2021-10-07T14:21:29-05:00 2020-12-31 131577780 SCHULTHEIS & PANETTIERI LLP 450 WIRELESS BLVD HAUPPAUGE NY 11788 990 2020-01-01 135542693 CEMENT AND CONCRETE WORKERS DC WELFARE FUND CEME 7187626133 35-30 FRANCIS LEWIS BLVD NO 201 FLUSHING NY 11358 MICHAEL SALGO EMPLOYER TRUSTEE 7187626133 2021-10-07 1 MICHAEL SALGO 999009999 CAROL WESTFALL P00539069 6312734778 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z MARGARET BOWEN 35-30 FRANCIS LEWIS BLVD NO 201 FLUSHING NY 11358 48742235 0 X WWW.CCWBF.ORG X 1949 NY TO PROVIDE HEALTH AND OTHER BENEFITS TO ELIGIBLE PARTICIPANTS. 7 7 12 0 0 0 0 0 27223545 24765260 11808278 2002612 131544 206377 39163367 26974249 0 0 35803992 34965884 1357022 1612936 0 0 0 1283860 276111 38444874 36854931 718493 -9880682 116121628 115159029 8241261 8660355 107880367 106498674 TO PROVIDE HEALTH AND OTHER BENEFITS TO ELIGIBLE PARTICIPANTS. 0 0 TO PROVIDE HEALTH AND OTHER BENEFITS TO ELIGIBLE PARTICIPANTS. 0 0 0 0 0 0 0 0 0 1 1 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 1 0 0 1 25 0 1 12 0 0 0 0 0 0 0 0 0 X 7 7 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X MARGARET BOWEN 7187626133 35-30 FRANCIS LEWIS BLVD FLUSHING NY 11358 X ANGELO ANGELONE UNION TRUSTEE 1.00 4.00 X 0 0 0 MICHAEL SALGO EMP TRUSTEE 1.00 4.00 X 0 0 0 ERIC LEE EMP TRUSTEE 1.00 4.00 X 0 0 0 ANTHONY AMELLA UNION TRUSTEE 1.00 4.00 X 0 0 0 KIERAN O'SULLIVAN UNION TRUSTEE 1.00 4.00 X 0 0 0 JOHN PETERS UNION TRUSTEE 1.00 4.00 X 0 0 0 KEVIN O'BRIEN EMP TRUSTEE 1.00 4.00 X 0 0 0 MARGARET BOWEN FUND ADMINISTRATOR 19.00 21.00 X 262376 0 92024 ABBY KAPLAN ASSISTANT FUND ADMINISTRAT 19.00 21.00 X 165868 0 63129 428244 0 155153 2 0 1 0 EMPIRE HEALTHCHOICE ASSURANCE INC ONE LIBERTY PLAZA STE 200 NEW YORK NY 10006 HEALTH CLAIMS PROCES 878126 GORLICK KRAVITZ & LISTHAUS PC 17 STATE STREET 4TH FLR NEW YORK NY 100041501 LEGAL 554391 BASYS 15300 W 105TH TERRACE LENEXA KS 66219 COMPUTER 201944 FITZSIMMONS ABRAMS LLP 7600 JERICHO TURNPIKE 403 WOODBURY NY 11797 PAYROLL AUDIT 167506 SCHULTHEIS & PANETTIERI LLP 450 WIRELESS BLVD HAUPPAUGE NY 11788 ACCOUNTING 125845 6 EMPLOYER CONTRIBUTIONS 238900 19037803 19037803 PARTICIPANT CONTRIBUTIONS 238900 5727457 5727457 24765260 1408160 1408160 22362438 21767986 594452 594452 594452 MEDICARE PART D 238900 109969 109969 OTHER INCOME 238900 96408 96408 206377 26974249 24971637 0 2002612 34965884 354400 824416 260156 95865 78099 668657 253752 89673 101332 177449 297738 249662 40428 93203 REIMBURSED EXPENSES -1695783 36854931 7242831 11225468 1077456 992137 7563625 5637572 21070 412610 43762 396776 368848 20852259 24244520 78935684 72669414 52997 0 116121628 115159029 191094 216406 8050167 8443949 8241261 8660355 X 0 0 0 0 107880367 106498674 107880367 106498674 116121628 115159029 -9880682 8498989 0 X 0 1 X 1 0 412610 43762 368848 368848 COMMON/COLLECTIVE TRUST FUNDS 35201629 F PARTNERSHIP/JOINT VENTURE INTERESTS 16382198 