2013-10-08T11:57:11-05:00 2012-12-31 522385296 LINDQUIST LLP 5000 EXECUTIVE PARKWAY SUITE 400 SAN RAMON CA 945834346 990 2012-01-01 936021113 UNITED ASSOC LOC NO 290 PLUMBER STEAMFITTER & SHIPFITTER IND H & W PLAN UNIT 5034543800 7600 SW MOHAWK STREET TUALATIN OR 97062 ED GORMLEY 5034543800 2013-10-08 1 LORI L SCOTT P01452038 9252779100 2012 2016-02-24 21:20:13Z ED GORMLEY POBOX 117 1715 LAFAYETTE MCMINNVILLE OR 97128 156618654 0 X N/A X 1957 OR PROVIDE HEALTH AND WELFARE BENEFITS. 8 0 117 0 0 0 0 0 40909343 48038661 1441801 1834498 400324 647607 42751468 50520766 0 0 39450338 49830199 0 0 0 0 0 1212787 1423860 40663125 51254059 2088343 -733293 66614294 74554348 25481144 32198130 41133150 42356218 TO PROVIDE HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS. 0 0 PROVIDED HEALTH, DENTAL, VISION, TIME LOSS, LIFE INSURANCE AND AD & D BENEFITS FOR ELIGIBLE PARTICIPANTS. 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 0 0 0 0 0 0 0 0 0 0 1 0 0 1 2095 0 1 117 1 0 0 0 0 0 0 X 8 0 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X ASSOCIATED THIRD PARTY ADMINISTRATORS 5034543800 7600 SW MOHAWK STREET TUALATIN OR 97062 X ED GORMLEY 1.00 X 0 0 0 LOU CHRISTIAN 1.00 X 0 0 0 FRANK WALL 1.00 X 0 0 0 DAN SMITH 1.00 X 0 0 0 MIKE ANDERSON 1.00 X 0 0 0 JOHN ENDICOTT 1.00 X 0 0 0 KEN EDENS 1.00 X 0 0 0 JON BERRY 1.00 X 0 0 0 AL SHROPSHIRE 1.00 X 0 0 0 RUSS HILL 1.00 X 0 0 0 BILL MEHRENS 1.00 X 0 0 0 0 0 0 0 0 0 0 ASSOCIATED THIRD PARTY ADMINISTRATORS 7600 SW MOHAWK STREET TUALATIN OR 97062 CONTRACT ADMINISTRATOR 880202 INNOVATIVE CARE MANAGEMENT INC 12300 SE MALLARD WAY SUITE 265 MILWAUKIE OR 97222 MEDICAL MANAGEMENT 129043 2 EMPLOYER CONTRIBUTIONS 900099 41121628 41121628 SUBSIDY FROM OTHER PLAN 900099 3429687 3429687 PARTICIPANT CONTRIBUTIONS 900099 3180369 3180369 MEDICARE-RETIREE DRUG SUBSIDY 900099 301184 301184 COBRA SUBSIDY 900099 5793 5793 48038661 1834498 1834498 106097888 106097888 0 PRESCRIPTION REBATES 900099 437377 437377 CCL DISTRIBUTION 900099 210224 210224 MISCELLANEOUS INCOME 900099 6 6 647607 50520766 48686268 0 1834498 49830199 880202 92927 39233 24253 188330 147619 18817 27055 MISCELLANEOUS 4290 UA RECIPROCITY FEES 1134 51254059 1286743 497679 21025085 12776166 5315578 3694334 9320 8868 38977568 57577301 66614294 74554348 1218949 564047 263895 265283 23998300 31368800 25481144 32198130 X 0 0 0 0 41133150 42356218 41133150 42356218 66614294 74554348 -733293 1956361 0 X X 0 1 X 1 0 0 ACCUMULATED ELIGIBILITY CREDITS 28265000 CLAIMS PAYABLE AND INCURRED BUT NOT REPORTED 3103800 31368800 