2022-11-14T15:04:34-06:00 2021-12-31 410746749 CLIFTONLARSONALLEN LLP 220 S 6TH STREET SUITE 300 MINNEAPOLIS MN 55402 990 2021-01-01 416023461 MINNESOTA & NORTH DAKOTA BRICKLAYERS & ALLIED CRAFTWORKERS HEALTH FUND MINN 6512561801 2520 PILOT KNOB ROAD 325 MENDOTA HEIGHTS MN 55120 DOUGLAS SCHROEDER CHAIRMAN 6512561801 2022-11-14 1 DOUGLAS SCHROEDER 999009999 DOUG BERTOSSI P00637990 6123764500 3 AAL1 IAL1 2021 2022-09-23 18:48:47Z DOUGLAS SCHROEDER 2520 PILOT KNOB ROAD 325 MENDOTA HEIGHTS MN 55120 54297777 0 X N/A X 1961 MN PROVIDE HEALTH & WELFARE BENEFITS TO UNION MEMBERS AND THEIR DEPENDENTS. 11 1 0 10 0 0 0 0 24476039 23407112 2699686 7275447 0 0 27175725 30682559 0 0 19599098 22253183 0 0 0 0 0 1294578 1425004 20893676 23678187 6282049 7004372 98836850 109193253 166640 66983 98670210 109126270 PROVIDE HEALTH AND WELFARE BENEFITS TO UNION MEMBERS AND THEIR DEPENDENTS. 0 0 PAYMENT OF HOSPITAL, MEDICAL, DENTAL, DISABILITY, DEATH, AND VISION BENEFITS FOR 2,205 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 1 0 0 0 0 0 0 0 0 0 1 0 0 1 9 0 0 0 0 0 0 0 0 0 0 X 11 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 REBECCA NOHAVA UNION TRUSTEE - ALTERNATE 1.00 40.00 X 0 0 0 ALEXIS MILLER MANAGEMENT TRUSTEE 1.00 42.00 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 41.00 X 0 0 0 PAUL WIESE MANAGEMENT TRUSTEE 1.00 41.00 X 0 0 0 TERRY WONG SEE SCHEDULE O 4.00 45.00 X 0 0 0 0 0 0 0 0 0 0 HEALTH PARTNERS 8170 33RD AVE S BLOOMINGTON MN 55425 PPO 1152039 ZENITH AMERICAN SOLUTIONS 2520 PILOT KNOB ROAD 325 MENDOTA HEIGHTS MN 55120 PLAN ADMINISTRATOR 811191 MAIRS & POWER INC 332 MINNESOTA ST W1520 ST PAUL MN 55101 INVESTMENT MANAGEMENT 118662 BRICKLAYERS AND ALLIED CRAFTWORKERS SERV 2520 PILOT KNOB ROAD 325 MENDOTA HEIGHTS MN 55120 ADMINISTRATIVE SERVICES 106700 4 CONTRIBUTIONS 525100 23407112 23407112 23407112 1537622 1537622 29353043 23615218 5737825 5737825 5737825 30682559 23407112 0 7275447 22253183 890088 83469 33550 254957 81600 54222 2320 16300 AFFORDABLE CARE ACT FEE 8498 23678187 2273061 2467972 4760910 3776825 1710970 1877667 5030 11333 2295 16449 69271927 73936153 20066338 26497407 746319 609447 98836850 109193253 151870 49812 14770 17171 166640 66983 X 0 0 0 0 98670210 109126270 98670210 109126270 98836850 109193253 7004372 3451688 0 X X 0 1 X 1 0 0 LIMITED PARTNERSHIPS 9220967 F LIMITED LIABILITY COMPANY 10974366 F 103-12 INVESTMENT ENTITY 6302074 F 26497407 ADVANCE CONTRIBUTIONS FROM EMPLOYEES FOR FUTURE COVERAGE 17171 17171 X 33879290 3451688 3451688 30427602 254957 254957 30682559 23423230 0 23423230 254957 254957 23678187 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. CONTRIBUTING EMPLOYER CONTRIBUTING EMPLOYER LATE CONTRIBUTIONS X 3713 3713 0 0 0 CONTRIBUTING EMPLOYER CONTRIBUTING EMPLOYER LATE CONTRIBUTIONS X 2581 2581 0 0 0 CONTRIBUTING EMPLOYER CONTRIBUTING EMPLOYER LATE CONTRIBUTIONS X 2620 2620 0 0 0 CONTRIBUTING EMPLOYER CONTRIBUTING EMPLOYER LATE CONTRIBUTIONS X 44 44 0 0 0 CONTRIBUTING EMPLOYER CONTRIBUTING EMPLOYER LATE CONTRIBUTIONS X 94 94 0 0 0 CONTRIBUTING EMPLOYER CONTRIBUTING EMPLOYER LATE CONTRIBUTIONS X 1246 1246 0 0 0 CONTRIBUTING EMPLOYER CONTRIBUTING EMPLOYER LATE CONTRIBUTIONS X 316 316 0 0 0 CONTRIBUTING EMPLOYER CONTRIBUTING EMPLOYER LATE CONTRIBUTIONS X 719 719 0 0 0 11333 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 TERRY