2014-02-01T10:21:33-06:00 2013-06-30 320043599 LEGACY PROFESSIONALS LLP 311 S WACKER DRIVE STE 4000 CHICAGO IL 60606 990 2012-07-01 362392752 PRIVATE SCAVENGERS HEALTH & WELFARE FUND 731 I B OF T PRIV 6308874150 1000 BURR RIDGE PKWY BURR RIDGE IL 60527 TERRENCE J HANCOCK 6308874150 2014-02-01 1 TIMOTHY CIBULKA P00841100 3123680500 2012 2015-11-30 17:44:51Z TERRENCE J HANCOCK 1000 BURR RIDGE PKWY BURR RIDGE IL 60527 31643017 0 X N/A X 1953 IL PROVIDE HEALTH BENEFITS 6 6 0 0 0 0 0 0 21577118 21616670 2226255 2271072 0 0 23803373 23887742 0 0 21707812 22866926 0 0 0 0 0 931276 954550 22639088 23821476 1164285 66266 42004965 42894581 141128 100702 41863837 42793879 TO PROVIDE HEALTH BENEFITS 0 0 TO PROVIDE MEDICAL, DENTAL, VISION, LIFE AND LOSS OF TIME BENEFITS TO ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS. 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 1 189 0 1 0 0 0 0 0 0 0 0 0 X 6 6 0 0 0 0 0 0 0 1 0 0 0 1 1 0 0 0 0 1 1 0 X MR TERRENCE J HANCOCK 6308874150 1000 BURR RIDGE PARKWAY BURR RIDGE IL 60527 TERRENCE J HANCOCK 0.50 X 0 0 0 JOHN LISNER 0.50 X 0 0 0 TIM DUNLAP 0.50 X 0 0 0 THOMAS YONKER 0.50 X 0 0 0 LAWRENCE GROOT 0.50 X 0 0 0 STEVE VOGRIN 0.50 X 0 0 0 RICHARD CLARSON 40.00 X 129856 0 10888 129856 0 10888 1 0 0 1 BLUE CROSS BLUE SHIELD 300 EAST RANDOLPH STREET CHICAGO IL 606015099 PPO PROVIDER 846604 HEALTH MANAGEMENT CONCEPTS INC 181 COMMODORE DRIVE JUPITER FL 33477 WELLNESS BENEFITS 121481 2 EMPLOYER CONTRIB. 900099 18235981 18235981 PARTICIPANT & RETIREE CONTRIB. 900099 3380689 3380689 21616670 210642 210642 9815705 7755275 2060430 2060430 2060430 23887742 21616670 0 2271072 22866926 50883 30814 163595 37493 91578 23637 66946 9481 15622 REIMB. OF ADMN EXP 464501 23821476 2041414 1567615 722746 599887 2385648 2577750 15632 22957 68606 58172 15267 10434 13170202 20230616 23654056 17885322 42004965 42894581 46013 50078 95115 50624 141128 100702 X 0 0 0 0 41863837 42793879 41863837 42793879 42004965 42894581 66266 863776 0 X 0 1 X 1 0 68606 58172 10434 10434 COMMON AND COLLECTIVE TRUST 17885322 F 17885322 DUE TO RELATED ORGANIZATIONS 17476 DUE TO BROKER 33148 50624 X 24587923 863776 863776 23724147 163595 163595 23887742 23657881 0 23657881 163595 163595 23821476 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: THE PLAN FILES FORM 990, RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX AND FORM 5500, ANNUAL RETURN/REPORT OF EMPLOYEE BENEFIT PLAN. THE PLANS RETURNS ARE SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE UNTIL THE APPLICABLE STATUTE OF LIMITATION EXPIRES. 0 0 0 RICHARD CLARSON 129856 0 0 0 0 0 0 0 10888 0 140744 0 0 0 PART I, LINE 7 SUPPLEMENTAL INFORMATION PART III FORM 990, PART VII, ITEM 5 AND SCHEDULE J, PART II: RICHARD CLARSON IS THE ADMINISTRATOR OF THE SCAVENGERS HEALTH AND WELFARE FUND (THE REPORTING ORGANIZATION) IN ADDITION TO PERFORMING SIMILAR DUTIES FOR THE REPORTING ORGANIZATION'S AFFILIATED, BUT UNRELATED ORGANIZATIONS. HIS COMPENSATION IS PAID DIRECTLY BY THE EXCAVATING, GRADING AND ASPHALT CRAFT LOCAL 731 HEALTH AND WELFARE FUND AND A PORTION IS REIMBURSED TO THAT FUND BY THE REPORTING ORGANIZATION. HIS COMPENSATION IS COMPRISED OF WAGES AND CONTRIBUTIONS TO A HEALTH BENEFIT PLAN. HE IS CONSIDERED AN OFFICER OF THE REPORTING ORGANIZATION FOR 990 REPORTING PURPOSES. FORM 990, PART VI, SECTION A, LINE 8B