2023-11-13T14:28:51-06:00 2022-12-31 410746749 CLIFTONLARSONALLEN LLP 220 S 6TH STREET SUITE 300 MINNEAPOLIS MN 55402 990 2022-01-01 416023461 MINNESOTA & NORTH DAKOTA BRICKLAYERS & ALLIED CRAFTWORKERS HEALTH FUND MINN 6512561801 2520 PILOT KNOB ROAD 325 MENDOTA HEIGHTS MN 55120 DOUGLAS SCHROEDER CHAIRMAN 6512561801 2023-11-13 1 DOUGLAS SCHROEDER 999009999 0 DOUG BERTOSSI P00637990 6123764500 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z DOUGLAS SCHROEDER 2520 PILOT KNOB ROAD 325 MENDOTA HEIGHTS MN 55120 45234797 0 X N/A X 1961 MN PROVIDE HEALTH & WELFARE BENEFITS TO UNION MEMBERS AND THEIR DEPENDENTS. 8 1 0 12 0 0 0 0 23407112 23875934 7275447 2600239 0 0 30682559 26476173 0 0 22253183 23018831 0 0 0 0 0 1425004 1445881 23678187 24464712 7004372 2011461 109193253 97292256 66983 57106 109126270 97235150 PROVIDE HEALTH AND WELFARE BENEFITS TO UNION MEMBERS AND THEIR DEPENDENTS. 0 0 PAYMENT OF HOSPITAL, MEDICAL, DENTAL, DISABILITY, DEATH, AND VISION BENEFITS FOR 3,266 UNION MEMBERS AND THEIR DEPENDENTS. 0 0 0 0 0 0 0 0 0 0 1 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 3 0 0 0 0 0 0 0 0 0 0 X 8 1 0 0 0 0 0 1 0 1 0 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 X DOUGLAS SCHROEDER SEE SCHEDULE O 1.00 50.00 X X 0 0 0 MICHAEL GANZ SEE SCHEDULE O 1.00 44.00 X 0 0 0 FRANK GRAZZINI II MANAGEMENT TRUSTEE 1.00 41.00 X 0 0 0 AMY THOMPSON MANAGEMENT TRUSTEE 1.00 41.00 X 0 0 0 STAN PACZYNSKI SEE SCHEDULE O 1.00 41.00 X 0 0 0 RON RASLEY MANAGEMENT TRUSTEE 1.00 41.00 X 0 0 0 JOHN NESSE MANAGEMENT TRUSTEE 1.00 42.00 X 0 0 0 BOB MILLER MANAGEMENT TRUSTEE 1.00 40.00 X 0 0 0 TRENT SCHIEFFER MANAGEMENT TRUSTEE 1.00 40.00 X 0 0 0 ERIC VIK SEE SCHEDULE O 1.00 42.00 X 0 0 0 AMANDA EIYNK ALTERNATE MANAGEMENT TRUSTEE 1.00 40.00 X 0 0 0 JAKE NELSON UNION TRUSTEE 1.00 40.00 X 0 0 0 0 0 0 0 0 0 0 HEALTH PARTNERS 8170 33RD AVE S BLOOMINGTON MN 55425 PPO 931438 ZENITH AMERICAN SOLUTIONS 2520 PILOT KNOB ROAD 325 MENDOTA HEIGHTS MN 55120 PLAN ADMINISTRATOR 794877 THE UNION LABOR LIFE INSURANCE COMPANY 8403 COLESVILLE ROAD SILVER SPRING MD 20910 INVESTMENT MANAGEMENT 136883 3 CONTRIBUTIONS 525100 23875934 23875934 23875934 1768153 1768153 19590710 18758624 832086 832086 832086 26476173 23875934 0 2600239 23018831 846990 64688 35490 319744 83725 64418 5708 16996 AFFORDABLE CARE ACT FEE 8122 24464712 2467972 3516802 3776825 4181561 1877667 1609000 11333 0 16449 112390 73936153 60555605 26497407 26712237 609447 604661 109193253 97292256 49812 42927 17171 14179 66983 57106 X 0 0 0 0 109126270 97235150 109126270 97235150 109193253 97292256 2011461 -13902581 0 X 0 1 X 1 0 0 LIMITED PARTNERSHIPS 10035030 