2022-12-07T12:09:49-06:00 2022-02-28 320043599 LEGACY PROFESSIONALS LLP 222 INDIANAPOLIS BLVD STE 103 SCHERERVILLE IN 46375 990 2021-03-01 350940329 BRICKLAYERS UNION LOCAL NO 6 OF INDIANA WELFARE FUND INDI 2197693376 7985 MARSHALL STREET MERRILLVILLE IN 46410 ROBERT PUZA FUND MANAGER 2197693376 2022-12-07 1 ROBERT PUZA 999009999 DAVID ZABRECKY P01460569 2198361065 2022-12-07 3 AAL1 IAL1 2021 2022-09-23 18:48:47Z ROBERT PUZA 7985 MARSHALL STREET MERRILLVILLE IN 46410 8925409 0 X N/A X 1954 IN TO PROVIDE HEALTH AND WELFARE BENEFITS AND LIFE INSURANCE COVERAGE FOR PARTICIPANTS AND THEIR ELIGIBLE DEPENDENTS. 10 7 4 0 0 0 0 0 3728118 4091823 310750 240689 0 0 4038868 4332512 0 0 3302281 3471325 164663 176785 0 0 0 177011 194022 3643955 3842132 394913 490380 11274059 11685696 136933 107978 11137126 11577718 HEALTH BENEFIT FUND. 0 0 TO PROVIDE HEALTH AND WELFARE BENEFITS AND LIFE INSURANCE COVERAGE FOR PARTICIPANTS AND THEIR ELIGIBLE DEPENDENTS. 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 3 0 1 4 1 0 0 0 0 0 0 0 0 0 0 X 10 7 0 0 0 0 0 0 0 1 0 0 0 1 1 1 1 1 1 1 0 0 IN X ROBERT PUZA 2197693376 7985 MARSHALL STREET MERRILLVILLE IN 46410 JEREMY RIVAS TRUSTEE 1.00 40.00 X 0 97880 76881 ANTHONY ARENS TRUSTEE 1.00 1.00 X 0 0 0 PATRICK CLARK TRUSTEE 1.00 1.00 X 0 0 0 JEFFREY COLVIN TRUSTEE 1.00 1.00 X 0 0 0 CHRIS DOOLIN TRUSTEE 1.00 1.00 X 0 0 0 JEFFREY CAVINDER TRUSTEE 1.00 40.00 X 0 87701 51865 ROBERT ZEMAITIS TRUSTEE 1.00 1.00 X 0 0 0 TIM WHITE TRUSTEE 1.00 1.00 X 0 116 93 JASON BARNARD TRUSTEE 1.00 1.00 X 0 0 0 TIM KAPITAN TRUSTEE 1.00 1.00 X 0 0 0 ROBERT PUZA FUND MANAGER 20.00 20.00 X 0 80559 53425 0 266256 182264 0 0 1 0 ANTHEM 220 VIRGINIA AVE INDIANAPOLIS IN 46204 PPO NETWORK PROVIDER 148253 1 EMPLOYER CONTRIBUTIONS 900099 3730865 3730865 PARTICIPANT/RETIREE CONTRIBUTIONS 900099 360958 360958 4091823 232223 232223 4601363 4592897 8466 8466 8466 4332512 4091823 0 240689 3471325 67198 48271 34099 19639 7578 35624 38961 8000 54654 8858 24833 7303 952 13636 FEES MANDATED BY ACA 1201 3842132 79257 122750 398545 312285 615052 477812 17367 18604 16304 16304 0 0 10163838 10754245 11274059 11685696 124967 98312 7972 8248 3994 1418 136933 107978 X 0 0 0 0 11137126 11577718 11137126 11577718 11274059 11685696 490380 -49788 0 X 0 1 X 1 0 16304 16304 0 0 DUE TO RELATED PENSION FUND 1418 1418 X 4274724 -49788 -49788 4324512 8000 8000 4332512 3834132 0 3834132 8000 8000 3842132 PART X, LINE 2: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE THE PLAN TO EVALUATE TAX POSITIONS TAKEN BY THE PLAN AND RECOGNIZE A TAX LIABILITY IF THE PLAN HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY TAX AUTHORITIES. THE PLAN IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. 