X 52452874 1956361 1956361 50496513 24253 24253 50520766 43859306 0 43859306 24253 7370500 7394753 51254059 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE THE TAX POSITIONS TAKEN BY THE PLAN AND TO RECOGNIZE A TAX LIABILITY IF THE PLAN HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE PLAN AND HAS CONCLUDED THAT, AS OF DECEMBER 31, 2012, 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 BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR THE YEARS PRIOR TO 2009. PART XII, LINE 4B - OTHER ADJUSTMENTS: CHANGE IN BENEFIT OBLIGATIONS FORM 990, PART VI, SECTION A, LINE 3 THE PLAN HAS CONTRACTED WITH ASSOCIATED THIRD PARTY ADMINISTRATORS TO PROVIDE ADMINISTRATIVE SERVICES FOR THE ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 11 A COPY OF THE ORGANIZATION'S FORM 990 WAS PROVIDED TO EACH VOTING MEMBER OF THE GOVERNING BODY OF THE ORGANIZATION PRIOR TO ITS FILING WITH THE IRS. ALSO, THE ORGANIZATION'S ATTORNEY AND THE CHAIRMAN OF THE BOARD OF TRUSTEES READ THE FORM 990 FOR COMPLETENESS AND ACCURACY, PRIOR TO FILING THE FORM WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION ADOPTED THEIR CONFLICT OF INTEREST POLICY DURING MARCH 2009. THE POLICY COVERS ALL TRUSTEES AND SERVICE PROVIDERS. THE POLICY PROVIDES FOR AN ANNUAL REVIEW OF PARTY-IN-INTEREST TRANSACTIONS; THE ADMINISTRATOR AND LEGAL COUNSEL ARE TO DISTRIBUTE PARTY-IN-INTEREST INQUIRIES AND REVIEW RESPONSES TO THE INQUIRIES. 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 XII, LINCE 2C: THE BOARD OF TRUSTEES IS RESPONSIBLE FOR OVERSIGHT OF THE ANNUAL AUDIT AND FOR SELECTION OF THE INDEPENDENT ACCOUNTANT. THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. SEE EXPLANATION PART VII VARIOUS CA UA LOCAL 290 401K PLAN 7600 SW MOHAWK ST TUALATIN OR 97062 931143757 TO PROVIDE RETIREMENT BENEFITS. OR 501A N/A N/A 0 UA LOCAL 290 PENSION PLAN 7600 SW MOHAWK ST TUALATIN OR 97062 936021114 TO PROVIDE PENSION BENEFITS. OR 501A N/A N/A 0 UA LOCAL 290 RETIREE HEALTH 7600 SW MOHAWK ST TUALATIN OR 97062 931143759 TO PROVIDE HEALTH AND WELFARE BENEFITS. OR 501(C)(9) N/A N/A 0 UA LOCAL 290 EDUCATION REIMBSCHOLORSHIP & VACATION PLAN 7600 SW MOHAWK ST TUALATIN OR 97062 931255764 TO PROVIDE VACATION, SCHOLARSHIP AND EDUCATIONAL REIMBURSEMENT BENEFITS. OR 501(C)(9) N/A N/A 0 UNITED ASSOCIATION OF JOURNEYMEN & LOCAL 290 20210 SW TETON AVE TUALATIN OR 97062 930895184 LABOR ORGANIZATION OR 501(C)(5) N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 UNITED ASSOC UNION LOC #290 PLUMBER STEAMFITTER & SHIPFITTER IND RET HEAL S 3429687 OBTAINED FROM THE PLAN'S RECORDS. 