2013-10-03T11:27:02-05:00 2012-12-31 410746749 CLIFTONLARSONALLEN LLP 220 SOUTH SIXTH STREET SUITE 300 MINNEAPOLIS MN 55402 990 2012-01-01 416023461 MINNESOTA & NORTH DAKOTA BRICKLAYERS & ALLIED CRAFTWORKERS HEALTH FUND MINN 6512561801 2520 PILOT KNOB ROAD NO 325 MENDOTA HEIGHTS MN 55120 MICHAEL COOK 6512561801 2013-10-01 1 DOUG BERTOSSI P00637990 6123764500 2012 2016-02-25 16:41:14Z MICHAEL COOK 2520 PILOT KNOB ROAD NO 325 MENDOTA HEIGHTS MN 55120 44100536 0 X N/A X 1961 MN PROVIDE HEALTH & WELFARE BENEFITS TO UNION MEMBERS AND THEIR DEPENDENTS. 8 8 18 10 0 0 0 0 14645194 15838781 2729693 2577659 7555 0 17382442 18416440 0 0 18292355 19298152 0 0 0 0 0 1326112 1384515 19618467 20682667 -2236025 -2266227 55472790 56717958 566047 379872 54906743 56338086 PROVIDE HEALTH AND WELFARE BENEFITS TO UNION MEMBERS AND THEIR DEPENDENTS. 0 0 PAYMENT OF HOSPITAL, MEDICAL, DENTAL, DISABILITY, DEATH, AND VISION BENEFITS FOR 1,844 UNION MEMBERS 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 0 0 1 0 0 0 0 0 0 0 0 0 1 0 0 1 258 0 18 1 0 0 0 0 0 0 X 8 8 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 0 1 0 0 0 X ZENITH AMERICAN SOLUTIONS 6512561900 2520 PILOT KNOB ROAD 325 MENDOTA HEIGHTS MN 55120 X MICHAEL COOK 1.00 2.00 X X 0 0 0 ROGER BUIRGE 1.00 0.00 X 0 0 0 MIKE HAWTHORNE 1.00 2.00 X 0 0 0 MARK CARON 1.00 0.00 X 0 0 0 PAUL WIESE 1.00 0.00 X X 0 0 0 RON RASLEY 1.00 0.00 X 0 0 0 MONICA KELLEY 1.00 1.00 X 0 0 0 MICHAEL LAPENSKY 1.00 0.00 X 0 0 0 FRANK GRAZZINI II 1.00 0.00 X 0 0 0 MICHAEL GANZ 1.00 1.00 X 0 0 0 0 0 0 0 0 0 0 ZENITH AMERICAN SOLUTIONS 2520 PILOT KNOB ROAD 325 MENDOTA HEIGHTS MN 55120 PLAN ADMINISTRATOR 806175 MEDICA DBA SELECT CARE ROUTE CP260 401 CARLSON PKWY PO BO MINNEAPOLIS MN 554409310 PPO 261975 FELHABER LARSON FENLON & VOGT 444 CEDAR STREET SUITE 2100 ST PAUL MN 551012136 LEGAL 159594 3 CONTRIBUTIONS 525100 15838781 15838781 15838781 1489874 1489874 26771881 25684096 1087785 1087785 1087785 18416440 15838781 0 2577659 19298152 823770 159594 23985 135939 99872 114465 11363 15527 20682667 4430200 2037871 3303512 7812335 1039691 1211000 36309 45839035 45321654 689043 470098 55472790 56717958 125404 155963 440643 223909 566047 379872 X 0 0 0 0 54906743 56338086 54906743 56338086 55472790 56717958 -2266227 3697570 0 X 0 1 X 1 0 0 ADVANCE CONTRIBUTIONS FROM EMPLOYEES FOR FUTURE COVERAGE 223909 223909 X 21978071 3697570 3697570 18280501 135939 135939 18416440 20546728 0 20546728 135939 135939 20682667 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: THE TRUST ESTABLISHED UNDER THE PLAN TO HOLD THE PLAN'S ASSETS IS INTENDED TO QUALIFY PURSUANT TO SECTION 501(C)(9) OF THE INTERNAL REVENUE CODE