2014-08-04T13:17:16-05:00 2013-12-31 522385296 LINDQUIST LLP 5000 EXECUTIVE PARKWAY SUITE 400 SAN RAMON CA 945834346 990 2013-01-01 943138272 TEAMSTERS MANAGED HEALTH CARE TRUST FUND TEAM 9254263555 PO BOX 757 PLEASANTON CA 945660075 JIM BEARD TRUSTEE 9254263555 2014-08-04 1 JOSEPH M THIERMANN P01066616 9252779100 2013 2015-11-30 17:44:51Z JIM BEARD PO BOX 757 PLEASANTON CA 945660075 58641034 0 X N/A X 1991 CA TO PROVIDE MEDICAL, DENTAL, VISION AND LIFE INSURANCE BENEFITS. 6 1 0 0 0 0 0 0 48131986 58582920 100076 58102 154 12 48232216 58641034 0 0 46175310 56331620 0 0 0 0 0 894946 1136944 47070256 57468564 1161960 1172470 14924145 17279342 4244340 5448942 10679805 11830400 TO PROVIDE MEDICAL, DENTAL, VISION AND LIFE INSURANCE BENEFITS. 0 0 PROVIDED MEDICAL, DENTAL, VISION AND LIFE INSURANCE FOR ELIGIBLE PARTICIPANTS 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 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 2 0 1 0 0 0 0 0 0 0 X 6 1 0 1 0 0 0 0 0 1 0 0 0 1 1 1 1 1 1 0 0 0 X DMC INSURANCE ADMINISTATORS 9254263555 1181 QUARRY LANE SUITE 400 PLEASANTON CA 94566 X JIM BEARD TRUSTEE 1.00 X 0 0 0 BOB STRELO TRUSTEE 1.00 X 0 0 0 SAM ROSAS TRUSTEE 1.00 X 0 0 0 JOHN BECKER TRUSTEE-PAST 1.00 X 0 0 0 DIANA DOUGHTIE TRUSTEE 1.00 X 0 0 0 GERRY EISELMAN TRUSTEE 1.00 X 0 0 0 BO MORGAN TRUSTEE 1.00 X 0 0 0 0 0 0 2 0 0 0 DMC ADMINISTRATORS INC PO BOX 757 PLEASANTON CA 94566 THIRD-PARTY ADMINISTRATION SERVICES 873619 LINDQUIST LLP 5000 EXECUTIVE PARKWAY SUITE 400 SAN RAMON CA 94583 ACCOUNTING SERVICE 105397 2 ER CONTRIBUTIONS 900099 56584549 56584549 PARTICIPANT CONTRIBUTIONS 900099 1885133 1885133 LIQUIDATED DAMAGES 900099 113238 113238 58582920 58102 58102 OTHER INCOME 900099 12 12 12 58641034 58582920 0 58114 56331620 860940 30641 100222 29875 59249 44497 6985 MISCELLANEOUS EXPENSES 3772 DUES & SUBSCRIPTIONS 763 57468564 3132700 4551269 2048641 292742 4347000 5251000 5392009 7184135 3795 196 14924145 17279342 74000 90253 1340 9689 4169000 5349000 4244340 5448942 X 0 0 0 0 10679805 11830400 10679805 11830400 14924145 17279342 1172470 -21875 0 X X 0 1 X 1 0 0 CERTIFICATES OF DEPOSIT 7184135 F 7184135 ACCUMULATED ELIGIBILITY CREDITS 5349000 5349000 X 58619159 -21875 -21875 58641034 0 58641034 56291564 0 56291564 1177000 1177000 57468564 PART X, LINE 2: THE PLAN'S ADMINISTRATOR HAS ANALYZED THE TAX POSITIONS TAKEN BY THE PLAN AND HAS CONCLUDED THAT, AS OF DECEMBER 31, 2013, THERE ARE NO UNCERTAIN POSITIONS TAKEN, OR EXPECTED TO BE TAKEN, THAT WOULD REQUIRE RECOGNITION OF A LIABILITY 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 PERIODS IN PROGRESS. THE PLAN'S ADMINISTRATOR BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR THE FISCAL YEARS PRIOR TO 2010. PART XII, LINE 4B - OTHER ADJUSTMENTS: CHANGE IN BENEFIT OBLIGATIONS FORM 990, PART VI, SECTION A, LINE 3 THE PLAN HAS CONTRACTED WITH DMC ADMINISTRATORS, INC. TO PROVIDE ADMINISTRATIVE