2014-03-11T13:29:28-05:00 2013-04-30 362152389 BANSLEY AND KIENER LLP 8745 W HIGGINS RD STE 200 CHICAGO IL 606312704 990 2012-05-01 510245220 CHICAGO PAINTERS AND DECORATORS WELFARE FUND CHIC 6309603322 18861 90TH AVE SUITE A MOKENA IL 60448 ANDREW PERCH 6309603322 2014-03-04 1 PAUL A MERKEL P00420901 3122632700 2012 2015-11-30 17:44:51Z ANDREW PERCH 18861 90TH AVE SUITE A MOKENA IL 60448 183853279 0 X N/A X 1953 IL TO PROVIDE HOSPITALIZATION, MEDICAL, AND OTHER RELATED BENEFITS TO ELIGIBLE MEMBERS AND THEIR DEPENDENTS. 6 0 0 0 0 0 0 0 37422840 39246924 3252575 2726518 173109 16729 40848524 41990171 0 0 31939717 37223438 0 0 0 0 0 2085473 2059092 34025190 39282530 6823334 2707641 104013251 116913427 21309415 24166327 82703836 92747100 SEE BELOW 0 0 TO PROVIDE HOSPITALIZATION, MEDICAL AND OTHER RELATED BENEFITS TO ELIGIBLE MEMBERS AND THEIR DEPENDENTS. 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 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 14 0 1 0 0 0 0 0 0 0 X 6 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 X EDWARD OTSTOTT 6309603322 18861 90TH AVENUE SUITE A MOKENA IL 60448 MARTIN TEW 2.00 X 0 0 0 RICHARD TAMBORSKI-FORMER 2.00 X 0 9858 4980 DONALD STEADMAN 2.00 X 0 0 0 TERRENCE FITZMAURICE 2.00 X 0 216409 72621 ANDREW PERCH 2.00 X 0 128839 61087 NORBERT SOLTYSIAK - FORMER 2.00 X 0 0 0 HUGO MANZO 2.00 X 0 129145 61087 ANTHONY BOCHNIAK 2.00 X 0 0 0 0 484251 199775 0 0 1 0 ARNOLD AND KADJAN 19 WEST JACKSON BLVD CHICAGO IL 60604 LEGAL AND COLLECTION 891953 BLUE CROSS BLUE SHIELD 300 E RANDOLPH CHICAGO IL 60601 HEALTH CARE PROVIDER 645408 ZENITH-AMERICAN 18861 90TH AVE STE A MOKENA IL 60448 THIRD PARTY ADMINISTRATOR 599509 AETNA HEALTH INSURANCE 7400 CAMPUS ROAD NEW ALBANY OH 43054 HEALTH CARE PROVIDER 194162 DELTA DENTAL 801 OGDEN AVENUE LISLE IL 60532 HEALTH CARE PROVIDER 114325 7 EMPLOYER CONTRIBUTIONS 900099 36650695 36650695 EMPLOYEE CONTRIBUTIONS 900099 2596229 2596229 39246924 1967799 1967799 142621827 141863108 758719 758719 758719 MEDICARE REIMBURSEMENT 900099 16729 16729 16729 41990171 39263653 0 2726518 37223438 599509 354296 176144 105345 93090 113160 4151 13734 40799 COLLECTION FEES 558105 MISCELLANEOUS 759 39282530 1487548 3522369 4493077 4009173 3265533 3481967 260942 233257 67556533 71280690 25674343 33915974 1275275 469997 104013251 116913427 126980 98227 21182435 24068100 21309415 24166327 X 0 0 0 0 82703836 92747100 82703836 92747100 104013251 116913427 2707641 7335623 0 X X 0 1 X 1 0 0 COMMON TRUST FUNDS 33915974 F 33915974 EMPLOYER BONDS PAYABLE 196045 DUE TO BROKER FOR SECURITIES PURCHASED 507055 CLAIMS AND PREMIUMS PAYABLE 1084000 CLAIMS INCURRED, NOT REPORTED 2029000 ACCRUED ELIGIBILITY 17924000 FUTURE INSURANCE PREMIUMS 40000 COBRA BENEFITS 2288000 24068100 49220449 7335623 7335623 41884826 105345 105345 41990171 34626185 0 34626185 105345 4551000 4656345 39282530 PART XII, LINE 4B - OTHER ADJUSTMENTS: INCREASE IN CHANGES IN BENEFIT OBLIGATIONS 4,551,000. 