AND, ACCORDINGLY, THE TRUST'S NET INVESTMENT INCOME IS EXEMPT FROM INCOME TAXES. THE TRUST HAS OBTAINED A TAX EXEMPTION LETTER FROM THE INTERNAL REVENUE SERVICE AND THE BOARD OF TRUSTEES BELIEVES THAT THE TRUST, AS AMENDED, CONTINUES TO QUALIFY AND TO 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 DECEMBER 31, 2012 AND 2011, 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. ALL AGAPE CONTRIBUTING EMPLOYER LATE CONTRIBUTIONS X 5973 5973 0 0 0 BLACKHAWK TILE & STONE CONTRIBUTING EMPLOYER LATE CONTRIBUTIONS X 973 973 0 0 0 COMMERCIAL MASONRY CONTRIBUTING EMPLOYER LATE CONTRIBUTIONS X 4622 4622 0 0 0 CONSTRUCTION 25 LLC CONTRIBUTING EMPLOYER LATE CONTRIBUTIONS X 1892 1892 0 0 0 DAVIS MASONRY CONTRIBUTING EMPLOYER LATE CONTRIBUTIONS X 4018 4018 0 0 0 HICKS CONCRETE CONTRIBUTING EMPLOYER LATE CONTRIBUTIONS X 4018 4018 0 0 0 LAKE COUNTRY MASONRY CONTRIBUTING EMPLOYER LATE CONTRIBUTIONS X 5740 5740 0 0 0 RICE LAKE CONSTRUCTION CONTRIBUTING EMPLOYER LATE CONTRIBUTIONS X 8685 8685 0 0 0 TAILORED FOAM CONTRIBUTING EMPLOYER LATE CONTRIBUTIONS X 63 63 0 0 0 UNITED REFRACTORIES CONTRIBUTING EMPLOYER LATE CONTRIBUTIONS X 325 325 0 0 0 36309 FORM 990, PART VI, SECTION B, LINE 11 FORM 990 WAS REVIEWED BY THE BOARD OF TRUSTEES IN CONJUNCTION WITH THE REVIEW OF THE ANNUAL AUDIT. FORM 990, PART VI, SECTION B, LINE 12C THE POLICY IS DISCUSSED ANNUALLY BY THE BOARD OF TRUSTEES TO ENSURE THE TRUSTEES UNDERSTAND THE CONFLICT OF INTEREST POLICY AND UNDERSTANDS THE FUND IS A TAX-EXEMPT ORGANIZATION THAT MUST ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX EXEMPT PURPOSES. PER THE POLICY, ANY PERSON DISCOVERING A CONFLICT SHOULD DISCLOSE IT IMMEDIATELY TO THE CHARIMAN OF THE BOARD OF TRUSTEES. THE BOARD OF TRUSTEES DETERMINES IF A CONFLICT EXISTS AND MAY PLACE APPROPRIATE RESTRICTIONS ON THE INDIVIDUAL OR TRANSACTIONS AFFECTED AT THEIR DISCRETION. ANY CONFLICTS ARE DOCUMENTED IN MEETING MINUTES. NO SUCH CONFLICTS AROSE DURING THE YEAR. FORM 990, PART VI, SECTION C, LINE 19 THE FUND'S GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST; HOWEVER THE CONFLICT OF INTEREST POLICY IS NOT MADE AVAILABLE. MN & ND BRICKLAYERS AND ALLIED CRAFTSWORKERS PENSION FUND 2520 PILOT KNOB RD MENDOTA HEIGHTS MN 55120 516029930 PROVIDE RETIREMENT BENEFITS TO UNION MEMBERS. MN N/A 0 MN & ND BRICKLAYERS AND ALLIED CRAFTSWORKERS VACATION FUND 2520 PILOT KNOB RD MENDOTA HEIGHTS MN 55120 237068471 PROVIDE VACATION BENEFITS TO UNION MEMBERS. MN 501(C)(9) N/A 0 MN & ND BRICKLAYERS AND ALLIED CRAFTSWORKERS APPRENTICE FUND 328 UNITED LABOR CTR 312 CENTRAL AV MPLS MN 55414 416319702 PROVIDE TRAINING AND RETRAINING TO CURRENT AND PROSPECTIVE UNION MEMBERS. MN 