SERVICES FOR THE ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 8B THE ORGANIZATION HAS NO COMMITTEES WITH AUTHORITY TO ACT ON BEHALF OF THE BOARD OF TRUSTEES. FORM 990, PART VI, SECTION B, LINE 11 A COPY OF THE FORM 990 IS PROVIDED TO EACH OF THE VOTING MEMBERS WITHIN THE GOVERNING BODY FOR REVIEW PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE BOARD OF TRUSTEES IS SUBJECT TO THE FIDUCIARY RESPONSIBILITY PROVISIONS OF THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974 (ERISA), AS AMENDED, INCLUDING THE CONFLICT-OF-INTEREST PROVISIONS OF ERISA SECTION 406. ANNUALLY AT THE BOARD OF TRUSTEES MEETING, THE TRUSTEES ARE REQUIRED TO DISCLOSE IF THERE ARE ANY CONFLICTS OF INTEREST. IF A CONFLICTING INTEREST EXISTS, THE PERSON WITH THE CONFLICT IS EXCLUDED FROM THE DISCUSSION AND APPROVAL OF SUCH TRANSACTION. 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 12 LINE 2C THE ORGANIZATION HAS A BOARD OF TRUSTEES THAT ASSUMES RESPONSIBILITY FOR THE OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED. TEAMSTERS MANAGED ANNUNITY TRUST PO BOX 757 PLEASANTON CA 94566 943138275 TO PROVIDE SUPPLEMENTAL RETIREMENT SAVINGS PROGRAM TO ELIGIBLE PARTICIPANTS. CA 501(A) N/A N/A 0 SEE EXPLANATION IN SCHEDULE R PART VII VARIOUS CA 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 SCHEDULE R, IDENTIFICATION OF RELATED ORGANIZATIONS: THE FILING ORGANIZATION IS A TAFT-HARTLEY MULTIEMPLOYER TRUST THAT PROVIDES HEALTH AND WELFARE BENEFITS TO ELIGIBLE EMPLOYEES AND THEIR DEPENDENTS. AS OF DECEMBER 31, 2013, THERE ARE APPROXIMATELY 148 SPONSORING ORGANIZATIONS AND EMPLOYERS THAT CONTRIBUTE TO THE TRUST. THE ADMINISTRATIVE OFFICE MAINTAINS A DATABASE OF THESE SPONSORING ORGANIZATIONS AND CONTRIBUTING EMPLOYERS, INCLUDING NAMES, ADDRESSES AND OTHER CONTACT INFORMATION. THE FEDERAL TAX CLASSIFICATION (DISREGARDED ENTITY, TAX-EXEMPT ORGANIZATION, PARTNERSHIP, TAXABLE CORPORATION OR TRUST) FOR EACH CONTRIBUTING EMPLOYER IS NOT ON FILE WITH THE ADMINISTRATIVE OFFICE AND IT COULD NOT BE REASONABLY OBTAINED. AS A RESULT, THE NAMES OF THE CONTRIBUTING EMPLOYERS ARE LISTED ON PART VII BELOW AND NOT ON PARTS II THROUGH IV BY FEDERAL TAX CLASSIFICATION. ALAMEDA COUNTY FAIR ASSOCIATION ALBERT PAPER COMPANY ALLIED CONCRETE REDY MIX SERVICES ALSCO, INC. ALSCO-IBT 315 ALSCO-IBT 665 ALUM ROCK USD - ARUSD AMERIPRIDE UNIFORM SERVICES AMPCO - OAKLAND AIRPORT DRIVERS AMPORTS AMPORTS - MACHINIST AMPORTS - OPERATING ENGINEERS ANDERSON CLAYTON CORPORATION ANIXTER SF ARAMARK CLEANROOM SERVICES ARAMARK REFRESHMENT SERVICES ARAMARK REFRESHMENT SERVICES OCS ARYITA, LLC ASPEN DENTAL CARE BASF CONSTRUCTION CHEMICALS BAY AREA OCS BEST WESTERN GROSVENOR BRENNTAG PACIFIC, INC BROOKS BROTHERS BUCHANAN FOOD SERVICE CALAVERAS MATERIALS, INC. CALCOT,LTD.