F LIMITED LIABILITY COMPANY 9488939 F 103-12 INVESTMENT ENTITY 7188268 F 26712237 ADVANCE CONTRIBUTIONS FROM EMPLOYEES FOR FUTURE COVERAGE 14179 14179 X 12253848 -13902581 -13902581 26156429 319744 319744 26476173 24144968 0 24144968 319744 319744 24464712 PART X, LINE 2: THE VEBA TRUST FUNDING BENEFITS OF THE PLAN RECEIVED AN EXEMPTION LETTER FROM THE INTERNAL REVENUE SERVICES (IRS) DATED FEBRUARY 27, 1963, STATING THAT THE TRUST IS TAX-EXEMPT UNDER THE PROVISIONS OF SECTION 501(C)(9) OF THE INTERNAL REVENUE CODE (IRC). HOWEVER, AS A RESULT OF THE PLAN'S FUNDING POLICY, FROM TIME TO TIME THE TRUST MAY BE SUBJECT TO INCOME TAXES. NO FEDERAL OR STATE INCOME TAXES HAVE BEEN RECORDED IN 2021 OR 2020 FOR UNRELATED BUSINESS TAXABLE INCOME. IN ADDITION, THE PLAN AND TRUST ARE REQUIRED TO OPERATE IN CONFORMITY WITH THE IRC TO MAINTAIN THE TAX-EXEMPT STATUS OF THE TRUST. THE PLAN ADMINISTRATOR BELIEVES THAT THE PLAN IS BEING OPERATED IN COMPLIANCE WITH THE APPLICABLE REQUIREMENTS OF THE IRC AND, THEREFORE, BELIEVES THAT THE RELATED TRUST IS TAX-EXEMPT. 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 IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. FORM 990, PART VI, SECTION A, LINE 7A THE BRICKLAYERS AND ALLIED CRAFTWORKERS LOCAL UNION 1 MINNESOTA/NORTH DAKOTA AND THE ASSOCIATED GENERAL CONTRACTORS OF MINNESOTA EACH APPOINT 50% OF THE BOARD OF TRUSTEES. FORM 990, PART VI, SECTION A, LINE 8B THERE ARE NO COMMITTEES WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BOARD. FORM 990, PART VI, SECTION B, LINE 11B 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 UNDERSTAND 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 CHAIRMAN 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, FINANCIAL STATEMENTS, AND CONFLICT OF INTEREST POLICY ARE NOT MADE AVAILABLE TO THE GENERAL PUBLIC. FORM 990 PART VII, SECTION A, LINE 1A TRUSTEES ARE NOT COMPENSATED BY THE FUND. COMPENSATION PAID TO TRUSTEES EMPLOYED BY OTHER RELATED ORGANIZATIONS IS REPORTED ON THE FORM 990 FILED WITH THE INTERNAL REVENUE SERVICE BY THE RELATED TAX-EXEMPT ORGANIZATION. THE FOLLOWING RELATED ORGANIZATIONS REPORTED COMPENSATION FOR A TRUSTEE LISTED ON THE MINNESOTA & NORTH DAKOTA BRICKLAYERS & ALLIED CRAFTWORKERS HEALTH FUND: DOUGLAS SCHROEDER, CHAIRMAN BRICKLAYERS AND ALLIED CRAFTWORKERS LOCAL UNION NO. 1 MINNESOTA/NORTH DAKOTA EIN: 41-1716458 STAN PACZYNSKI, UNION - ALTERNATE TRUSTEE BRICKLAYERS AND ALLIED CRAFTWORKERS LOCAL UNION NO. 1 MINNESOTA/NORTH DAKOTA EIN: 41-1716458 MICHAEL GANZ, UNION TRUSTEE BRICKLAYERS AND ALLIED CRAFTWORKERS LOCAL UNION NO. 1 MINNESOTA/NORTH DAKOTA EIN: 41-1716458 ERIK VIK, UNION