAWN BARNES TRUSTEE 5.00 X 0 0 0 ROBERT DUMESNIL TRUSTEE 5.00 X 0 0 0 BRIAN GARDNER TRUSTEE 5.00 X 0 0 0 MARK REYNOSA TRUSTEE 5.00 X 0 0 0 KEITH SHANKS TRUSTEE 5.00 X 0 0 0 BEN ESPINOZA TRUSTEE 5.00 X 0 0 0 HECTOR CORTEZ TRUSTEE 5.00 X 0 0 0 GREG LEVY TRUSTEE 5.00 X 0 0 0 0 0 0 0 0 0 0 NORTHERN CALIFORNIA CEMENT MASONS FUNDS 220 CAMPUS LANE FAIRFIELD CA 94534 ADMINISTRATOR 943319 ANTHEM BLUE CROSS PO BOX 629 WOODLAND HILLS CA 91365 CLAIMS ADMINISTRATOR 330191 THE SEGAL COMPANY 100 MONTGOMERY ST STE 500 SAN FRANCISCO CA 94104 CONSULTING 176236 DELTA DENTAL 100 FIRST STREET SAN FRANCISCO CA 94105 CLAIMS ADMINISTRATOR 122773 WEINBERG ROGER & ROSENFELD 1001 MARINA VILLAGE PARKWAY SUITE ALAMEDA CA 94501 ATTORNEY 101610 5 EMPLOYER CONTRIBUTIONS 900099 27472777 27472777 EMPLOYEE CONTRIBUTIONS 900099 3243214 3243214 COBRA CONTRIBUTIONS 900099 140724 140724 30856715 533731 533731 11549227 11631998 -82771 -82771 -82771 REBATES AND SUBSIDIES 900099 532101 532101 SETTLEMENT INCOME 900099 14549 14549 546650 31854325 31320594 0 533731 28174490 943319 197854 33361 50797 176236 18563 44116 BENEFIT SERVICE FEES 606626 ACA TRANSITIONAL REINS. 58338 PRINTING & STATIONERY 7969 30311669 6276374 12230140 821633 249331 3222771 3493397 30000 30000 6131 6397 22350573 23116812 2943363 1761744 35650845 40887821 299401 121106 9080461 13193090 9379862 13314196 X 0 0 0 0 26270983 27573625 26270983 27573625 35650845 40887821 1542656 -240014 0 X X 0 1 X 1 0 0 CLAIMS PAYABLE - IBNR 1129000 DUE TO NORTHERN CALIDORNIA CEMENT MASONS FUNDS ADMINISTRATION, INC 229523 GROUP INSURED PREMIUMS PAYABLE 1224361 SELF-FUNDED BENEFIT CLAIMS PAYABLE 2677206 BANK OF HOURS 7933000 13193090 X 31614311 -240014 -240014 31854325 0 31854325 30311669 0 30311669 0 30311669 PART X, LINE 2: THE TRUST HAS ADOPTED GUIDANCE ON ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES ISSUED BY THE FNIANCIAL 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 21, 2012. 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 COMMITTEES 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 C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. 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. CEMENT MASONS PENSION FUND FOR NORTHERN CALIFORNIA 220 CAMPUS LANE FAIRFIELD CA 94534 946277669 TO PROVIDE PENSION BENEFITS TO ELIGIBLE PARTICIPANTS CA 401A N/A 0 CEMENT MASONS VACATION AND HOLIDAY FUND FOR NORTHERN CALIFORNIA 220 CAMPUS LANE FAIRFIELD CA 94534 946108055 TO PROVIDE VACATION AND HOLIDAY BENEFITS TO ELIGIBLE PARTICIPANTS CA 501(C)(9) N/A 0 CEMENT MASONS APPRENTICESHIP AND TRAINING FUND FOR NORTHERN CALIFORNIA 220 CAMPUS LANE FAIRFIELD CA 94534 946428343 TO PROVIDE TRAINING TO ELIGIBLE PARTICIPANTS CA 501(C)(5) N/A 0 THE NORTHER CALIFORNIA CEMENT MASONS FUNDS ADMINISTRATION INC 220 CAMPUS LANE FAIRFIELD CA 94534 941583754 TO PROVIDE ADMINSTRATIVE SERVICES FOR RELATED CEMENT MASONS TRUST FUNDS CA C 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 