0 0 0 TERRENCE FITZMAURICE 0 213598 0 0 0 2811 0 0 0 72621 0 289030 0 0 ANDREW PERCH 0 128159 0 0 0 680 0 0 0 61087 0 189926 0 0 HUGO MANZO 0 128159 0 0 0 986 0 0 0 61087 0 190232 0 0 FORM 990, PART VI, SECTION A, LINE 8B THERE ARE NO OTHER COMMITTEES WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11 FORM 990 IS PREPARED BY AN INDEPENDENT CPA AND IS REVIEWED AND APPROVED BY THE FUND REPRESENTATIVE PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS FORM 990 AND FORM 5500 (WHICH INCLUDES AUDITED ANNUAL FINANCIAL STATEMENTS) AND SUMMARY ANNUAL REPORT AVAILABLE FOR INSPECTION UPON REQUEST. FORM 990, PART XI, LINE 2C THE ORGANIZATION'S BOARD OF TRUSTEES ASSUMES THE RESPONSIBILITY FOR THE OVERSIGHT OF THE AUDIT OF THE FINANCIAL STATEMENTS. THERE HAS BEEN NO CHANGE IN THIS PROCESS FROM THE PRIOR YEAR. CHICAGO PAINTERS AND DECORATORS DEFERRED SAVINGS PLAN 18861 90TH AVE STE A MOKENA IL 60448 366162468 SAVINGS FUND IL 501(C)(9) 0 PAINTERS DISTRICT COUNCIL NO 14 1456 WEST ADAMS STREET CHICAGO IL 60607 361593286 UNION IL 501(C)(5) 0 BOARD OF TRUSTEES OF CHICAGO PAINTERS WELFARE FUND 18861 90TH AVE STE A MOKENA IL 60448 510245220 PLAN SPONSOR AND ADMINISTRATOR IL 0 400 CONDO ASSOCIATION THE 69 WWASHINGTON MGMT CO A & P PAINTING CO A GRAMER PTG & DEC SERVICE AB PAINTING & DECORATING AC BROWN CONSTR CO INC ACCURATE BRANDING CORP ACE METAL REFINISHERS ACTION PAINTING COINC ADVANTAGE SIGN INSTALLATION AIRTITE INTERIORS INC ALCA INC ALF COMMERCIAL INTERIORS ALL AMERICAN PTG & DEC INC ALL TECH DECORATING COMPANY ALLIANCE DRYWALL & ACOUSTICAL ALLPORT CONSTRUCTION CORP ALPINE PAINTING & MAINTENANCE ALUMITEC LTD AM-COAT PAINTING INC ANCHOR MECHANICAL INC ANDERSON MORAN CONSTRUCTION ANNING-JOHNSON COMPANY APRIL BUILDING SERVICES INC APRIL DECORATING INC ARC ELECTRO REFINISHER INC ARCHITECTURAL 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CONSTR CO CLARION CONSTRUCTION INC CLASSIC TOUCH PAINTING INC COMMERCIAL CONSTRUCTION INC COMPRO PTG & DEC SERVICE CONFORTI CONSTR SERVICESINC CONRAD SCHMITT STUDIOS INC CONTINENTAL COMMERCIAL INTINC CONTINENTAL PTG & DECINC COPPER CONSTRUCTION CORNERSTONE BUILDING MAINT COSGROVE CONSTRUCTION INC COTE DECORATING COMPANY COURTHOUSE DEVELOPMENT INC CREATION CARPENTRY COMPANY INC CROWN COMMERCIAL PTGINC CROWN PAINTING INC CUSTOM CUT WOODWORK INC D & B INDUSTRIAL D & M