-HANFORD CALIFORNIA SAW & KNIFE WORKS CANTEEN VENDING - SAN JOSE CALIFORNIA TANK UNES CBS OUTDOOR INC. CEMEX CONSTRUCTION MATERIALS, LP CERTAINTEED CHERIN FURNITURE COMPANY CHRISTY VAULT COMPANY CITY OF TRACY TEAMSTERS CLEARCHANNEL OUTDOOR, INC. COAST COUNTIES TRUCK - SAN LEANDRO CON AGRA, INC CORE MARK DAVIS INSTRUMENTS DMC INSURANCE ADMINISTRATORS, INC. DOUBLE D TRANSPORTATION DOUGLAS PARKING DOUGLAS PARKING LLC DP SERVICE, LLC E.M. HUNDLEY ENERSYS, INC. FAIRMONT HOTEL OF SAN JOSE FAIRN & SWANSON, INC. FARMERS PRODUCE FARMERS RICE COOPERATIVE FEDERATED LOGISTICS - HAYWARD FEDERATED LOGISTICS - UNION CITY FERALLOY CORPORATION FERALLOY PYRAMID STRUCTURAL SOLUTIONS 03/01/12 FIRST STUDENT, INC. FIRST TRANSIT - ANTIOCH FOOD EXPRESS, INC. G P GYPSUM - STATIONARY ENGINEERS G P GYPSUM, LLC - ANTIOCH FACILITY G P GYPSUM, LLC - SAN LEANDRO FACILITY GENESIS LOGISTICS GHIGLIONE, INC GIUSTOS SPECIALTY FOODS, INC. GLOBE PLUMBING SUPPLY HEATH CERAMICS HENKEL CORPORATION HERTZ - RENT A CAR HYATT REGENCY - SFO JC PAPER JCDECAUX NORTH AMERICA KEENAN SUPPLY KELLOGG USA, INC. KRAFT FOODS GLOBAL, INC KWAJALEIN RANGE SERVICE LAZ PARKING - OAKLAND AIRPORT LEADING EDGE LINDE GAS USA LLC MACMURRAY PACIFIC MARTIN BROWER MARTIN BROWER - CLERICAL MARTIN BROWER - FLEET MATHESON, INC. - OAKLAND MATHESON, INC. - NORTH BAY MEYER PLUMBING SUPPLY COMPANY MORTON SALT INTERNATIONAL MOUNKIN RED MAN CORPORATION MV TRANSPORTATION NAPA RECYCLING & WASTE SERVICES, LLC P & S SALES PCAM, LLC PEERLESS COFFEE COMPANY PETALUMA POULTRY PROCESSORS PPG INDUSTRIES, INC PREGIS CORPORATION PRUDENTIAL CLEANROOM SERVICES PRUDENTIAL OVERALL SUPPLY R & K INDUSTRIAL PRODUCTS RELIABLE TRUCKING COMPANY RIGHT AWAY - OAKLAND RIGHT AWAY REDY MIX - MARTINEZ RIGHT AWAY REDY MIX - PLEASANTON RIGHT AWAY REDY MIX - PLEASANTON SHOP RIVER GARDEN FARMS ROCK TRANSPORT, INC. RODGERS TRUCKING COMPANY RYERSON SACRAMENTO LOGISTICS GMD - RECEIVING SACRAMENTO LOGISTICS GMD- WAREHOUSE SAN FRANCISCO PARKING, INC SAN LEANDRO VENDING SAN MATEO HOUSING AUTHORITY SARONI SUGAR & RICE - WHSE SARONI SUGAR AND RICE, INC. SCHAEFER COLD STORAGE SENTINEL TRANSPORTATION SFO SHUTTLE BUS COMPANY SIERRA DENTAL CARE SIERRA PACIFIC READY MIX SERVICES SIMS METAL SIMS METAL MANAGEMENT SODEXHO VENDING SOLANO GARBAGE - CLERICAL SPICERS PAPER - DRIVERS SPICERS PAPER, INC. STAR PACIFIC, INC. STEVE DORING SERVICES OF AMERICA SUTTER BASIN GROWERS - CORP. T & J GRAPHIC ARTS T. MARZETTI COMPANY THE J. M. SMUCKER COMPANY THE MERCURY NEWS - DRIVERS TIRE DISTRIBUTION SYSTEMS (TDS) TRACY LOGISTICS - CMSP TRACY LOGISTICS, LLC VALET HOSPITALITY SERVICE - JLS VEOLIA NORTH AMERICA-WEST, LLC VILLAGE DENTAL CARE WASTE MANAGEMENT OF ALAMEDA COUNTY 08/01/13 WEST COAST VENDING WESTERN APPLIANCE WESTERN APPLIANCE - SAN JOSE NON UNION WHEELER - SONOMA PRINTERS YOUNG'S MARKET COMPANY EXPRESS INDUSTRIAL EMPLOYERS AND DISTRIBUTORS ASSOCIATION TEAMSTERS WAREHOUSE, WHOLESALE LIQUOR SALESPERSON, MILK DRIVER UNION LOCAL 853 INTERNATIONAL BROTHERHOOD OF TEAMSTERS LOCAL 439 BEARD AFFILIATES, LLC