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 CONTRIBUTING EMPLOYERS IS REPORTED ON PART VII, SUPPLEMENTAL INFORMATION. AMERICAN PAVING COMPANY AMOROSO S J CONST CO INC ALBANESE JOSEPH J INC ACME CONSTRUCTION CO INC ANNUZZI CONCRETE SVC INC ARB INC BIANCHI GEO CONSTR INC BRAY J L & SON INC CONCO COMPANIES DOLAN CONCRETE CONSTR FERRANDO F & CO GRANITE CONSTRUCTION CO HARRIS CONSTR CO INC JOHNSON AA & SON INC KAWEAH CONSTRUCTION CO LANDAVAZO BROS INC LAMON CONSTRUCTION CO INC MC GUIRE & HESTER MERLO LEWIS M INC MIHOLOVICH CONCR CO INC NICHOLSON D W CORP OTTO CONSTRUCTION PACIFIC MECHANICAL CORP RANSOME COMPANY ROEN C W CONSTR CO REED GEORGE INC TEICHERT A & SONS UNGER CONSTR CO WATTIS CONSTR CO INC WEST VALLEY CONSTR CO APARICIO C CEM CONTR INC BERKELEY CEMENT INC BAY AREA PAVING CO MAGGIORA & GHILOTTI INC RUDOLPH & SLETTEN INC VALENTINE CORPORATION CLARK PACIFIC MBI MIDSTATE BARRIER INC WESTERN WATERPROOFING CO DEVINCENZI CONCRETE CONST BAY AREA CONCRETE INC SUPERIOR GUNITE HENSEL PHELPS BAY CITIES PAV & GRAD INC F & H CONSTRUCTION F & H CONSTRUCTION F & H CONSTRUCTION JOHNSTON FLOYD CONST CO NOR-CAL CONCRETE CASEY-FOGLI CONCRETE CON COLEMAN BILL CONCRETE PANKOW CHARLES BLDRS LTD MAHER M F INC MAHER R & R CONST CO INC WEBCOR CONSTRUCTION L.L.P HARRIS R M CO M & M LIGHTWEIGHT CONCR ANZA ENGINEERING CORP CALIF ENG CONTRS INC SWISHER W E CEM CONTR CELL-CRETE CORP M C M CONSTRUCTION INC NADAR INC R & W CONCRETE CONTRS INC SPOSETO ENGINEERING INC TERA-LITE INC SWANSON CONSTRUCTION INC POPUCH CONCRETE CAL-WEST CONCRETE CUTTING D S S CO KNIFE RIVER PERFORMANCE MECH INC MYERS C C INC NEMETZ R A CONSTR CO INC YOUNG D W CONSTR CO INC PORTER CONCR CONSTR INC BAUMAN LANDSCAPE INC STACY & WITBECK INC KIEWIT INFRASTRUCTURE WES LYLES W M CO SAN JOSE CONSTRUCTION INC J M O'NEILL INC MCCARTHY BLDG COMPANIES D Y K INC GOLDEN BAY CONSTR INC URATA & SONS CEMENT MACLEAN DONALD S INC FRESNO CONCRETE CONSTR MURGA STRANGE & CHALMERS ALL FORMS INC JAEGER CONSTRUCTION INC SHASTA CONSTRUCTORS INC WHITESIDE CONSTRUCTION AMER CIVIL CONSTRS WEST C IMBIMBO CONCRETE ROBYN CONSTRUCTION INC RGW CONSTRUCTION INC SHIMMICK CONSTR CO INC D P R CONSTRUCTION CARPENTER GREG CONCR INC BRAHMA CONSTRUCTION INC S J D CONSTRUCTION INC GHILOTTI BROTHERS INC BALL GORDON N INC GHILOTTI CONSTR COMPANY J.J.R. CONSTRUCTION INC D L R BUILDERS T C B INDUSTRIAL N M N CONSTRUCTION Q & D CONSTRUCTION CO ROMERO GENERAL CONST CORP BROSAMER R & L INC WATERTIGHT RESTORATION IN PACIFIC EXCAVATION INC BLAISDELL CONSTR INC DRILL TECH DRILLING/SHOR MAHERCO INC A C L CONSTRUCTION CO INC STEELHEAD CONSTRUCTORS ALLIED-WEST CONSTRUCTION HATHAWAY DINWIDDIE CONSTR FLATIRON WEST INC MAHER R E INC VANGUARD CONSTRUCTION ROEBBELEN CONTRACTING INC PAVE-TECH INC VIKING CONSTR CO INC COFFMAN SPECIALTIES INC MARTIN BROS CONSTRUCTION GONSALVES J A & SON CONST DOYLE'S WORK CO INC SYBLON REID ABEL'S CONCRETE WEST CONCRETE INC MASCON INC CHAZMAT CONCRETE CONSTR