CONSTRUCTION SERVICES D B M SERVICESINC DAS CONSTRUCTION INC DES PAINTING INC DANIEL DECORATING INC DAVID ALLARD PAINTING CO DEASY ENTERPRISES INC DELGAR CONSTRUCTION CO INC DELTA PAINTING INC DEMOS PAINTING & DECORATING DENK & ROCHE BUILDERS INC DEPAUL UNIVERSITY DEPINTO CARPENTRY LLC DIAMOND SIGN & DESIGN LTD DIAZ INTERIOR CONTRACTORS DOHERTY CONSTRUCTION INC DORA BUILDERS LLC DRAKE HOTEL HILTON DRIFTWOOD HOSPITALITY MNGLLC DRIVE CONSTRUCTION DRYWALL SERVICE OF GARY INC DURANGO PAINTING INC DYNAMIC CONSTRUCTION EAGLE 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II INC HERNER-GEISSLER WOODWORK CORP HESTER DECORATING COINC HIGHLAKE CONSTRUCTION CORP HILTON HOTEL CHICAGO HOMEOWNERS ASSOCIATION HOMER H FLENTYE PROPERTY MGMT HOMES BY HEINTZ INC HUNTER DRYWALL & TAPING INC HYATT REGENCY CHICAGO HYLAND-NOLAN PLASTERING CONTR ICARUS PAINTING CO INC IDEAL PTG & DECORATING IMPERIAL WOODWORKING COMPANY IMPERIOM LLC INDEPENDENT MECHANICAL IND INTER OCEAN-CABINET COMPANY INTERNATIONAL CHIMNEY CORP INTERNATIONAL DECORATORS INC INTERPAINT DECORATING IRELAND LTD PAINTING CONTRAC J & M DECORATING INC J C ANDERSON INC J F CARPENTRY SERVICES INC J M C CONSTRUCTION INC J N A CONSTRUCTION INC JP PHILLIPS INC J2 INTERIORS INC JAMES D AHERN CO JAMES MC HUGH CONSTRUCTION CO JANECYK CONSTRUCTION COMPANY JANOTA PNTG & DECORATING JC'S UNITED BUILDING MAINT INC JETCO LTD JEWEL CONSTRUCTION CO INC JOHANSON DECORATING LLC JOHN A EBY & SONS JOHN J HEITKOTTER INC JORE-HARD SURFACE FINISHER INC JOSEPH WOODWORKING INC K & E PTG & DECORATING INC K D K DECORATORS KATHERINE FRANK CREATIVEINC KIM INTERIORS INC KINGDOM COMMUNITY CONSTRUCTION KLECKNER INTERIOR SYSTEMS INC KNUDSEN CONSTRUCTION INC KOLE CONSTRUCTION CO INC L J MORSE CONSTRUCTION LAKESIDE RESTORATION LAKEWOOD CARPENTRY LANEE DECORATING LTD LANKFORD CONSTRUCTION CO INC LEE QUIGLEY COMPANY LEGACY PAINTING INC LEOPARDO COMPANIES INC LETTERMEN SIGNAGE LEVY COMPANY THE LINN INTERIOR CONSTRUCTION CO LOHRE PAINTING CO INC M P M CONTRACTORS INC MFC BUILDERS MJB DECORATING INC MK SIGNS MACK CONSTRUCTION SERVICES LLC MADISON COATINGS INC MAGNUM CONSTRUCTION SERVICES MAK SPECIALTY PAINTING MANTA INDUSTRIAL INC MARIN BROTHERS INC MARKET CONTRACTING SERVICES MARKHAM DIVISION 9 INC MATAN'S DECORATING SERVICE MAXCOR INCORPORATED MAXIMUS PAINTING CO LLC MAY DECORATING II INC MC GUINESS DECORATING INC MC NULTY BROTHERS CO MERIDIENNE CORP METAL MAINTENANCE INC METRO FAIR & EXPO AUTHORITY MG-PLUS CONSTRUCTION INC MIDWEST DECORATING INC MIDWEST PRO PAINTING INC MIDWEST SIGNATURE BLDG SVCS MILLARD MAINTENANCE MON 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DECORATING PINNACLE