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Washington Bakers Trust: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
Washington Bakers Trust (EIN 91-6029112)
Tax period
2012-06-01 to 2013-05-31
Filed
2014-04-12
IRS object ID
201431029349300118
Schema version
2012v2.0
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2014-04-12T11:18:49-07:00Timestamp
Tax Period End Date2013-05-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1ANASTASI MOORE & MARTIN PLLCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1104 S DivisionAddressLine1
CitySpokaneCity
StateWAState
ZIP Code99202ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-06-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN916029112EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Washington Bakers TrustBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlWASHNameControl
Phone2062824100Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1201 Queen Anne Avenue NorthAddressLine1
CitySeattleCity
StateWAState
ZIP Code98109ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameJerry D'AmbrosioName
TitleChairmanTitle
Date Signed2014-04-12DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NamePaul J Anastasi CPAName
PTINP00395796PTIN
Phone5093230272Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Gross Receipts13041961GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
All Affiliates IncludedfalseAllAffiliatesIncluded
Organization501cXOrganization501c
Web SiteN/AWebSite
Type Of Organization TrustXTypeOfOrganizationTrust
Year Formation1953YearFormation
State Legal DomicileWAStateLegalDomicile
Activity Or Mission Descriptionto provide health and welfare benefits to qualified participants as specified in the plan.ActivityOrMissionDescription
Nbr Voting Members Governing Body6NbrVotingMembersGoverningBody
Nbr Independent Voting Members6NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Gross UBI0TotalGrossUBI
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year13355512ProgramServiceRevenuePriorYear
Program Service Revenue CY12975264ProgramServiceRevenueCY
Investment Income Prior Year91595InvestmentIncomePriorYear
Investment Income Current Year66697InvestmentIncomeCurrentYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year13447107TotalRevenuePriorYear
Total Revenue Current Year13041961TotalRevenueCurrentYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year13357963BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY13637565BenefitsPaidToMembersCY
Salaries Etc Current Year0SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year719008OtherExpensePriorYear
Other Expenses Current Year737492OtherExpensesCurrentYear
Total Expenses Prior Year14076971TotalExpensesPriorYear
Total Expenses Current Year14375057TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-629864RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-1333096RevenuesLessExpensesCY
Total Assets BOY7116085TotalAssetsBOY
Total Assets EOY6295347TotalAssetsEOY
Total Liabilities BOY3466021TotalLiabilitiesBOY
Total Liabilities EOY4033156TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY3650064NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY2262191NetAssetsOrFundBalancesEOY
Mission Descriptionprovide health and welfare benefits to eligible participants.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Descriptiontp provide health and welfare benefits to qualified participants of the planDescription
Described In501 C3falseDescribedIn501C3
Schedule B RequiredfalseScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquipfalseReportLandBldgEquip
Report Invest Oth SecuritiestrueReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotetrueReportFin48Footnote
Independent Audit Financial StmttrueIndependentAuditFinancialStmt
Consolidated Audit Financial StmtfalseConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredfalseScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Invest Tax Exempt BondsfalseInvestTaxExemptBonds
Escrow AccountfalseEscrowAccount
On Behalf Of IssuerfalseOnBehalfOfIssuer
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With10960NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingfalseComplianceWithBackupWitholding
Number Of Employees0NumberOfEmployees
Employment Tax Returns FiledfalseEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Form990-T FiledfalseForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Excess Business HoldingsfalseExcessBusinessHoldings
Taxable DistributionsfalseTaxableDistributions
Distribution To DonorfalseDistributionToDonor
Filed Lieu1041falseFiledLieu1041
Licensed More Than One StatefalseLicensedMoreThanOneState
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members6NbrVotingGoverningBodyMembers
Number Independent Voting Members6NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiestrueDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
Election Of Board MembersfalseElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOfalseCompensationProcessCEO
Compensation Process OtherfalseCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonZenith American SolutionsNamePerson
Telephone Number2062824100TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1201 Queen Anne Ave NorthAddressLine1
CitySeattleCity
StateWAState
ZIP Code98109ZIPCode
FieldValueIRS element (for citing)
No Listed Persons CompensatedXNoListedPersonsCompensated

Form990 Part VII Section A Form990PartVIISectionA (6 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekAverage Hours Per Week RelatedAverageHoursPerWeekRelatedIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficer
Mary Trujillo
Trustee1.000.00X000
Cheryl Stone
Secretary1.000.00X000X
Robert Odegard
Trustee1.000.00X000
Colin Jackson
Trustee1.000.00X000
Sue Bonnett
Trustee1.000.00X000
Jerry D'Ambrosio
Chairman1.000.00X000X
FieldValueIRS element (for citing)
Number Individuals GT100 K0NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KfalseTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (2 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
Zenith American Solutions
201 Queen Anne Avenue NorthSeattleWA98109plan administraation492785
First Choice Health Network iNc
600 University St 1400seattleWA98109preferred provider107445
FieldValueIRS element (for citing)
Number Of Contractors GT100 K2NumberOfContractorsGT100K
Total Contributions0TotalContributions