TRUSTEE BRICKLAYERS AND ALLIED CRAFTWORKERS LOCAL UNION NO. 1 MINNESOTA/NORTH DAKOTA EIN: 41-1716458 CITY OF MINNEAPOLIS CITY OF ST PAUL INTERNAT'L MASONRY INSTITUTE MINNEAPOLIS PUBLIC SCHOOL ST PAUL PUBLIC SCHOOLS UNIVERSITY OF MINNESOTA MINNESOTA AND NORTH DAKOTA BRICKLAYERS & ALLIED CRAFTWORKERS PENSION FUND 2520 PILOT KNOB RD MENDOTA HEIGHTS MN 55120 516029930 PROVIDE RETIREMENT BENEFITS TO UNION MEMBERS MN 401(A) N/A N/A 0 MINNESOTA AND NORTH DAKOTA BRICKLAYERS & ALLIED CRAFTWORKERS VACATION FUND 2520 PILOT KNOB RD MENDOTA HEIGHTS MN 55120 237068471 PROVIDE VACATION BENEFITS TO UNION MEMBERS MN 501(C)(9) N/A N/A 0 BRICKLAYERS LOCAL NO 1 APPREN 35420 INTERNATIONAL PARKWAY NEW HOPE MN 55428 416319702 PROVIDE TRAINING AND RETRAINING TO CURRENT AND PROSPECTIVE UNION MEMBERS MN 501(C)(5) N/A N/A 0 ASSOCIATED GENERAL CONTRACTORS OF MINNESOTA INC 525 PARK STREET NO 110 ST PAUL MN 55103 410132580 REPRESENTING MEMBERS INVOLVED IN MINNESOTA'S CONSTRUCTION INDUSTRY MN 501(C)(6) N/A N/A 0 MINNESOTA CERAMIC TILE AND ALLIED TRADES 2520 PILOT KNOB RD MENDOTA HEIGHTS MN 55120 416059404 TO PROVIDE RETIREMENT BENEFITS TO UNION MEMBERS MN 401(A) N/A N/A 0 BRICKLAYERS AND ALLIED CRAFTWORKERS LOCAL UNION NO 1 MINNESOTANORTH DAKOTA 312 CENTRAL AVENUE SUITE 328 MINNEAPOLIS MN 55414 411716458 PROTECT AND IMPROVE THE GENERAL WELFARE OF ITS MEMBERS AND EMPLOYEES MN 501(C)(5) N/A N/A 0 D R FRANTZ CONCRETE CONST RAM CONSTRUCTION SERVICES BRICKALYERS AND ALLIED CRAFTWORKERS SERVICE CORPORATION 2520 PILOT KNOB ROAD MENDOTA HEIGHTS MN 55120 811520819 ADMINISTRATIVE SERVICES TO RELATED FUND MN N/A C 61608 56167 0.20000 0 A J SPANJERS CO ACME TUCKPOINTING & RESTOR ACOUSTICS ASSOCIATES INC ADVANCE TERRAZZO & TILE CO ADVANCED MASONRY RESTORATION ALVIN BENIKE INC AMERICAN MAS RESTORATION CORP AMERICAN MASONRY INC ANCHOR GLASS CONTAINER INC API CONSTRUCTION ARCHITHORITY UNITED LLC AXEL H OHMAN INC A-Z CONSTRUCTION MAS DBA B&D B & D ASSOCIATES LLC B & M MASONRY INC B & W MASONRY BARTEL TILE & MARBLE LLC BEDROCK-FLINT INC BERGER TILE & STONE BERGLUND CONSTRUCTION COMPANY BLACKHAWK TILE & STONE INC BOB'S SW INC DBA BOBS SW CONST BRATRUD CONSTRUCTION BROWN REFRACTORY SERVICE C R MEYER & SONS COMPANY CAMCO CONSTRUCTION INC CARCIOFINI COMPANY INC CD SMITH CONSTRUCTION INC CD TILE & STONE INC COMMERCIAL FLOORING INSTALL COMMERCIAL SPECIALTY CONTRACT CON'S MASONRY INC CONSTRUCTION & TURNAROUND SERV CONTRACT CAULKING CONTRACT TILE & CARPET INC CORVAL CONSTRUCTORS INC CROSSTOWN MASONRY INC D & D STONE LLC D J KRANZ CO INC DAROLD BERGER MASONRY INC DAVIS-BIRD CONTRACTING INC DAYCO CONCRETE DEL'S CONSTRUCTION CO INC DOMINIONAIRE