THE PLAN HAS A HEALTHCARE COMMITTEE COMPRISED OF TWO TRUSTEES FROM EACH OF THE LOCAL 731 HEALTH AND WELFARE FUNDS WHICH HAS AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 IS PROVIDED TO THE ENTIRE BOARD OF TRUSTEES AND FUND ADMINISTRATOR PRIOR TO FILING. AFTER THE BOARDS REVIEW, THE FORM IS APPROVED AND FILED. FORM 990, PART VI, SECTION B, LINE 15 SALARIES ARE INCLUDED IN AN ANNUAL COST ALLOCATION STUDY WITH OTHER TEAMSTERS LOCAL 731 BENEFIT FUNDS. THE STUDY IS REVIEWED AND APPROVED BY THE BOARD OF TRUSTEES. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST AT THE FUND OFFICE. LOCAL #731 PRIVATE SCAVENGER & GARAGE ATTEND PENS TRUST FD 1000 BURR RIDGE PARKWAY BURR RIDGE IL 60527 366513567 TO PROVIDE RETIREMENT BENEFITS FOR ELIGIBLE PARTICIPANTS IL 401(A) N/A N/A 0 ACCURATE RECYCLING SOLUTIONS CONTRIBUTING EMPLOYER 0 ADVANCED DISPOSAL SERVICE CONTRIBUTING EMPLOYER 0 ALLIED WASTE SERVICES CONTRIBUTING EMPLOYER 0 ARC DISPOSAL COMPANY CONTRIBUTING EMPLOYER 0 AUBURN DISPOSAL INC CONTRIBUTING EMPLOYER 0 BOLT SCAVENGER SERVICE INC CONTRIBUTING EMPLOYER 0 CHICAGO DISPOSAL INC CONTRIBUTING EMPLOYER 0 CLASSIC CARRIERS INC CONTRIBUTING EMPLOYER 0 D & P CONSTRUCTION CO INC RECY CONTRIBUTING EMPLOYER 0 DISPOSAL MANAGEMENT SYSTEMS CONTRIBUTING EMPLOYER 0 DJURIC TRUCKING CONTRIBUTING EMPLOYER 0 ECONOMY DISPOSAL SERVICE INC CONTRIBUTING EMPLOYER 0 EMESCO MARINE SERVICES CONTRIBUTING EMPLOYER 0 EMIL & ED'S TIRE CONTRIBUTING EMPLOYER 0 ENO INC CONTRIBUTING EMPLOYER 0 FLOOD BROS DISPOSAL CONTRIBUTING EMPLOYER 0 G & J INC CONTRIBUTING EMPLOYER 0 GROOT INDUSTRIES INC CONTRIBUTING EMPLOYER 0 H F P ENTERPRISES INC CONTRIBUTING EMPLOYER 0 H2 TRANSPORT INC CONTRIBUTING EMPLOYER 0 HERITAGE DISPOSAL LLC CONTRIBUTING EMPLOYER 0 HOMEWOOD DISPOSAL CONTRIBUTING EMPLOYER 0 HOOSIER HAULERS WASTE SERV INC CONTRIBUTING EMPLOYER 0 ILLIANA DISTRIBUTION SYSTEMS CONTRIBUTING EMPLOYER 0 INDEPENDENT RECYCLING SER INC CONTRIBUTING EMPLOYER 0 J & B TRUCKING CONTRIBUTING EMPLOYER 0 J & H DISPOSAL SERVICES INC CONTRIBUTING EMPLOYER 0 JGB TRUCKING CONTRIBUTING EMPLOYER 0 KAL TRUCKING INC CONTRIBUTING EMPLOYER 0 LAKE SHORE WASTE SERVICES LLC CONTRIBUTING EMPLOYER 0 LAND & LAKES DISPOSAL SERV LLC CONTRIBUTING EMPLOYER 0 LAND OF LINCOLN DEVELOPMENT CO CONTRIBUTING EMPLOYER 0 MBL RECYCLING INC CONTRIBUTING EMPLOYER 0 MIDWEST MARINE TERMINALS INC CONTRIBUTING EMPLOYER 0 MIDWEST REM ENTEPRISES INC CONTRIBUTING EMPLOYER 0 PRAIRIE DISPOSAL SERVICE INC CONTRIBUTING EMPLOYER 0 PULLMAN WASTE PROCESSING INC CONTRIBUTING EMPLOYER 0 RAY SCHRAMER & COMPANY CONTRIBUTING EMPLOYER 0 RECYCLING SYSTEMS INC CONTRIBUTING EMPLOYER 0 RIVERSIDE CONSTRUCTION CONTRIBUTING EMPLOYER 0 SKYLINE DISPOSAL CO INC CONTRIBUTING EMPLOYER 0 SOLLE TRUCKING CONTRIBUTING EMPLOYER 0 STA-CLEAN SYSTEMS INC CONTRIBUTING EMPLOYER 0 STROM REFUSE & REMOVAL SERVICE CONTRIBUTING EMPLOYER 0 TC TRANSPORT CONTRIBUTING EMPLOYER 0 TRI STATE DISPOSAL INC CONTRIBUTING EMPLOYER 0 U S ARBOR INC CONTRIBUTING EMPLOYER 0 UNION RECYCLING & WASTE CONTRIBUTING EMPLOYER 0 VANS DISPOSAL CONTRIBUTING EMPLOYER 0 WASTE MANAGEMENT CONTRIBUTING EMPLOYER 0 WILLEN ENTERPRISES INC CONTRIBUTING EMPLOYER 0 ZENERE EXCAVATING CONTRIBUTING EMPLOYER 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 1 LOCAL 731 GARAGE ATTENDANTS PENSION TRUST FUND K 66946 ALLOCATION APPROVED BY TRUSTEES