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescriptionTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
Prescription Rebates7693476934
participants contribution145436145436
employer contributions1275289412752894
FieldValueIRS element (for citing)
Total Program Service Revenue12975264TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column66697TotalRevenueColumn
Exclusion$66,697ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
FieldValueIRS element (for citing)
Total Other Revenue0TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column13041961TotalRevenueColumn
Related Or Exempt Function Income12975264RelatedOrExemptFunctionIncome
Exclusion$66,697ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total13637565Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total0Total

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total0Total

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total0Total

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total0Total

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total0Total

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total481207Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total9600Total

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total10900Total

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total29808Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total146047Total

Advertising Advertising

FieldValueIRS element (for citing)
Total0Total

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total20657Total

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total0Total

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total0Total

Travel Travel

FieldValueIRS element (for citing)
Total12342Total

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total0Total

Interest Interest

FieldValueIRS element (for citing)
Total0Total

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total0Total

Insurance Insurance

FieldValueIRS element (for citing)
Total6661Total

Other Expenses OtherExpenses

FieldValueIRS element (for citing)
DescriptionPostage and ShippingDescription
Total20270Total

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total0Total

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total14375057Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY1539678BOY
EOY560582EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
EOY0EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY40338BOY
EOY121219EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
BOY1107681BOY
EOY1111283EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
EOY0EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
EOY0EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY664BOY
EOY664EOY

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
EOY0EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
EOY0EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY4427724BOY
EOY4501599EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
EOY0EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY7116085BOY
EOY6295347EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY103021BOY
EOY116156EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY3363000BOY
EOY3917000EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY3466021BOY
EOY4033156EOY
FieldValueIRS element (for citing)
Do Not Follow SFAS117XDoNotFollowSFAS117

Retained Earnings Endowment Etc RetainedEarningsEndowmentEtc

FieldValueIRS element (for citing)
BOY3650064BOY
EOY2262191EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY3650064BOY
EOY2262191EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY7116085BOY
EOY6295347EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses-1333096ReconcilationRevenueExpenses
Reconciliation Unrealized Invest9223ReconciliationUnrealizedInvest
Reconcilation Other Changes-64000ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement SeparateXFinancialStatementSeparate
FieldValueIRS element (for citing)
Audit CommitteetrueAuditCommittee
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Total Of Book Value Securities4501599TotalOfBookValueSecurities

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescriptionAmountAmount
lag months eligibility coverage$2,050,000
incurred but not reported claims payable$1,867,000
FieldValueIRS element (for citing)
Total Of Amounts3917000TotalOfAmounts
Footnote In Part XIIIXFootnoteInPartXIII
Tot Revenue Etc Audited Fincl Stmt13021376TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments9223NetUnrealizedGainsInvestments
Revenue Not Rptd F9909223RevenueNotRptdF990
Revenue Subtotal13012153RevenueSubtotal
Investment Expenses Not Included29808InvestmentExpensesNotIncluded
Revenue Not Rptd On Fin Stmt29808RevenueNotRptdOnFinStmt
Total Revenue Per Form99013041961TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt13846468TotExpensesEtcAuditedFinclStmt
Expenses Subtotal13846468ExpensesSubtotal
Investment Expenses Not Included229808InvestmentExpensesNotIncluded2
Other Expenses Not Included498781OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt528589ExpensesNotRptdOnFinStmt
Total Expenses Per Form99014375057TotalExpensesPerForm990

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Part XII, Line 4bPart XII, Line 4b: Other revenue amounts included on 990 but not included in F/Spremiums and claims incurred but not rep $-1460329 premiums and claims incurred but not rep $1959110
Part XPart X : FIN48 FootnoteThe Trust established under the Plan to hold the Plan's assets is qualified pursuant to the appropriate section of the Internal Revenue Code (IRC), and accordingly, the Plan's net investment income is exempt from income taxes. The Plan has obtained a favorable determination letter from the Internal Revenue Service (IRS) dated December 14, 1977, and the Plan sponsor believes that the Plan, as amended, continues to qualify and operate as designed. Accounting principles generally accepted in the United States of America require Plan management to evaluate tax positions taken by the Plan and recognize a tax liability (or asset) if the Plan has taken an uncertain position that more likely than not would not be sustained upon examination by the IRS. The Plan administrator has analyzed the tax positions taken by the Plan, and has concluded that as of May 31, 2013 and 2012, there are 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 taxing jurisdictions; however, there are currently no audits for any tax periods in progress. The Plan administrator believes it is no longer subject to income tax examinations for years prior to 2009.