501(C)(4) N/A 0 MINNESOTA CERAMIC TILE AND ALLIED TRADES RETIREMENT FUND 2520 PILOT KNOB RD MENDOTA HEIGHTS MN 55120 416059404 PROVIDE RETIREMENT BENEFITS TO UNION MEMBERS. MN N/A 0 BRICKLAYERS LOCAL #1 SUITE 328 MINNEAPOLIS MN 55414 LABOR UNION MN 501(C)(5) 0 BRICKLAYERS LOCAL #1 APPREN SUITE 328 MINNEAPOLIS MN 55414 TRAINING UNION MEMBERS MN 501(C)(4) 0 CITY OF ST PAUL 15 WEST KELLOGG BLVD ST PAUL MN 55102 GOVERNMENT MN 509(A)(1) 0 CMS LLC MN 0 0 A D B CONSTRUCTION CO INC MN 0 A J SPANJERS CO 0 A&M CONSTRUCTION INC 0 ACME TUCKPOINTING & RESTOR MN 0 ADVANCE TERRAZZO & TILE CO MN 0 ADVANCE TERRAZZO & TILE CO MN 0 ADVANCED MASONRY RESTORATION 0 ALVIN BENIKE INC MN 0 AMERICAN MAS RESTORATION CORP MN 0 AXEL H OHMAN INC MN 0 B & D ASSOCIATES INC MN 0 B & M MASONRY INC 0 B & M MASONRY INC 0 BEDROCK-FLINT INC 0 BEDROCK-FLINT INC MN 0 BLACKHAWK TILE & STONE INC 0 BOB'S SPARKLE WASH MN 0 BRICKLAYERS LOCAL #1 0 C R MEYER & SONS COMPANY 0 CAMCO CONSTRUCTION INC MN 0 CARCIOFINI COMPANY INC MN 0 CD TILE & STONE INC MN 0 CD TILE & STONE INC MN 0 CHAMPION STEELE & CONCRETE LLC 0 CHESLEY AND SONS INC 0 CITY OF MINNEAPOLIS 0 CMS LLC 0 COMMERCIAL MASONRY INC MN 0 COMMERCIAL SPECIALTY CONTRACT 0 CON'S MASONRY INC MN 0 CONSTRUCTION & TURNAROUND SERV 0 CONSTRUCTION SPECIALISTS INC 0 CONTRACT CAULKING MN 0 CONTRACT TILE & CARPET INC 0 CROSSTOWN MASONRY INC MN 0 D J KRANZ CO INC 0 D R FRANTZ CONCRETE CONST 0 DAROLD BERGER MASONRY INC 0 DAROLD BERGER MASONRY INC 0 DAYCO CONCRETE MN 0 DEBCON II DBA O'CONNOR CONST 0 DEL'S CONSTRUCTION CO INC MN 0 DZIEDZIC CAULKING INC MN 0 EICHOLTZ MASONRY INC MN 0 EXTERIOR BUILDING SERVICES INC 0 FABCON INC MN 0 FLEMMING TILE INC 0 FRANDRUP MASONRY INC MN 0 GABEL MASONRY CONSTRUCTION INC 0 GEORGE SIEGFRIED CONST CO MN 0 GLASS DESIGN INC MN 0 GORDON CONST OF MAHNOMEN INC 0 GRANITE-TOPS INSTALLATION INC MN 0 GRAZZINI BROTHERS CO MN 0 GRESSER COMPANIES INC 0 HANSON STRUCT PRCST MIDWST INC 0 HARBOR CITY MASONRY INC MN 0 HARBOR CITY MASONRY INC 0 HARBOR CITY MASONRY INC MN 0 HARLAN FALCK & SON INC 0 HARRISON TILE CO INC 0 HAUGEN MASONRY CONTRACTORS INC MN 0 HAUGEN MASONRY CONTRACTORS INC MN 0 HAWKEYE FLOORING COMPANY 0 HEYMANN CONSTRUCTION CO MN 0 HEYMANN CONSTRUCTION CO MN 0 HOLLENBACK & NELSON INC MN 0 HOVLAND INC MN 0 HUESMAN SCHREIBER MASONRY MN 0 INCOR INSTALLATION INC MN 0 INDUSTRIAL MAINTENANCE SERVICE MN 0 INSTALLATION CONCEPTS INC 0 INTERNAT'L MASONRY INSTITUTE 0 J E DUNN CONSTRUCTION COMPANY 0 JAMES STEELE CONSTRUCTION CO MN 0 JOHNNY MASONRY INC MN 0 JOHNSON & NELSON 0 JOHNSON & NELSON MN 0 JOHNSON CARPET MN 0 KASELLA CONCRETE INC MN 0 KASELLA CONCRETE INC MN 0 KIFFMEYER INC 0 KIFFMEYER INC 0 KNUTSON