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, 2012, THERE ARE APPROXIMATELY 191 EMPLOYERS THAT CONTRIBUTE TO THE TRUST. THE ADMINISTRATIVE OFFICE MAINTAINS A DATABASE OF THESE 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. A & A DRILLING ABINGDON PLUMBING & HEATING ACCURATE CONCRETE CUTTING, INC. ADDISON PLUMBING LLC ADVANCED PNEUMATIC TUBES, INC ADVANCED TECHNOLOGY GROUP INC AIR PRIDE INC. AIRTRONIX ALBINA PIPE BENDING CO INC ALLIANT SYSTEMS, LLC ALPINE BUILDING SERVICES INC AM TECHNICAL SOLUTIONS, INC APOLLO SHEET METAL APPLIED MECH TECH & CONCEPTS INC ARCTIC SHEET METAL, INC AUBURN MECHANICAL INC BASELINE INDUSTRIAL CONSTRUCTION, INC BAY CITIES FABRICATORS BEAVER CONCRETE CUTTING BEDROCK CONCRETE CUTTING INC BELL PRODUCTS INC BILL BAILEY PLUMBING INC BMWC CONSTRUCTORS, INC BOANERGES GROUP, LLC BOHEMIA PLUMBING AND CONST BOILER & COMBUSTION SERVICE INC BROTHERS PLUMBING, LLC BRYAN MEARS PLUMBING, LLC BUILDING ENERGY LLC.COM C.J. HANSEN CO, INC CALEDONIA PLUMBING CARD PLUMBING AND HEATING CO CARR ELECTRICAL TECH, INC CARRIER BUILDING SERVICES CARTER MECHANICAL CASCADE ENERGY SOLUTIONS, LLC CASCADE GENERAL INC CASCADE HYDRO AIR OF OREGON LLC CENTRAL WASHINGTON REFRIGERATION LLC CHAMBERS PLUMBING & HEATING INC CHANDLER PLBG, HTG & REFRIG CHARTER MECHANICAL CONTRACTORS INC CHINOOK PLUMBING CHRISTENSON ELECTRIC, INC COMMERCIAL PIPING CO; DBA GORMLEY PLUMBING AND HEATING COMMERCIAL REFRIGERATION INC CONSTRUCTION SOLUTIONS, INC CONTROL CONTRACTORS, INC COUNTRY PLUMBING INC CR MEYER CRAIG ANDERSON PLUMBING INC CROREY MECHANICAL ENGINEERING & CONSTRUCTION, INC D & F PLUMBING INC DARCO MECHANICAL DEAN WARREN PLMG & REMODEL DESERT PLUMBING & HEATING CO, IN DETEMPLE COMPANY INC DEVCO MECHANICAL DLH GENERAL CONTRACTOR INC DR. HVAC, INC. E C COMPANY EMK MECHANICAL F M SHEET METAL FAB-TEC FINISH LINE CONCRETE CUTTING INC. FLUOR MAINTENANCE SERVICES FUITEN MECHANICAL INC., DBA FUITEN'S PLUMBING & HEATING CO. GEO. A. MORLAN PLUMBING & APPLIANCE CO., INC. GERAGHTY MECHANICAL, INC GOZA PLUMBING, INC GRAY BEAR CONSTRUCTION CO. HARDER MECHANICAL CONTRACTORS INC. HARVEY & PRICE COMPANY HEINZ BUILDING AUTOMATION, INC HEINZ MECHANICAL INC. HEINZ MECHANICAL SERVICE, INC HILL CONSTRUCTION HOFFMAN MECHANICAL HOLLINGSWORTH PLUMBING INC HONEYWELL INTERNATIONAL INC. HOOD RIVER PLUMBING & HEATING INC. HOODLAND PLUMBING, INC HOOVER COMMERCIAL REFRIG INC. IDEAL PLUMBING CO INDUCCO, INC ISLAND MECHANICAL INC J H KELLY J P PLUMBING CO INC JAY JAY'S PLUMBING INC JOHN BURGER