0 0 0 JEREMY RIVAS TRUSTEE 0 97880 0 0 0 0 0 56511 0 20370 0 174761 0 0 FORM 990, PART VI, SECTION A, LINE 8B THE ORGANIZATION HAS NO COMMITTEES WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11B A COPY OF THE FORM 990 IS PROVIDED TO THE BOARD OF TRUSTEES FOR THEIR REVIEW AND APPROVAL BEFORE IT IS FILED. FORM 990, PART VI, SECTION B, LINE 12C THE PLAN HAS A CONFLICT OF INTEREST POLICY TO HELP ENSURE THAT ANY ACTUAL OR POTENTIAL CONFLICTS OF INTEREST ARE DISCLOSED AND ADDRESSED ON A TIMELY BASIS. IT IS THE DUTY OF THE FUND TRUSTEES AND EMPLOYEES TO IDENTIFY ACTUAL OR POTENTIAL CONFLICTS. IN CONNECTION WITH AN ACTUAL OR POTENTIAL CONFLICT, THE PARTY-IN-INTEREST (OR ANY INTERESTED PARTY) WILL IMMEDIATELY DISCLOSE TO THE BOARD OF TRUSTEES THE EXISTENCE OF SUCH CONFLICT WITH DETAILED AND SPECIFIC FACTS. UPON DISCLOSURE, THE BOARD OF TRUSTEES WILL MEET FOR DISCUSSION AND A LEGAL OPINION IS SOUGHT WHETHER THERE IS, IN FACT, A CONFLICT. FORM 990, PART VI, SECTION B, LINE 15A THE BOARD OF TRUSTEES DETERMINES THE FUND MANAGER'S SALARY. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST AT THE FUND OFFICE. FORM 990, PAGE 1, LINE 5 AND PAGE 10 LINES 5 AND 7 THIS ENTITY SHARES EMPLOYEES WITH BRICKLAYERS UNION LOCAL NO. 6 OF INDIANA PENSION FUND. THE PAYROLL TAX FILINGS AND FORMS W-2 FOR THESE WAGES ARE FILED BY THE PENSION FUND. THE WELFARE FUND'S SHARE OF SALARY EXPENSE FOR THESE EMPLOYEES APPEAR ON PAGE 10. THE NUMBER OF PARTICIPANTS REPORTED ON W-3 FOR PART V QUESTION 2A REPRESENTS THE NUMBER OF PARTICIPANTS WHO RECEIVED THIRD PARTY SICK PAY FROM THIS FUND DURING THE YEAR. BRICKLAYERS UNION LOCAL NO6 OF INDIANA PENSION FUND 7985 MARSHALL STREET MERRILLVILLE IN 46410 516113680 PROVIDE RETIREMENT BENEFITS TO MEMBERS OR THEIR BENEFICIARIES IN 401(A) 0 BAC LOCAL 4 INKY 2041 N BROADWAY ANDERSON IN 46012 351938121 LABOR UNION IN 501(C)(5) 0 BAC LOCAL 4 INKY APPRENTICE AND TRAINING PROGRAM CONTRIBUTING EMPLOYER 0 ABLE MASONRY DEVELOPMENT CO CONTRIBUTING EMPLOYER 0 ACMS GROUP INC CONTRIBUTING EMPLOYER 0 ADAMS MASONRY INC CONTRIBUTING EMPLOYER 0 ADVANTAGE INDUSTRIAL SYSTEMS CONTRIBUTING EMPLOYER 0 AMEX NOOTER LLC CONTRIBUTING EMPLOYER 0 ARCELORMITTAL USA INC CONTRIBUTING EMPLOYER 0 ART MOSAIC & TILE CONTRIBUTING EMPLOYER 0 ATLAS BUILDING SERVICES CONTRIBUTING EMPLOYER 0 BARTON MALOW CONTRIBUTING EMPLOYER 0 BELDON INTERIORS INC CONTRIBUTING EMPLOYER 0 BERGLUND CONSTRUCTION COMPANY CONTRIBUTING EMPLOYER 0 BEST BRICKWASHING INC CONTRIBUTING EMPLOYER 0 BISCO REFRACTORIES INC CONTRIBUTING EMPLOYER 0 BRUNO'S TUCKPOINTING INC CONTRIBUTING EMPLOYER 0 C & S MASONRY RESTORATIONS LLC CONTRIBUTING EMPLOYER 0 CCI FLOORING INC CONTRIBUTING EMPLOYER 0 COLVIN MASONRY INC CONTRIBUTING EMPLOYER 0 CREATIVE