2015-12-18T13:16:11-06:00 2015-05-31 470900880 CALIBRE CPA GROUP PLLC 566 W LAKE ST SUITE 300 CHICAGO IL 60661 990 2014-06-01 366147408 FOX VALLEY & VICIN CONSTRUCTION WEL FUND FOXV 4144761220 3333 N MAYFAIR RD No 201 MILWAUKEE WI 53226 Art Sturms TRUSTEE 4144761220 2015-12-18 1 COREY BILKEY P00499751 3126550037 2014 2016-03-07 17:11:31Z ART STURMS 3333 N MAYFAIR RD No 201 MILWAUKEE WI 53226 14968310 0 X N/A X 1961 WI TO PROVIDE MEDICAL, DENTAL, VISION, TEMPORARY DISABILITY, AND DEATH BENEFITS. 10 10 0 0 0 0 0 0 7068863 7311610 360384 1204828 0 0 7429247 8516438 0 0 6071775 5736712 0 0 0 0 0 748035 556604 6819810 6293316 609437 2223122 22155209 22351278 3484814 2866547 18670395 19484731 X TO PROVIDE MEDICAL, DENTAL, VISION, TEMPORARY DISABILITY, AND DEATH BENEFITS 0 0 TO PROVIDE MEDICAL, DENTAL, VISION, TEMPORARY DISABILITY, AND DEATH BENEFITS TO ELIGIBLE MEMBERS TO PROVIDE MEDICAL, DENTAL, VISION, TEMPORARY DISABILITY, AND DEATH BENEFITS TO ELIGIBLE MEMBERS AND THEIR DEPENDENTS. 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 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 5 0 1 0 0 0 0 0 0 0 X 10 10 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 0 0 0 X OLIVIA PEDOLZKY 4144761220 3333 MAYFAIR RD MILWAUKEE WI 53226 PETER CULVER FORMER SECRETARY 2.00 X 0 0 0 DONALD DEETJEN TRUSTEE 2.00 X 0 0 0 DAN AUSSEM CHAIRMAN 2.00 X 0 0 0 RUBEN COLLAZO FORMER TRUSTEE 2.00 X 0 0 0 JAMES ZUIDEMA FORMER TRUSTEE 2.00 X 0 0 0 JOHN SZECH TRUSTEE 2.00 X 0 0 0 JOSH BOLLER TRUSTEE 2.00 X 0 0 0 KENNETH SANDENO TRUSTEE 2.00 X 0 0 0 ART STURMS SECRETARY 2.00 40.00 X 0 102694 65876 DAVE FLEURY FORMER TRUSTEE 2.00 40.00 X 0 145178 66637 ANTHONY FRESCURA JR TRUSTEE 2.00 40.00 X 0 88396 46873 PETE NIELSEN TRUSTEE 2.00 X 0 0 0 RICHARD LANGE TRUSTEE 2.00 40.00 X 0 89938 49420 0 426206 228806 0 0 1 0 ZENITH AMERICAN SOLUTIONS 18861-90th AVENUE SUITE A MOKENA IL 60448 ADMINISTRATOR 220742 BLUE CROSS BLUE SHIELD OF IL 300 E RANDOLPH ST CHICAGO IL 60601 INSURANCE ADMIN 129042 2 EMPLOYER CONTRIBUTIONS 525100 6721884 6721884 EMPLOYEE CONTRIBUTIONS 525100 589726 589726 7311610 442937 442937 7213763 6451872 761891 761891 761891 8516438 7311610 0 1204828 5736712 239086 17328 18708 26200 214433 28998 3510 8341 6293316 -66968 -64498 834351 1293670 53444 9680 21315166 21096036 19216 16390 22155209 22351278 16896 1174 3467918 2865373 3484814 2866547 X 0 0 0 0 18670395 19484731 18670395 19484731 22155209 22351278 X 2223122 -362440 -1046346 X X 0 1 X 1 0 0 EXTENDED ELIGIBILITY 2339000 EST LIAB FUT CLMS INCRRD NOT REPRTD 412500 CLAIMS PAYABLE 103100 DUE TO ASSOCIATED FUNDS 10773 2865373 X 8127798 -362440 -362440 8490238 26200 26200 8516438 6869216 0 6869216 26200 -602100 -575900 6293316 Part X, Line 2: AS OF MAY 31, 2015, THERE WERE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY (OR ASSET) 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 PERIOD IN PROGRESS. AT MAY 31, 2015 THE PLAN IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO THE FISCAL YEAR ENDED MAY 31, 2012. Part XII, Line 4b - Other Adjustments: CHANGE IN CURRENT BENEFIT OBLIGATIONS -602,100. 0 0 0 ART STURMS SECRETARY 0 102694 0 0 0 0 0 65876 0 0 0 168570 0 0 DAVE FLEURY FORMER TRUSTEE 0 145178 0 0 0 0 0 47949 0 18688 0 211815 0 0 Form 990, Part VI, Section B, line 11 THE TRUSTEES AUTHORIZE THE FUND'S THIRD-PARTY ADMINISTRATOR AND A DESIGNATED TRUSTEE TO REVIEW THE FORM 990 BEFORE IT IS FILED. Form 990, Part VI, Section B, line 12c THE TRUSTEES ARE GOVERNED BY THE TRUST DOCUMENT AND HAVE A FIDUCIARY RESPONSIBILITY UNDER ERISA TO ADMINISTER THE PLAN IN THE BEST INTEREST OF THE MEMBERSHIP. THE US DEPARTMENT OF LABOR REQUIRES ALL LABOR TRUSTEES TO REPORT ON FORM LM-30 POTENTIAL SITUATIONS WHERE THERE MAY BE CONFLICTS OF INTEREST. THIS INFORMATION IS OPEN TO THE PUBLIC. Form 990, Part VI, Section C, line 19 A SUMMARY ANNUAL REPORT IS DISTRIBUTED TO ALL PARTICIPANTS. PARTICIPANTS ARE ABLE TO REQUEST THE AUDITOR'S REPORT AND OTHER FINANCIAL INFORMATION FROM THE PLAN ADMINISTRATOR AND/OR THE US DEPARTMENT OF LABOR. ALSO, FORM 5500 IS OPEN TO PUBLIC INSPECTION THROUGH THE US DEPARTMENT OF LABOR. Form 990, Part XI, line 9: TRANSFER OF NET ASSETS TO ADC 1 WELFARE FUND -1,046,346. Form 990, Part XII, Line 2c: The process has not changed from the prior year. 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