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (6 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Form 990, Part XI, Line 9Other Changes In Net Assets Or Fund Balances - Other Increasespremiums and claims incurred but not reported 5/31/2013 = $1986000
Form 990, Part XI, Line 9Other Changes In Net Assets Or Fund Balances - Other Decreasespremiums and claims incurred but not reported 5/31/2012 = -$2050000
Form 990, Part VI, Line 19Form 990, Part VI, Line 19: Other Organization Documents Publicly AvailableTHE PLAN ADMINISTRATOR MAINTAINS CURRENT COPIES AND WILL PROVIDE THE PLAN'S GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS TO PLAN MEMBERS UPON REQUEST. THE PLAN CURRENTLY DOES NOT HAVE A WRITTEN CONFLICT IN INTEREST POLICY.
Form 990, Part VI, Line 12cForm 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of ConflictsANNUAL LETTERS ARE SENT TO THE TRUSTEES INQUIRING ABOUT CONFLICTS OF INTEREST.
Form 990, Part VI, Line 11bForm 990, Part VI, Line 11b: Form 990 Review ProcessTHE PLAN'S AUDITOR PREPARES FORM 990 AND PROVIDES A COPY TO THE PLAN'S ADMINISTRATOR. THE ADMINISTRATOR DISTRIBUTES THE FORM 990 TO THE BOARD OF TRUSTEES WHO REVIEW THE FORM 990 WITH ADVICE FROM THE PLAN'S CONSULTANTS AND COUNSEL.
Form 990, Part VI, Line 3Form 990, Part VI, Line 3: Description of Delegated Duties to Management CompanyZENITH AMERICAN SOLUTIONS IS RESPONSIBLE FOR THE DAY TO DAY OPERATIONS OF THE PLAN.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionDirect Controlling Entity NADirectControllingEntityNAControlled OrgControlledOrg
Bakery Union No 9
5950 6th Avenue S 201SeattleWA98108910135325to unite into one organizationWA501(c)5N/Afalse
Washington Bakers Retiree Welfare Trust
201 Queen Anne Ave NseattleWA98109911514696health and welfare benefitsWA501(C)9N/Afalse

Form990 Schedule R Part III Form990ScheduleRPartIII (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateDirect Controlling Entity NADirectControllingEntityNADisproportionate AllocationsDisproportionateAllocationsGeneral Or Managing PartnerGeneralOrManagingPartner
Pacific Northwest Baking Co
P O Box 890SumnerWA98390911420639soft roll bakeryWAN/Afalsefalse
Hostess BrandsInterstate BC Signature
6414 204th St SW 100LynnwoodWA98036911670391manufacturer bakery productsWAN/Afalsefalse

Form990 Schedule R Part IV Form990ScheduleRPartIV (10 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeLegal Domicile StateLegalDomicileStateDirect Controlling Entity NADirectControllingEntityNAControlled OrgControlledOrgEINEINPrimary ActivityPrimaryActivityType Of EntityTypeOfEntityBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
QFC
1401 BroadwaySeattleWA98122WAN/Afalse
Fred Meyer
400 S Thor StSpokaneWA99202WAN/Afalse
The Markets
4350 Cordata ParkwayBellinghamWA982268190WAN/Afalse
Centennial Mills
1131 E Sprague AvenueSpokaneWA99202WAN/Afalse
Olson Baking Company
6414 204th St SWLynwoodWA98036WAN/Afalse
United States Bakery Snyders Bakery
315 NE 10th AvePortlandOR97232ORN/Afalse930302130bakery productsS Corp
Safeway Inc
1701 Santa Rita RdPleasantonCA94588CAN/Afalse943019135retailC corp
Rosauers Supermarkets Inc
1808 W 3rd AveSpokaneWA99205WAfalse910582615retail grocerC CorpURM Stores Inc
United States Bakery GaisLangendorf
315 NE 10th AvePortlandOR97232ORN/Afalse930302130bakery productsS Corp
New Albertsons Inc
7075 Flying Cloud DrEden PrairieMN55344MNfalse204057706wholesale & Retail tradeC CorpSupervalu Inc
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Dividends Related OrganizationfalseDividendsRelatedOrganization
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgsfalsePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeesfalseSharingOfPaidEmployees
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgtrueOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (12 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
QFC
s551160cash
Fred Meyer
s338940cash
The Markets
s158880cash
Centennial Mills
s106500cash
Olson Baking Company
s211740cash
United States Bakery Snyders Bakery
s1125360cash
Safeway Inc
s6594420cash
Rosauers Supermarkets Inc
s420780cash
United States Bakery GaisLangendorf
s1870380cash
New Albertsons Inc
s731400cash
Pacific Northwest Baking Co
s276780cash
Hostess BrandsInterstate BC Signature
s284700cash