2021-11-08T07:06:55-06:00 2020-12-31 611436956 NOVAK FRANCELLA LLC 40 MONUMENT RD 5TH FLR BALA CYNWYD PA 19004 990 2020-01-01 135521921 LAUNDRYDRY CLEANING WORKERS AND ALLIED INDUSTRIES HEALTH FUND WORKERS UNITED LAUN 9143675000 333 WESTCHESTER AVENUE WHITE PLAINS NY 106042910 MICHAEL POTACK TRUSTEE 9148403240 2021-10-12 1 MICHAEL POTACK XXX-XX-XXXX LOUIS VERZELLA CPA P00360279 6106689400 2021-11-08 3 AAL1 IAL1 2020 2022-09-23 18:48:47Z MICHAEL POTACK 275 7TH AVENUE NEW YORK NY 10001 93068845 0 X N/A X 1946 NY VEBA HEALTH FUND PROVIDING HEALTH BENEFITS TO ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS. 6 4 4 0 0 0 0 0 17178952 10971990 2052169 837178 15100 13500 19246221 11822668 0 0 14785946 13774969 235832 219580 0 0 0 2077252 1874331 17099030 15868880 2147191 -4046212 23435271 19768454 357285 447757 23077986 19320697 TO PROVIDE MEDICAL, HOSPITALIZATION, DENTAL, VISION & PRESCRIPTION BENEFITS PAID TO ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS. 0 0 MEDICAL, HOSPITALIZATION, DENTAL, VISION & PRESCRIPTION BENEFITS PAID TO ELIGIBLE PARTICIPANTS 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 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 42 0 4 1 0 0 0 0 0 0 0 0 0 0 X 6 4 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X FUNDS OFFICE 9143675000 333 WESTCHESTER AVENUE WHITE PLAINS NY 10604 MEGHAN CHAMBERS UNION TRUSTEE 1.00 40.00 X 0 129969 41663 ALBERTO ARROYO UNION TRUSTEE 1.00 40.00 X 0 129351 41663 MICHAEL POTACK EMPLOYER TRUSTEE 1.00 X 0 0 0 BRIAN SANTONELLI EMPLOYER TRUSTEE (P) 1.00 X 0 0 0 WILFREDO LARANCUENT UNION TRUSTEE (P) 1.00 40.00 X 0 0 0 JOHN MAGLIOCCO EMPLOYER TRUSTEE 1.00 X 0 0 0 ROBERT POTACK EMPLOYER TRUSTEE 1.00 X 0 0 0 0 259320 83326 0 0 1 0 AMALGAMATED EMPLOYEE BENEFITS ADMINISTRA 333 WESTCHESTER AVE WHITE PLAINS NY 16064 ADMIN. & INVESTMENT SERVICES 1458706 EMPIRE HEALTHCHOICE ASSURANCE INC ONE LIBERTY PLAZA NEW YORK NY 10006 CLAIM PROCESSING 528292 SCHULTE ROTH & ZABEL LLP 919 THIRD AVE NEW YORK NY 10022 LEGAL 175749 3 EMPLOYER CONTRIBUTIONS 525100 10886535 10886535 MEMBER CONTRIBUTIONS 525100 66294 66294 COBRA CONTRIBUTIONS 525100 19161 19161 10971990 523260 523260 81560095 81246177 313918 313918 313918 SHARED EXPENSE REIMBURSEMENT 525100 13500 13500 13500 11822668 10985490 0 837178 13774969 136970 19560 50018 13032 1344706 215586 35646 119625 71687 11283 18000 4500 421 29422 ALLOCATED COMMON EXPENS 16100 FEES MANDATED BY ACA 7355 15868880 250 250 1546977 996135 1112997 1105669 212 212 17817291 15069769 2580306 2287213 377238 309206 23435271 19768454 161159 155097 196126 292660 357285 447757 X 0 0 0 0 23077986 19320697 23077986 19320697 23435271 19768454 -4046212 288923 0 X X 0 1 X 1 0 0 HEDGE FUND OF FUNDS - DIVERSIFIED 381027 F COMMON COLLECTIVE TRUST 1906186 F 2287213 DUE TO RELATED ENTITIES 16100 CASH OVERDRAFT 99948 OBLIGATION TO DIST. CONTRIBUTIONS TO RELATED PARTIES 63318 FEES MANDATED BY THE ACA 7355 DUE TO OTHER ENTITIES 89503 OTHER LIABILITIES 16436 292660 X 11978466 288923 288923 11689543 119625 13500 133125 11822668 15735755 0 15735755 119625 13500 133125 15868880 