ERECTORS CONTRIBUTING EMPLOYER 0 C-STONE INSTALLATION CO CONTRIBUTING EMPLOYER 0 CUSTOM MASONRY RESTORATION INC CONTRIBUTING EMPLOYER 0 EMPIRE REFRACTORY SERVICES INC CONTRIBUTING EMPLOYER 0 FABCON INC CONTRIBUTING EMPLOYER 0 FLUOR CONSTRUCTORS INTERNATIONAL INC CONTRIBUTING EMPLOYER 0 FOSBEL INC CONTRIBUTING EMPLOYER 0 GARIUP CONSTRUCTION INC CONTRIBUTING EMPLOYER 0 GLASSROCK PRODUCTS INC CONTRIBUTING EMPLOYER 0 GOUGH INC CONTRIBUTING EMPLOYER 0 HAGERMAN CONSTRUCTION CONTRIBUTING EMPLOYER 0 HARBISON-WALKER REFRACTORIES CO CONTRIBUTING EMPLOYER 0 ICC COMMONWEALTH CORP CONTRIBUTING EMPLOYER 0 INTERIOR FINISHES INC CONTRIBUTING EMPLOYER 0 IWANSKI-PYZIK MASONRY AND BUILDERS INC CONTRIBUTING EMPLOYER 0 J & E DUFF INC CONTRIBUTING EMPLOYER 0 J & H CONSTRUCTION INC CONTRIBUTING EMPLOYER 0 J & J MASONRY INC CONTRIBUTING EMPLOYER 0 J & M TILE CONTRIBUTING EMPLOYER 0 J W SEALANTS INC CONTRIBUTING EMPLOYER 0 J T THORPE & SON INC CONTRIBUTING EMPLOYER 0 JOE'S MASONRY CONTRIBUTING EMPLOYER 0 KAUFMANN-GALLAGHER WATERPROOFING INC CONTRIBUTING EMPLOYER 0 KINGSTON TILE COMPANY LTD CONTRIBUTING EMPLOYER 0 KNIOLA'S INDUSTRIAL SERVICE CONTRIBUTING EMPLOYER 0 KORELLIS ROOFING INC CONTRIBUTING EMPLOYER 0 KORSGUARD CO CONTRIBUTING EMPLOYER 0 KRAWN CONSTRUCTION LLC CONTRIBUTING EMPLOYER 0 KWIATKOWSKI MASONRY INC CONTRIBUTING EMPLOYER 0 LARSON-DANIELSON CONSTRUCTION CO INC CONTRIBUTING EMPLOYER 0 M P BRICK CLEANING CONTRIBUTING EMPLOYER 0 MARK 1 RESTORATION COMPANY CONTRIBUTING EMPLOYER 0 MASTER TILE INC CONTRIBUTING EMPLOYER 0 MID-AMERICAN GUNITE INC CONTRIBUTING EMPLOYER 0 MIDWEST REFRACTORY INSTALLATION CONTRIBUTING EMPLOYER 0 MIDWEST TILE & INTERIORS CONTRIBUTING EMPLOYER 0 MORRISON CONSTRUCTION COMPANY INC CONTRIBUTING EMPLOYER 0 MR DAVID'S FLOORING CONTRIBUTING EMPLOYER 0 NORRIS AND SON INC CONTRIBUTING EMPLOYER 0 ONEX CONSTRUCTION INC CONTRIBUTING EMPLOYER 0 PAUL'S CONSTRUCTION INC CONTRIBUTING EMPLOYER 0 PHILLIPS BRICK CLEANING CONTRIBUTING EMPLOYER 0 PREMIER CAULKING INC CONTRIBUTING EMPLOYER 0 RAM CONSTRUCTION SERVICES OF MICHIGAN INC CONTRIBUTING EMPLOYER 0 RD MASONRY CONTRIBUTING EMPLOYER 0 READY TILE LLC CONTRIBUTING EMPLOYER 0 REFTECH INTERNATIONAL REFRACTORIES CONTRIBUTING EMPLOYER 0 RESTOREWORKS CONTRIBUTING EMPLOYER 0 ROGERS & SONS CONSTRUCTION INC CONTRIBUTING EMPLOYER 0 RV BUILDERS CONTRIBUTING EMPLOYER 0 SONGER SERVICES INC CONTRIBUTING EMPLOYER 0 SOUTHWEST REFRACTORY OF TEXAS CONTRIBUTING EMPLOYER 0 T & K MASONRY INC CONTRIBUTING EMPLOYER 0 TOTAL MILL SERVICES INC CONTRIBUTING EMPLOYER 0 UNLIMITED MASONRY CONTRIBUTING EMPLOYER 0 VOGT CONSTRUCTION CO CONTRIBUTING EMPLOYER 0 ZIOLKOWSKI CONSTRUCTION COMPANY CONTRIBUTING EMPLOYER 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 0 0