CONSTRUCTION SERVICES 0 KNUTSON CONSTRUCTION SERVICES 0 LAKE COUNTRY MASONRY INC 0 LAKEHEAD CONSTRUCTORS INC MN 0 LANGER CONSTR CO 0 LEE'S CERAMICS INC MN 0 LOAHR BROTHERS TILE & MARBLE MN 0 LONDON BRICK 0 LOUHI & KIVELA MASONRY INC MN 0 M A MORTENSON CO 0 MACPHERSON-TOWNE CO MN 0 MAERTENS-BRENNY CONSTRUCTION MN 0 MARKET & JOHNSON INC MN 0 MARKET & JOHNSON INC MN 0 MAVERICK CUTTING & BREAKING 0 MCGOUGH CONSTRUCTION CO INC MN 0 METROPOLITAN TILE & MARBLE 0 MIDWESTERN MASONRY INC 0 MIDWESTERN MASONRY INC 0 MORTENSON MASONRY INC 0 MORTENSON MASONRY INC 0 NATUS INSTALLATIONS MN 0 NEECK CONSTRUCTION INC MN 0 NIKKEL TILE INC 0 NORTHLAND CONCRETE & MASONRY 0 NORTHWESTERN MARBLE & GRANITE 0 OPUS CORPORATION 0 PARAMOUNT CONCRETE & MAS INC MN 0 REFRACTORY SERVICE INC 0 RENAISSANCE CERAMIC INC MN 0 RESCH'S TILE INC 0 RESTORATION SYSTEMS INC MN 0 RICE LAKE CONSTRUCTION GROUP 0 RICE LAKE CONSTRUCTION GROUP 0 RIGHTWAY CAULKING MN 0 RON NELSON MASONRY INC MN 0 ROYL MASONRY MN 0 SEAL-TREAT INC MN 0 SEBCO INC 0 SERICE CONSTRUCTION INC MN 0 SHEEHY CONSTRUCTION CO MN 0 SHOTLEY CONSTRUCTION INC MN 0 SMITH-SHARPE FIRE BRICK SUPPLY MN 0 ST PAUL PUBLIC SCHOOLS 0 STEENBERG - WATRUD CONST INC MN 0 STRETAR MASONRY & CONCRETE INC MN 0 STRETAR MASONRY & CONCRETE INC 0 STRETAR MASONRY & CONCRETE INC MN 0 STRIPE RIGHT INC MN 0 SUMMIT CONCRETE & MAS CONST 0 SUNRISE SPECIALTY CONTR MN 0 SUPERIOR WATERPROOFING 0 TAILORED FOAM INC NC 0 TCR ENTERPRISES DBA J&K MASON 0 TCR ENTERPRISES DBA J&K MASON 0 TED KENNE CONSTRUCTION 0 THE CAULKERS COMPANY INC 0 THE CAULKERS COMPANY INC 0 THE JAMAR COMPANY 0 TWIN CITY TILE & MARBLE CO 0 TWIN CITY TILE & MARBLE CO 0 UNITED MASONRY INC 0 UNITED REFACTORIES INC 0 WEISE MASONRY INC 0 WELLS CONCRETE PRODUCTS CO 0 WESTERN WATERPROOFING 0 WESTERN WATERPROOFING 0 WESTERN WATERPROOFING 0 WTG TERRAZZO & TILE INC 0 YAW CONSTRUCTION GROUP INC MN 0 YOUNG MASONRY INC 0 ZACHMAN PRECAST INC 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 RELATED ORGANIZATIONS TAXABLE AS AN INDIVIDUAL OR SOLE PROPRIETOR SCHEDULE R HANSON MASONRY & CONCRETE LLC RELATED ORGANIZATIONS WITH UNIDENTIFIED ENTITY TYPE SCHEDULE R A & L CONSTRUCTION INC. ATOMIC ARCHITECTUAL SHEET METAL BAC INTERNATIONAL FUND C.E. KORSGARD COMPANY CARLSON-LAVINE, INC. EAGLE CAULKING EXCALIBUR CAULKING, INC. GEORGE P REINTJES CO INC. HICKS CONCRETE CONST HINES & SONS, INC. INTEGRITY TILE & STONE, LLC LANDWEHR CONSTR CO M C MAGNEY CONST MIRON CONSTRUCTION CO., INC. MOLIN CONCRETE PRODUCTS S & L MASONRY SCHAHN CONSTRUCTION SERVICES SPECIAL SCHOOL DISTRICT #1 SPS INFRASTRUCTURE INC STONE CONSTRUCTION INC. TOTAL CONSTRUCTION & EQUIPMENT TRI STATE MASONRY UNIVERSITY OF MINNESOTA