2014-09-02T10:31:35-05:00 2013-10-31 470900880 CALIBRE CPA GROUP PLLC 19615 SOUTH LAGRANGE ROAD MOKENA IL 60448 990 2012-11-01 363265979 LIQUOR & ALLIED WORKERS LOCAL 3 UNION LOCAL 3 HEALTH AND WELFARE SALES LIQU 3122434300 1640 W VAN BUREN CHICAGO IL 60612 PATRICK DUFF 3122434300 2014-08-28 1 CHARLES DIGIOVANNI P00284901 7089957180 2012 2015-11-30 17:44:51Z PATRICK DUFF 1640 W VAN BUREN CHICAGO IL 60612 18575394 0 X N/A X 1983 IL TO PROVIDE HEALTH RELATED BENEFITS TO PARTICIPANTS AND THEIR DEPENDENTS 4 4 1 0 0 0 0 0 13210321 14263195 50988 205121 0 0 13261309 14468316 0 0 12259558 13280934 0 0 0 0 0 145770 147952 12405328 13428886 855981 1039430 20646333 21604070 1591198 1652950 19055135 19951120 TO PROVIDE HEALTH RELATED BENEFITS TO PARTICIPANTS AND THEIR DEPENDENTS 0 0 TO PROVIDE MEDICAL, LIFE, DISABILITY, VISION, DENTAL AND COUNSELING BENEFITS FOR ELIGIBLE PARTICIPANTS 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 1 500 0 1 1 1 0 0 0 0 0 0 0 0 X 4 4 1 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1 1 0 X X THOMAS SLOTA 3122434300 1640 W VAN BUREN CHICAGO IL 60612 PATRICK DUFF 5.00 40.00 X 0 221904 43978 JOHN DUFF III 5.00 40.00 X 0 203380 43635 DALE HUHNKE 3.00 X 0 0 0 KARIN MATURA 3.00 X 0 0 0 THOMAS SLOTA 5.00 40.00 X 0 177598 13828 0 602882 101441 0 0 1 0 BLUE CROSS BLUE SHIELD 1211 W 22ND ST OAK BROOK IL 60523 PROVIDER NETWORK 400129 ELITE ADMINISTRATION 300 E RANDOLPH CHICAGO IL 60601 CLAIM ADMINISTRATOR 229456 2 EMPLOYER CONTRIBUTIONS 900099 14153463 14153463 PARTICIPANT CONTRIBUTIONS 900099 109732 109732 14263195 197199 197199 4115000 4107078 7922 7922 7922 14468316 14468316 0 0 13280934 16750 126 35763 REIMBURSEED ADMIN EXPEN 59040 REIMBURSEED ADMIN EXPEN 29340 BANK FEES 5777 EXCISE TAX 1156 13428886 141128 -228595 13612516 14395476 748017 1426947 6144672 6010242 20646333 21604070 216106 253458 1375092 1399492 1591198 1652950 X 0 0 0 0 19055135 19951120 19055135 19951120 20646333 21604070 1039430 -143445 0 X X 0 1 X 1 0 0 INCURRED, UNREPORTED & CLAIMS PAYABLE 1339400 DUE TO RELATED ORGANIZATION 60092 1399492 X 14324871 -143445 -143445 14468316 0 14468316 13404486 0 13404486 24400 24400 13428886 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: THE PLAN MANAGEMENT HAS ANALYZED THE POSITIONS TAKEN BY THE PLAN AND HAVE CONCLUDED AS THAT OF OCTOBE 31, 2013 THERE ARE NO UNCERTAIN TAX POSITIONS TAKEN OR THAT WOULD REQUIRE RECOGNITION OF A LIABILITY (OR ASSET) OR DISCLOSURE IN THE FINANCIAL STATEMENTS. PART XII, LINE 4B - OTHER ADJUSTMENTS: INCREASE IN INCURRED BUT NOT REPORTED & CLAIMS PAYABLE 0 0 0 PATRICK DUFF 0 194904 0 16424 0 10576 0 33257 0 10721 0 265882 0 0 JOHN DUFF III 0 183439 0 15287 0 4654 0 32914 0 10721 0 247015 0 0 THOMAS SLOTA 0 163937 0 13661 0 0 0 3107 0 10721 0 191426 0 0 FORM 990, PART VI, SECTION A, LINE 2 PATRICK DUFF, TRUSTEE AND JOHN DUFF III, TRUSTEE ARE BROTHERS FORM 990, PART VI, SECTION A, LINE 8B THERE ARE NO COMMITTEES FORM 990, PART VI, SECTION B, LINE 11 THE PLAN ADMINISTRATOR REVIEWS THE FORM WITH THE PLAN'S OUTSIDE ACCOUNTANTS FORM 990, PART VI, SECTION B, LINE 15 TRUSTEES RECEIVE NO COMPENSATION FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS AND TAX FILINGS ARE MADE AVAILABLE UPON REQUEST. FORM 990 IS ALSO AVAILABLE ON THE GUIDESTAR WEBSITE THE PROCESS HAS NOT CHANGED LOCAL 3 HEALTH AND WELFARE 1640 W VAN BUREN CHICAGO IL 60612 362947574 INSURANCE IL 501(C)(9) N/A 0 LOCAL 3 PENSION FUND 1640 W VAN BUREN CHICAGO IL 60612 516035372 DB PENSION IL 401 N/A 0 LOCAL 3 PENSION FUND SALES DIVISION 1640 W VAN BUREN CHICAGO IL 60612 366527340 DB PENSION IL 401 N/A 0 LOCAL 3 401K PLAN 1640 W VAN BUREN CHICAGO IL 60612 367270398 401K PLAN IL 401 N/A 0 LOCAL 3 UNION 1640 W VAN BUREN CHICAGO IL 60612 364044987 UNION IL 501(C)(5) N/A 0 CLARK FOAM LIQUOR AND ALLIED WORKERS IL C 0 HERITAGE WINE CO LIQUOR AND ALLIED WORKERS IL C 0 MIDWAY WHOLESALERS LIQUOR AND ALLIED WORKERS IL C 0 POWER DISTRIBUTING LIQUOR AND ALLIED WORKERS IL C 0 SOUTHERN WINE & SPIRITS OF ILLINOIS LIQUOR AND ALLIED WORKERS IL C 0 TENSING WINE & SPIRITS LIQUOR AND ALLIED WORKERS IL C 0 WIRTZ BEVERAGE IL LIQUOR AND ALLIED WORKERS IL C 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 LOCAL 3 SALES PENSION FUND N LOCAL 3 SALES PENSION FUND O LOCAL 3 SALES PENSION FUND P 59040 EXPENSE ALLOCATION LOCAL 3 UNION N LOCAL 3 UNION O LOCAL 3 UNION P 29340 EXPENSE ALLOCATION