F UNALLOCATED INSURANCE CONTRACTS 6646000 F 103-12 INVESTMENT ENTITIES 14439587 F 72669414 DUE TO AFFILIATES 2365670 PLANS CURRENT BENEFIT OBLIGATIONS 6078279 8443949 35383565 8498989 8498989 26884576 89673 89673 26974249 37140382 0 37140382 89673 -375124 -285451 36854931 PART XII, LINE 4B - OTHER ADJUSTMENTS: CHANGE IN IBNR -375,124. X 0 0 0 MARGARET BOWEN FUND ADMINISTRATOR 262376 0 0 0 0 0 81564 0 10460 0 354400 0 0 0 ABBY KAPLAN ASSISTANT FUND ADMINISTRAT 165868 0 0 0 0 0 52245 0 10884 0 228997 0 0 0 ALEXA ANGELONE FAMILY MEMBER 124426 EMPLOYMENT 0 FORM 990, PART VI, SECTION B, LINE 11B A COPY OF FORM 990 IS PROVIDED TO ALL VOTING MEMBERS OF THE GOVERNING BODY AND REVIEWED AT A REGULARLY SCHEDULED BOARD MEETING PRIOR TO SUBMISSION. FORM 990, PART VI, SECTION B, LINE 12C AS REQUIRED BY THE FUND'S POLICY AND BY ERISA, OFFICERS, DIRECTORS, AND KEY EMPLOYEES HAVE A CONTINUOUS OBLIGATION TO REPORT POTENTIAL CONFLICTS OF INTEREST. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENTS ARE AVAILABLE TO THE PUBLIC TO THE EXTENT REQUIRED BY LAW. PARTICIPANTS MAY VIEW DOCUMENTS AT THE FUND OFFICE UPON REQUEST. CCW ANNUITY FUND 35-30 FRANCIS LEWIS BLVD STE 201 FLUSHING NY 11358 112942389 EMPLOYEE BENEFIT FUND NY 501(A) N/A N/A 0 CCW PENSION FUND 35-30 FRANCIS LEWIS BLVD STE 201 FLUSHING NY 11358 135629824 EMPLOYEE BENEFIT FUND NY 501(A) N/A N/A 0 CCW SCHOLARSHIP FUND 35-30 FRANCIS LEWIS BLVD STE 201 FLUSHING NY 11358 306082178 SCHOLARSHIP FUND NY 501(C)3 10 N/A 0 CCW LABOR MGMT FUND 30-56 WHITESTONE EXWY STE 320 FLUSHING NY 11354 616337806 LABOR ORGANIZATION NY 501(C)5 N/A N/A 0 CCW TRAINING AND EDUC FUND 29-18 35TH AVENUE ASTORIA NY 11106 113443290 EMPLOYEE BENEFIT FUND NY 501(C)3 N/A N/A 0 LIUNA LOCAL 18A 4235 KATONAH AVE BRONX NY 10741 130558180 LABOR ORGANIZATION NY 501(C)5 N/A N/A 0 LIUNA CEMENT & CONCRETE LOCAL 20 36-36 33RD STREET ASTORIA NY 11106 130872405 LABOR ORGANIZATION NY 501(C)5 N/A N/A 0 CONCRETE WORKERS LOCAL 6A 30-56 WHITESTONE EXPRESSWAY FLUSHING NY 11354 134988576 LABOR ORGANIZATION NY 501(C)5 N/A N/A 0 CONCRETE WORKERS DISTRICT COUNCIL 30-56 WHITESTONE EXPRESSWAY FLUSHING NY 11354 135541522 LABOR ORGANIZATION NY 501(C)5 N/A N/A 0 GBLL 66 WELFARE FUND 1600 WALT WHITMAN RD MELVILLE NY 11747 111627279 WELFARE FUND NY 501A N/A N/A 0 LABORERS LOCAL 235 WELFARE FUND 41 KNOLLWOOD RD ELMSFORD NY 10523 131777458 WELFARE FUND NY 501A N/A N/A 0 NEW YORK STATE LABORERS ORG FUND 35-11 35TH AVE ASTORIA NY 11106 208063145 LABOR ORGANIZATION NY 501(C)5 N/A N/A 0 CCW ORGANIZING FUND 29-18 35TH AVENUE ASTORIA NY 11106 830561890 LABOR ORGANIZATION NY 501(C)5 N/A N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 SCHEDULE R, PART 11 AND IV: CERTAIN TRUSTEES LISTED ON PART VII, SECTION A, SERVE AS VOLUNTEERS AND DO NOT RECEIVE COMPENSATION FROM THIS ORGANIZATION OR ANY RELATED ORGANIZATION. 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