CONTRACTING INC DZIEDZIC CAULKING INC EICHOLTZ MASONRY INC EXTERIOR BUILDING SERVICES INC FABCON INC FLEMMING TILE INC FLOORS BY BECKERDBA D INSTALL FOWLER AND HAMMER FRANDRUP MASONRY INC GAGE BROTHERS CAULKING GAGNON INCORPORATED GEORGE SIEGFRIED CONST CO GOFF MASONRY LLC GORDON CONST OF MAHNOMEN INC GRANITE-TOPS INSTALLATION INC GRAZZINI BROTHERS CO GRESSER COMPANIES INC HANSON MASONRY & CONCRETE LLC HARBOR CITY MASONRY INC HARLAN FALCK & SON INC HARRISON TILE CO INC HAUGEN MASONRY CONTRACTORS INC HENKEMEYER COATINGS HOLLENBACK & NELSON INC HOVLAND INC HUESMAN SCHREIBER MASONRY INCOR INSTALLATION INC INSTALLATION CONCEPTS INC J & D MASONRY INC J & K MASONRY J E DUNN CONSTRUCTION COMPANY JENSEN MASONRY INC JOHN FOLEY MASONRY JOHNSON & NELSON JOHNSON CARPET JOHNSON TERRAZZO CO INC KASELLA CONCRETE INC KIFFMEYER INC KNIGHT MATERIAL TECHNOLOGIES KNUTSON CONSTRUCTION SERVICES LAKEHEAD CONSTRUCTORS INC LANGER CONSTR CO LEE'S CERAMICS INC LOUHI & KIVELA MASONRY INC M & L MASONRY M A MORTENSON CO M C MAGNEY CONST MAERTENS-BRENNY CONSTRUCTION MARKET & JOHNSON INC MAVO SYSTEMS INC MCGOUGH CONSTRUCTION CO INC METROPOLITAN TILE & MARBLE MIDWEST PRECAST SERVICES LLC MIDWESTERN MASONRY INC MIRON CONSTRUCTION CO INC MN CONCRETE SPECIALTIES INC MN STATE BUILDING TRADES MOLIN CONCRETE PRODUCTS MOSAICA LLC NIKKEL TILE INC NORTHERN POOL RESTORATION NORTHLAND CONCRETE & MASONRY NORTHLAND CONSTRUCTORS PARAMOUNT CONCRETE & MAS INC PATZOLDT CONCRETE & MASONRY LL PROJECT RESTORATIONS INC REFRACTORY SERVICE INC RESCH'S TILE INC RESTORATION & CONSTRUCTION SER RESTORATION SYSTEMS INC RICE LAKE CONSTRUCTION GROUP RIGHTWAY CAULKING RON NOVAK CONSTRUCTION SCHLEIS FLOOR COVERING INC SERVAIS TILE & STONE INC SHEEHY CONSTRUCTION CO SMITH-SHARPE FIRE BRICK SUPPLY STEBBINS ENGINEERING STEENBERG - WATRUD CONST INC STILLWATER MASONRY RESTORATION STONE CONSTRUCTION INC STRETAR MASONRY & CONCRETE INC SUMMIT CONCRETE & MAS CONST SUNRISE SPECIALTY CONTR SWANSON & YOUNGDALE INC TC BRICKLAYERS TCR ENTERPRISES DBA J&K MASON TED KENNE CONSTRUCTION THE BOLDT COMPANY THE CAULKERS COMPANY INC TIM'S CONSTRUCTION GROUP TOTAL CONSTRUCTION & EQUIPMENT TR CONCRETE INC DBA TR MASONRY TWIN CITY SPECIALTIES INC TWIN CITY TILE & MARBLE CO UNITED MASONRY INC UNITED REFACTORIES INC VAN MINSEL BROS CONSTRUCTION WELLS CONCRETE PRODUCTS CO WENDT MASONRY INC WESTERN REFRACTORY CONST WESTERN SPECIALTY CONTRACTORS WILLIAMS MASONRY INC WILLIAMS REFRACTORY SERVICES WISCONSIN MASONS FRINGE FUNDS WISCONSIN TERRAZZO & TILE INC WTG TERRAZZO & TILE INC WYSAN PRECAST SERVICES LLC ZACHMAN PRECAST INC 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1