2011-02-15T17:09:34-06:00 2010-04-30 lINDQUIST llp 5000 executive pkwy 400 san ramon CA 94583 990 2009-05-01 941206350 CALIFORNIA SVC EMPLOYEEs HEALTH & WELFARE TRUST FUND CALI 5104334452 1640 south loop road alameda CA 94502 CHARLIE GILCHRIST 5104334452 2011-02-16 1 9252779100 2009 2016-02-24 21:20:13Z CHARLIE GILCHRIST 1640 south loop road alameda CA 94502 180732164 0 X n/a X 1951 CA to provide health and welfare benefits to eligible members and their dependents 4 2 20 0 0 0 0 64413537 73223916 2666550 2930759 455 0 67080542 76154675 0 59855128 69815926 408310 406373 0 0 2498093 1891745 62761531 72114044 4319011 4040631 99634605 113164723 17624753 19389390 82009852 93775333 To provide health and welfare benefits to eligible participants and their dependents. 0 0 provided health and welfare benefits to eligible participants and their dependents. 0 0 0 0 0 0 0 0 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 0 0 0 1 913 0 1 20 1 0 0 0 0 0 4 2 0 1 0 0 0 0 0 1 1 0 0 1 0 1 1 1 1 0 X assoc third party administrators 5104334452 1640 south loop road alameda CA 94502 David Stilwell 0.50 X 0 0 0 mike garcia 0.30 X 0 0 0 charlie gilchrist 5.00 X 14400 0 15631 ray nann 5.00 X 14400 0 15631 Larry T Smith 0.50 X 0 0 0 28800 0 31262 0 0 0 0 ASSOCIATED THIRD PARTY ADMINISTRATORS 989 MARKET STREET SUITE 320 San Francisco CA 94104 FUND ADMINISTRATION 768546 MCMORGAN & COMPANY 425 MARKET STREET SUITE 1600 SAN FRANCISCO CA 94105 INVESTMENT MANAGER 194356 Lindquist LLP 5000 Executive Parkway STE 400 San Ramon CA 94583 Auditing and Accounting Services 177285 Saltzman & Johnson Law Corporation 44 Montgomery Street Ste 2110 San Francisco CA 94104 Legal Services 151261 4 Employer Contributions 900099 71735522 71735522 Employee Contributions 900099 905095 905095 Stop Loss Income 900099 582527 582527 Other Income 900099 772 772 73223916 3430594 3430594 104077654 104577489 -499835 -499835 -499835 76154675 73223916 0 2930759 69815926 60062 244125 25708 48712 27766 696697 180136 188030 253352 240116 175199 25760 2080 18885 108654 OTHER EXPENSE 2836 72114044 -168342 252525 399125 13601690 9693561 10516296 111808 244954 89027110 87454472 571343 1094786 99634605 113164723 70753 89704 17554000 19299686 17624753 19389390 X 0 0 0 0 82009852 93775333 82009852 93775333 99634605 113164723 X 0 1 1 X 0 0 Accumulated Eligibility Credits 17703000 Claims Payable and IBNR 1339000 Due to Broker 257686 19299686 76154675 72114044 4040631 7724850 1488000 9212850 13253481 83626173 7724850 7724850 75901323 253352 253352 76154675 70372692 0 70372692 253352 1488000 1741352 72114044 Part XI, Line 8 - Other Adjustments: Change In Benefit Obligations Part XIII, Line 4b - Other Adjustments: Change in Benefit Obligations Form 990, Part VI, Section A, line 3 The organization 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 Form 990 was provided to the Board of Trustees for review prior to filing. Form 990, Part VI, Section B, line 15 The Board of Trustees reviews and approves compensation for the Plan's employees based on Staff Classifications and wage scales along with other data available. The compensation for the Trustees is reviewed and approved by the Board of Trustees based on the amount of time the Trustees spend performing their duties. Form 990, Part VI, Section C, line 19 The organization makes its governing documents and financial information available to the PUBLIC UPON REQUEST. Form 990, Part XI, Line 2C: THE BOARD OF TRUSTEES ASSUMES THE RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT AND SELECTION OF AN INDEPENDENT AUDITOR. FORM 990, PART V, LINE 2A: THE ORGANIZATION ISSUED 20 FORMS W-2 DURING 2009, INCLUDING 14 THAT WERE FOR DOMESTIC PARTNERS TAXABLE BENEFITS.