2015-08-17T14:37:17-05:00 2014-09-30 470900880 CALIBRE CPA GROUP PLLC 19615 SOUTH LAGRANGE ROAD MOKENA IL 60448 990 2013-10-01 362947574 TRUSTEES OF LIQUOR & ALLIED WORKER LOCAL NO 3 HEALTH & WELFARE LOCA 3122434300 1640 WEST VAN BUREN STREET CHICAGO IL 60612 PATRICK DUFF TRUSTEE 3122434300 2015-08-15 1 CHARLES DIGIOVANNI P00284901 7089957180 2013 2016-03-07 17:11:31Z PATRICK DUFF 1640 WEST VAN BUREN STREET CHICAGO IL 60612 5057429 0 X N/A X 1976 IL TO PROVIDE MEDICAL, DENTAL, VISION, LIFE AND DISABILITY BENEFITS TO ALL ELIGIBLE MEMBERS OF LOCAL 3 LIQUOR AND ALLIED WORKERS 4 4 0 0 0 0 0 0 7984166 5056295 2736 1134 0 0 7986902 5057429 0 0 8838468 6697952 0 0 0 0 0 80477 80280 8918945 6778232 -932043 -1720803 2709292 0 1762475 0 946817 0 TO PROVIDE MEDICAL, DENTAL, VISION, LIFE AND DISABILITY BENEFITS TO ALL ELIGIBLE MEMBERS OF LOCAL 3 LIQUOR AND ALLIED WORKERS 0 0 TO PROVIDE MEDICAL, DENTAL, VISION, LIFE AND DISABILITY BENEFITS TO ALL ELIGIBLE MEMBERS OF LOCAL 3 LIQUOR AND ALLIED WORKERS 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1 300 0 1 0 0 0 0 0 0 0 X 4 4 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 X X THOMAS SLOTTA 3122434300 1640 WEST VAN BUREN STREET CHICAGO IL 60612 PATRICK DUFF TRUSTEE 5.00 40.00 X 0 227047 47401 DALE HUHNKE TRUSTEE 3.00 X 0 0 0 KARIN MATURA TRUSTEE 3.00 X 0 0 0 THOMAS SLOTA TRUSTEE 5.00 40.00 X 0 191756 17648 0 418803 65049 0 0 1 0 BLUE CROSS BLUE SHIELD 300 E RANDOLH CHICAGO IL 60601 PROVIDER NETWORK 244430 1 EMPLOYER CONTRIBUTIONS 900099 5048645 5048645 PARTICIPANT CONTRIBUTI 900099 7650 7650 5056295 1134 1134 5057429 5056295 0 1134 6697952 18608 1206 11425 REIMBURSEMENT TO LOCAL 42098 REIMBURSEMENT TO LOCAL 6943 6778232 229223 0 1315891 0 1104086 0 60092 0 2709292 0 84975 0 1677500 0 1762475 0 X 0 0 0 0 946817 0 946817 0 2709292 0 X -1720803 773986 X X 0 1 X 1 0 0 X 5057429 0 5057429 0 5057429 6758914 0 6758914 19318 19318 6778232 PART X, LINE 2: THE PLAN MANAGEMENT HAS ANALYZED THE POSITIONS TAKEN BY THE PLAN, AND HAVE CONCLUDED THAT AS OF SEPTEMBER 30, 2014, THERE ARE NO UNCERTAIN TAX 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: INCREASE IN CLAIMS RESERVE AND PAYABLE 19,318. 0 0 0 PATRICK DUFF TRUSTEE 0 227047 0 0 0 0 0 0 0 47401 0 274448 0 0 THOMAS SLOTA TRUSTEE 0 191756 0 0 0 0 0 0 0 17648 0 209404 0 0 FORM 990, PART VI, SECTION A, LINE 8B THERE ARE NO SUBCOMMITTEES. FORM 990, PART VI, SECTION B, LINE 11 THE PLAN ADMINISTRATOR REVIEWS THE RETURN WITH THE PLAN'S INDEPENDENT ACCOUNTING FIRM FORM 990, PART VI, SECTION B, LINE 15 NO COMPENSATION IS PAID TO TRUSTEES. FORM 990, PART VI, SECTION C, LINE 19 UPON REQUEST, DOCUMENTS ARE PROVIDED TO INDIVIDUALS. THE FORM 990 IS ALSO AVAILABLE ON THE GUIDESTAR WEBSITE. FORM 990, PART XI, LINE 9: DEFICIT ON DISTRIBUTION OF ASSETS TO LOCAL 3 WELFARE SALES DIVISION 773,986. FORM 990, PART XII, LINE 2C THE PROCESS HAS NOT CHANGED LOCAL 3 HEALTH AND WELFARE- SALES 1640 W VAN BUREN CHICAGO IL 60612 363265979 INSURANCE IL 501(C)(9) N/A 0 LOCAL 3 PENSION FUND 1640 W VAN BUREN CHICAGO IL 60612 516035372 DB PENSION IL 401 N/A 0 LOCAL 3 PENSION FUND SALES DIVISION 1640 W VAN BUREN CHICAGO IL 60612 366527340 DB PENSION IL 401 N/A 0 LOCAL 3 401K PLAN 1640 W VAN BUREN CHICAGO IL 60612 367270398 401K PLAN IL 401 N/A 0 LOCAL 3 UNION 1640 W VAN BUREN CHICAGO IL 60612 364044987 UNION IL 501(C)(5) N/A 0 WENTWORTH TIRE ARLINGTON HEATING AND COOLING ARRP TRUCKING AND HAULING BERRY TIRE CHICAGO BANDAG INC DIAGEO JYOTSNA AND DAXA LOCAL 3 UNION LOCAL 3 SALES PENSION FUND WM CASSIDY TIRE NEMEH ZUGHAYER 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0