DECORATING INC PINTO BROS CONSTRUCTIONINC PLATINUM DRYWALL INC PREFORM TRAFFIC CONTROLINC PRESTIGE CONSTRUCTION COMPANY PRISM PAINTING COMPANY PRO SERVICES OF IL INC PROCACCIO PAINTING COINC PRODIGY CONSTRUCTION LLC PROFESSIONAL DEC & PTG INC PYRAMID PAINTING & DECINC R E S CONSTRUCTION INC R M SELLERGREN & ASSOC INC R P COATINGS INC R T G DECORATING REED ILL CORP REGAL DECORATING INC REGENCY DEC SERVICE INC RG CONSTRUCTION SERVICESINC RIGGIO BORON LTD RITZ-CARLTON HOTEL OF CHICAGO RIVER ROSE INTERIORS INC ROCK-IT DRYWALL SERVICE INC ROCK-IT INTERIORS INC ROCKWELL GROUP INC RODGERS CONSTRUCTION CORP ROMINGER CONSTRUCTION CO ROOSEVELT UNIVERSITY ROSEMARY DECORATING RUFFALO PAINTING CO INC S A BARNES COMPANY INC S E I COATINGS LLC SALAMONE BUILDERS INC SANDOVAL CONSTRUCTION SCACCIA DECORATING CO SCHMELZER PAINT COINC SCOTTCO PAINTING SELECT PAINTING & DRYWALL CO SELLENTIN PAINTINGINC SERVICE DRYWALL & DECINC SHAMROCK DECORATING SHANAHAN DRYWALL SERVICE INC SIGN CONCEPTS SIGN EFFECTS INC SIGN PAINTERS LOCAL 830 SKYLINE DECORATING INC SMART INTERIORS SMITH PTG& DECSERVINC SOLDIER FIELD JOINT VENTURE SOUTHLAND CUSTOM DECINC SOUTSOS DECORATING CO SPRAY SPECIALISTS STAN'S PAINTING & DEC INC STONE & WEBSTER CONSTRUCTION STRATA CONTRACTORS LTD STUART DEAN CO SUMMIT ENTERPRISES SUN INDUSTRIAL PTG COMPANY SUNDERMEYER LTD SUPERIOR EXHIBIT & DESIGNSINC SUPERIOR PTG & DEC INC T C H CONSTRUCTION INC TNT CONSTRUCTION INC TAET PAINTING LLC TANNERS SIGNS & DESIGNS INC TECORP INC THE STONE & METAL GROUP THORNE ASSOCIATES INC THREE D ENTERPRISES INC THREE STAR PAINTING INC THREE-WAY PAINTINGINC T-I NW INDIANA PAINTERS HW TIDAL CONSTRUCTION SERV INC TIFFINY DECORATING CO TOP NOTCH PAINTING INC TOUCAN SIGNS TPL SIGN SERVICE TRACY PTG & DECORATINGINC TRIANGLE DECORATING CO TRICOR CARPENTRY TRIPAR DRYWALL INC TURNER INDUSTRIAL MAINTENANCE TWINS DRYWALL INC ULTIMATE SIGNS INC UNIQUE DRYWALL SYSTEM INC UNIVERSAL INC UPTOWN PAINTING & DECOR INC VAN BRUGGEN SIGNS VERNATE CONSTRUCTION INC VGM ETA LLC FKA CAM COINC VISION INTERIOR VISION PTG & DEC SVCS INC W K MEYER CONSTRUCTION CORP WALGREENS COMPANY WALLFORMS INCORPORATED WALL-TECH INC WESTSIDE REALTY WILLIAM HUBER CABINET WORKS WILLIAMS POWER CORPORATION WOODBRIDGE CONST & CARPENTRY WOODS CONSTRUCTION INC 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 FORM 990, SCHEDULE R, PART IV: THE ORGANIZATION IS A MUTI-EMPLOYER COLLECTIVELY BARGAINED EMPLOYEE BENEFIT PLAN THAT IS SUBJECT TO THE PROVISIONS OF THE EMPLOYER RETIREMENT INCOME SECURITY ACT OF 1974 (ERISA). AS REQUIRED, ONLY THE NAMES OF THE CONTRIBUTING EMPLOYERS OF THE ORGANIZATION ARE LISTED IN PART IV OF SCHEDULE R.