PART X, LINE 2: 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 IF THE PLAN HAS TAKEN AN UNCERTAIN POSITION THAT, MORE LIKELY THAN NOT, WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE U.S. FEDERAL, STATE, OR LOCAL TAXING AUTHORITIES. THE PLAN IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. TYPICALLY, PLAN TAX YEARS WILL REMAIN OPEN FOR THREE YEARS; HOWEVER, THIS MAY DIFFER DEPENDING UPON THE CIRCUMSTANCES OF THE PLAN YEAR. PART XI, LINE 4B - OTHER ADJUSTMENTS: SHARED REIMBURSED EXPENSES 13,500. PART XII, LINE 4B - OTHER ADJUSTMENTS: SHARED REIMBURSED EXPENSES 13,500. 0 0 0 MEGHAN CHAMBERS UNION TRUSTEE 0 127274 0 0 0 2695 0 0 0 41663 0 171632 0 0 ALBERTO ARROYO UNION TRUSTEE 0 127274 0 0 0 2077 0 0 0 41663 0 171014 0 0 FORM 990, PART VI, SECTION A, LINE 2 TRUSTEES MICHAEL POTACK ABD ROBERT POTACK SHARE A FAMILY RELATIONSHIP. FORM 990, PART VI, SECTION B, LINE 11B LAUNDRY, DRY CLEANING WORKERS & ALLIED INDUSTRIES HEALTH FUND, WORKERS UNITED'S FORM 990 IS PREPARED BY ITS INDEPENDENT PUBLIC ACCOUNTANT WHO THEN FORWARDS THE COMPLETED RETURN TO THE BOARD OF TRUSTEES FOR REVIEW AND SIGNATURE. FORM 990, PART VI, SECTION B, LINE 12C LAUNDRY, DRY CLEANING WORKERS & ALLIED INDUSTRIES HEALTH FUND, WORKERS UNITED MONITORS ITS CONFLICT OF INTEREST POLICY ON AN ANNUAL BASIS. FORM 990, PART VI, SECTION C, LINE 19 LAUNDRY, DRY CLEANING WORKERS & ALLIED INDUSTRIES HEALTH FUND, WORKERS UNITED'S GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XII, LINE 2C: LAUNDRY, DRY CLEANING WORKERS & ALLIED INDUSTRIES HEALTH FUND,WORKERS UNITED BOARD OF TRUSTEES IS RESPONSIBLE FOR OVERSEEING THE FINANCIAL STATEMENT AUDIT AND SELECTION OF THE INDEPENDENT ACCOUNTANT WHO PERFORMED THE AUDIT. LAUNDRY DRY CLEANING WORKERS & ALLIED IND RET FUND 333 WESTCHESTER AVE NEW YORK NY 10604 135521921 PENSION FUND NY 401(A)/501(A) 0 LAUNDRY DRY CLEANING WORKERS EDUCATION & LEGAL ASSISTANCE FUND 333 WESTCHESTER AVE NEW YORK NY 10604 201072118 EDUCATIONAL & LEGAL ASSISTANCE NY 501(C)9 0 LAUNDRY DISTRIBUTION AND FOOD SERVICE JOINT BOARD WORKERS UNITED 703 MCCARTER HWY NEWARK NJ 07102 LABOR UNION NJ 501(C)5 0 ACLS NEW ENGLAND INC AMERICAN DRIVE IN CLEANERS OF HEWLETT ARAMARK UNIFORM SERVICES NEWARX NJ ARROW LINEN SUPPLY CO BEST METROPOLITAN ELITE AIRLINE LINEN OF NEW YORK INC ERNEST WINZER CLEANERS LLC HCSC LAUNDRY ASBURY PARK NJ HIGHLAND LIGHT STEAM LAUNDRY INC KEUM LIMITED MARVAL INDUSTRIES INC MED APPAREL SERVICES MERITEX LLC MERLIN INDUSTRIES NEW ENGLAND LINEN NEW YORK UNIFORM FKA MSJ NORTH EAST LINEN PAUL DYEING CO RIDDELL INC ALL AMERICAN SPORTS CORP SANITARY COAT APPRON & TOWEL SUPPLY CO INC STAIN-LESS INC STAR CLEANERS - ROCKVILLE UNITEX TEXTILE RENTAL INC H CHRISTIAN & SONS (VISION & RETIREMENT ONLY) WH LINEN SUPPLY 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 LAUNDRY DISTRIBUTION AND FOOD SERVICE JOINT BOARD WORKERS UNITED K 18000 FMV LAUNDRY DISTRIBUTION AND FOOD SERVICE JOINT BOARD WORKERS UNITED O 16100 FMV LAUNDRY DRY CLEANING WORKERS & ALLIED IND RET FUND Q 12300 FMV LAUNDRY DRY CLEANING WORKERS EDUCATION & LEGAL ASSISTANCE FUND Q 1200 FMV