WONG, UNION TRUSTEE BRICKLAYERS AND ALLIED CRAFTWORKERS LOCAL UNION NO. 1 MINNESOTA/NORTH DAKOTA EIN: 41-1716458 FORM 990 PART VII, LINE 2C THE ORGANIZATION HAS NOT CHANGED THEIR PROCESS FOR THE OVERSIGHT OR THE SELECTION OF THE INDEPENDENT ACCOUNTANT FROM THE PRIOR YEAR. MN & ND BRICKLAYERS AND 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 MN & ND BRICKLAYERS AND 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 RETIREMENT FUND 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 AVE SUITE 328 MINNEAPOLIS MN 55414 PROTECT AND IMPROVE THE GENERAL WELFARE OF ITS MEMBERS AND EMPLOYEES MN 501(C)(5) N/A N/A 0 CITY OF MINNEAPOLIS CITY OF ST PAUL SPECIAL SCHOOL DISTRICT #1 ST PAUL PUBLIC SCHOOLS UNIVERSITY OF MINNESOTA 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 63187 56340 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 ANCHOR GLASS CONTAINER INC AXEL H OHMAN INC B & D ASSOCIATES LLC B & M MASONRY B & W MASONRY BARTEL TILE & MARBLE LLC BERGER TILE & STONE BLACKHAWK TILE & STONE INC BOB'S SW INC DBA BOBS SW CONST BRATRUD CONSTRUCTION BROWN REFRACTORY SERVICE CAMCO CONSTRUCTION INC CARCIOFINI COMPANY INC CD SMITH CONSTRUCTION INC CD TILE & STONE INC CHRISTY INDUSTRIAL SERVICES COMMERCIAL FLOORING INSTALL CON'S MASONRY INC CONSTRUCTION & TURNAROUND SERV CONTRACT CAULKING CONTRACT TILE & CARPET INC CROSSTOWN MASONRY INC D G SKOUSE COMPANY INC D J KRANZ CO INC DAROLD BERGER MASONRY INC DAYCO CONCRETE DEL'S CONSTRUCTION CO INC DOMINIONAIRE CONTRACTING INC DZIEDZIC CAULKING INC EICHOLTZ MASONRY INC EXTERIOR BUILDING SERVICES INC FABCON INC FICHTER-DAVEY MASONRY CONST FLEMMING TILE INC 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 GUY NIELSON COMPANY DIV INC HANSON MASONRY & CONCRETE LLC HARBOR CITY MASONRY INC HARD ROCK STONE WORKS HARLAN FALCK & SON INC HARRISON TILE CO INC HAUGEN MASONRY CONTRACTORS INC HOLLENBACK & NELSON INC HOLM CONSTRUCTION INC HUESMAN SCHREIBER MASONRY INCOR INSTALLATION INC INSTALLATION CONCEPTS INC J E DUNN CONSTRUCTION COMPANY J P PHILLIPS INC J T THORPE & SON INC JOHN FOLEY MASONRY JOHNSON & NELSON JOHNSON CARPET JOHNSON TERRAZZO CO INC JOST CONSTRUCTION INC KASELLA CONCRETE INC KIFFMEYER INC KNUTSON CONSTRUCTION SERVICES LANGER CONSTR CO LEE'S CERAMICS INC LILJA CORPORATION 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 MN CONCRETE SPECIALTIES INC MOLIN CONCRETE PRODUCTS MOSAICA LLC NIKKEL TILE INC NORTHLAND CONCRETE & MASONRY PARAMOUNT CONCRETE & MAS INC PATZOLDT CONCRETE & MASONRY LL PRECISION PRECAST ERECTORS LLC PROJECT RESTORATIONS INC REFRACTORY SERVICE INC RESCH'S TILE INC RESTORATION & CONSTRUCTION SER RESTORATION SYSTEMS INC RICE LAKE CONSTRUCTION GROUP RIGHTWAY CAULKING SCHLEIS FLOOR COVERING INC SERVAIS TILE & STONE INC SHEEHY CONSTRUCTION CO SMITH-SHARPE FIRE BRICK SUPPLY STEBBINS ENGINEERING STEENBERG - WATRUD CONST INC STONE CONSTRUCTION INC STRETAR MASONRY & CONCRETE INC STREYLE MASONRY INC SUMMIT CONCRETE & MAS CONST SUNRISE SPECIALTY CONTR 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 TRON MECHANICAL INC TWIN CITY SPECIALTIES INC TWIN CITY TILE & MARBLE CO UNITED MASONRY INC VAN MINSEL BROS CONSTRUCTION WELLS CONCRETE PRODUCTS CO WENDT MASONRY INC WEST RIVER MASONRY WESTERN REFRACTORY CONST WESTERN SPECIALTY CONTRACTORS WILLIAMS REFRACTORY SERVICES 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