HEATING AND AC JOHN CRAIG PLUMBING JOHNSON CONTROLS JONES PLUMBING & HEATING INC. JR MERIT, INC K2 MECHANICAL, INC KAUFMANN PLUMBING AND MECHANICAL LLC KENNY PLUMBING CO KEY MECHANICAL CO OF WASHINGTON KINETIC SYSTEMS, INC LILJA CORPORATION LITCH PLUMBING, INC. LOY CLARK PIPELINE LYNCH MECHANICAL CONST CO LLC M P P PIPING INC MACDONALD-MILLER FACILITY SOLUTIONS, INC MACKIN & LITTLE, INC MAPLESERVICE INC MARLEY COOLING TOWER MCCLINTOCK & TURK, INC MCKINSTRY CO LLC MCMINNVILLE HEATING & A/C MCT SERVICES MEDFORD MECHANICAL INC MILWAUKIE HEATING & COOLING MISSION PLUMBING SERVICE MORGAN MILLWRIGHT & MECHANICAL SERVICES MORGAN MILLWRIGHT & MECHANICAL SERVICES, INC MURRAY COMPANY NAES POWER CONTRACTORS INC NORTHWEST CONTROL COMPANY INC NORTHWEST METAL FAB & PIPE INC NORTHWEST PLUMBING & BACKFLOW INC NW INDUSTRIAL MECHANICS, INC NW MECHANICAL CONTRACTORS LLC NW MECHANICAL GROUP, LLC OR & SW WA FAIR CONTRACTING FOUNDATION OREGON AIR REPS DBA ENVIRONMENTAL CONTROL CORP OREGON EQUIPMENT SERVICE CORP OREGON MECHANICAL INC OTTO PIPE CONSTRUCTION LLC PARAZOO PLUMBING, LLC PARKS PLUMBING & MECHANICAL, INC PATTERSON PLUMBING CO PELICAN BAY STATE PRISON PENHALL COMPANY PENINSULA PLUMBING CO PERMACOLD ENGINEERING, INC PHILLIPS REFRIGERATION CO PLUMBCRAZY PLUMBING & MECHANICAL CONTRACTORS ASSN PONDER BURNER CO. PORT OF VANCOUVER USA PORTLAND MECHANICAL CONSTRUCTION, INC DBA PLUMBING & MECHANICAL CONTRACTORS GROUP POWER PLUMBING CO PROCESS PIPING FABRICATION, LLC PROFESSIONAL MECHANICAL INC PROGRESSIVE MECHANICAL INC PURE COMMERCIAL PLUMBING RESOURCE MANAGEMENT RICHARD GIFFORD DBA: EAGLE LAKE PLUMBING RMS ENTERPRISES LLC DBA CROWN PLUMBING ROB'S SUPERIOR PLUMBING, INC ROCKFORD CORPORATION ROCKY'S MECHANICAL SERVICE ROSENDIN ELECTRIC, INC S F S, INC DBA SPECIALTY FIRESTOPING SYSTEMS S&D IRONWORKS S-2 INDUSTRIAL S3H, INC SANDPIPER PLUMBING SAVID INC DBA ROSE CITY PLUMBING SFB INC SIEMENS INDUSTRIES INC SKYLINE PLUMBING, LLC SNELSON COMPANIES, INC STEVE'S PLUMBING TEMP-CONTROL MECH SERVICE CORP TEMP-CONTROL MECHANCAL CORP THERMOPOWER INDUSTRIES INC TI TECH LLC TIMBER VALLEY PLUMBING TITTEL ENTERPRISES, INC. TOTAL MECHANICAL INC TOTAL RESOURCE, INC TRANE OREGON TRIAD MECHANICAL, INC TUTOR-SOLIBA CORP TWIN RIVERS PLUMBING U & I PLUMBING, LLC U A LOCAL 290 U A LOCAL 290 TRAINING CTR UNIVERSITY MECHANICAL CONT. USA MECHANICAL, INC VAN ROW MECH, LLC WACHS TECHNICAL SERVICES, LTD WATSON PLUMBING CO WAYNE MAPLES PLUMBING & HEATING WEST COAST MECHANICAL CONTRACTORS WEST LANE PLUMBING & HEAT WILLIAMS MECHANICAL INC YMC, INC.