SWINERTON BUILDERS HC DE HARO RAMIREZ GROUP HEAVEY MICHAEL CONSTR BIG B CONSTRUCTION INC R H CONCRETE YERBA BUENA ENG & CONSTR ROSAS BROTHERS CONSTR LC GEN ENG & CONSTR INC QUIMU CONTRACTING INC AVISON CONSTRUCTION INC GIAMPOLINI/COURTNEY EMMETT'S EXCAVATION INC SPENCON CONSTRUCTION BOTHMAN ROBERT A CONSTR HAZARD CONCRETE CONSTR MICHAM ORAL E INC WEBER TRACTOR SERVICE BROCK G & L CONST CO INC MARTIN GENERAL ENG INC GOLDEN STATE BRIDGE INC LEE ANDREW L INC DAWSON-MAULDIN CONSTRUC BALL CONSTRUCTION CO INC DISNEY CONSTRUCTION INC DIANI BUILDING CORP XL CONSTRUCTION SHOWTIME CONCRETE INC EMPIRE ENGINEERING & CONS R N R CONSTRUCTION INC TEAM GHILOTTI INC DEPT OF CORR - REG ACCTG DEPT OF CORR - REG ACCTG SYNERGY PROJ MANAGEMENT SECURITY PAVING CO INC A M CONCRETE INC GSL CONSTRUCTION LYLES MECHANICAL COMPANY TUTOR-SALIBA CORPORATION ASSOCIATED SURFACE PREP ANOZIRA INC. RHOADES S.T. CONST INC SHIMMICK-SKANSKA JV J D PARTNERS CONCRETE BELMONTE'S CONCRETE SVCS J.U.V. INC. VANIR CONSTR MANAGEMENT SUAREZ & MUNOZ CONSTR INC GEO CELL SOLUTIONS J M L ENG & CONSTR INC TREICHEL CONCRETE CONSTR CONCRETE BY SMC BRENEMAN INC. EXCAVATORS INC A & S CONSTRUCTION INC LISTER CONSTRUCTION INC TAYLOR DARREN CONSTR. MYERS & SONS CONST LP GIRON CONSTRUCTION DRAGADOS/FLATIRON/SUKUT J V & G BUILDERS INC LEVEL 10 CONSTRUCTION LP SETON PACIFIC CONSTR. MISSION CONSTRUCTORS INC HOOKER CREEK INC DEE ERNEST B K & G CONCRETE PUMPING WARM SPRINGS CONSTRUCTORS STACY & WITBECK/HERZOG JV ROAD & HGHWY BLDRS OF CAL CEMROCK LANDSCAPES INC CONCRETE NORTH INC SKANSKA/SHIMMICK/HERZOG GALLINO DONALD F GEN CONT CEMENT MASONS-JATC CONCO-WEST INC NAT'L PLASTERING IND-JATF PENINSULA CONCRETE CONST MARTIN & FAHEY CONCRETE ESQUIVEL GRADING & PAVING H & H TRENCHING INC WARD'S CONCRETE INC CARTER KELLY INC FRANK ROBERT J CONSTR BENEDETTI CONC CONST G R N CONSTRUCTORS INC J T S CONSTRUCTION BRUNS BELMONT CONSTR MOUNTAIN DEVELOPMENT R A O CONSTRUCTION SOUZA M E CONSTR INC ADROIT CONSTRUCTION CO MC CLONE CONSTRUCTION CO ALLEN S W CONST INC SANSONE CO INC K I D CONSTRUCTION INC CEMENT MASONS 400 CEMENT MASONS 400 PLASTER/CEMENT MASONS 300 BUGLER CONSTRUCTION F M K CONSTRUCTION BARRAZA'S FLOOR SYSTEMS GONZALEZ ROBERT AP & DECK WATERPROOFING SEQUOIA CONSTRUCTION SPEC LEWIS JOHN CONCRETE SSC CONSTRUCTORS INC WALTERS & WOLF PRECAST TURCHET DINO CONS INC PILE CONSTRUCTION R C DECORATIVE CONCR INC D & G CONCRETE INC CENTRAL VALLEY ENG/ASPHLT CALIFORNIA SKATE PARKS QLM INC CYPRESS MANDELA TRNG CTR MCKAY & CO. CONST. CHAPIN DON CO INC BOHANNAN CONCRETE INC DMCE CONCRETE & ENG CONTR MOUNTAIN CONSTRUCTION INC LOPEZ D JR GUERRA CONSTRUCTION GROUP WALLACE MARK MASONRY PENICK T.B. & SONS INC. BUSH ENGINEERING INC ON THE LEVEL CONCRETE PACIFIC INDUSTRIAL CONSTR ARGUELLO CONCRETE CONST. GILBERT E E CONST INC RAPELLA C & SONS INC NORTHWEST SURFACING ENHANCED CONCRETE CONSTR WHITING CONCRETE BMY CONSTRUCTION GP INC GRANT CONSTRUCTION INC BIONDI PAVING CO GRIFFITH