2021-11-15T10:49:20-06:00 2021-02-28 320043599 LEGACY PROFESSIONALS LLP 222 INDIANAPOLIS BLVD STE 103 SCHERERVILLE IN 46375 990 2020-03-01 350940329 BRICKLAYERS UNION LOCAL NO 6 OF INDIANA WELFARE FUND INDI 2197693376 7985 MARSHALL STREET MERRILLVILLE IN 46410 ROBERT PUZA FUND MANAGER 2197693376 2021-11-15 1 ROBERT PUZA 999009999 TIMOTHY LAKIS P00841931 2198361065 2021-11-15 3 AAL1 IAL1 2020 2022-09-23 18:48:47Z ROBERT PUZA 7985 MARSHALL STREET MERRILLVILLE IN 46410 8140039 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 3 0 0 0 0 0 4290101 3728118 222269 310750 0 0 4512370 4038868 0 0 3969282 3302281 160919 164663 0 0 0 184698 177011 4314899 3643955 197471 394913 10152093 11274059 109525 136933 10042568 11137126 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 3 1 0 0 0 0 0 0 0 0 0 0 X 10 7 1 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 95740 72651 FRED COLVIN TRUSTEE - PAST 1.00 1.00 X 0 0 0 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 85545 49228 ROBERT ZEMAITIS TRUSTEE 1.00 1.00 X 0 0 0 TIM WHITE TRUSTEE 1.00 1.00 X 0 152 93 JASON BARNARD TRUSTEE 1.00 1.00 X 0 0 0 TIM KAPITAN TRUSTEE 1.00 1.00 X 0 0 0 DAVID RODRIGUEZ TRUSTEE - PAST 1.00 1.00 X 0 136 82 ROBERT PUZA FUND MANAGER 20.00 20.00 X 0 81354 50466 0 262927 172520 0 0 1 0 ANTHEM 220 VIRGINIA AVE INDIANAPOLIS IN 46204 PPO NETWORK PROVIDER 160218 1 EMPLOYER CONTRIBUTIONS 900099 3386823 3386823 PARTICIPANT/RETIREE CONTRIBUTIONS 900099 341295 341295 3728118 288891 288891 4123030 4101171 21859 21859 21859 4038868 3728118 0 310750 3302281 65229 42060 31434 19073 6867 32531 38171 8000 44753 6549 24501 6809 1180 403 13031 FEES MANDATED BY ACA 1083 3643955 143903 79257 315350 398545 422088 615052 16581 17367 16304 16304 403 0 9253768 10163838 10152093 11274059 105036 124967 1916 7972 2573 3994 109525 136933 X 0 0 0 0 10042568 11137126 10042568 11137126 10152093 11274059 394913 699645 0 X 0 1 X 1 0 16304 16304 0 0 DUE TO RELATED PENSION FUND 3994 3994 X 4730513 699645 699645 4030868 8000 8000 4038868 3635955 0 3635955 8000 8000 3643955 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 95740 0 0 0 0 0 53151 0 19500 0 168391 0 0 FORM 990, PART VI, SECTION A, LINE 2 FRED COLVIN (TRUSTEE) AND JEFFREY COLVIN (TRUSTEE) ARE BROTHERS. 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 ACMS GROUP INC CONTRIBUTING EMPLOYER 0 ADAMS MASONRY INC CONTRIBUTING EMPLOYER 0 ART MOSAIC & TILE CO INC CONTRIBUTING EMPLOYER 0 BELDON INTERIORS INC CONTRIBUTING EMPLOYER 0 BERGLUND CONSTRUCTION COMPANY CONTRIBUTING EMPLOYER 0 BISCO REFRACTORIES INC CONTRIBUTING EMPLOYER 0 C & S MASONRY RESTORATION LLC CONTRIBUTING EMPLOYER 0 COLVIN MASONRY CO CONTRIBUTING EMPLOYER 0 CUSTOM MASONRY RESTORATION INC CONTRIBUTING EMPLOYER 0 FOSBEL INC CONTRIBUTING EMPLOYER 0 GARIUP CONSTRUCTION INC CONTRIBUTING EMPLOYER 0 GLASROCK PRODUCTS INC CONTRIBUTING EMPLOYER 0 GOUGH INC CONTRIBUTING EMPLOYER 0 HARBISON-WALKER REFRACTORIES CO CONTRIBUTING EMPLOYER 0 INTERIOR FINISHES INC CONTRIBUTING EMPLOYER 0 J T THORPE & SON INC CONTRIBUTING EMPLOYER 0 JP LARSEN INC CONTRIBUTING EMPLOYER 0 KAUFMANN-GALLAGHER WATERPROOFING INC CONTRIBUTING EMPLOYER 0 KORELLIS ROOFING INC CONTRIBUTING EMPLOYER 0 KWIATKOWSKI MASONRY INC CONTRIBUTING EMPLOYER 0 LARSON-DANIELSON CONSTRUCTION CO INC CONTRIBUTING EMPLOYER 0 MASTER TILE INC CONTRIBUTING EMPLOYER 0 MATRIX NORTH AMERICAN CONSTRUCTION INC CONTRIBUTING EMPLOYER 0 MID-AMERICAN GUNITE INC CONTRIBUTING EMPLOYER 0 MIDWEST TILE & INTERIORS CONTRIBUTING EMPLOYER 0 MORRISON CONSTRUCTION COMPANY INC CONTRIBUTING EMPLOYER 0 NATIONAL MACHINERY & CONVEYOR INC CONTRIBUTING EMPLOYER 0 ONEX CONSTRUCTION INC CONTRIBUTING EMPLOYER 0 PAULS CONSTRUCTION INC CONTRIBUTING EMPLOYER 0 PREMIER CAULKING CONTRIBUTING EMPLOYER 0 RAM CONSTRUCTION SERVICES OF MICHIGAN INC CONTRIBUTING EMPLOYER 0 RAMCORP INC CONTRIBUTING EMPLOYER 0 REFTECH INTERNATIONAL REFRACTORIES CONTRIBUTING EMPLOYER 0 RESTOREWORKS CONTRIBUTING EMPLOYER 0 SONGER SERVICES INC CONTRIBUTING EMPLOYER 0 T&K MASONRY INC CONTRIBUTING EMPLOYER 0 ZIOLKOWSKI CONSTRUCTION INC CONTRIBUTING EMPLOYER 0 BARTON MALOW CONTRIBUTING EMPLOYER 0 BRUNO'S TUCKPOINTING INC CONTRIBUTING EMPLOYER 0 FLUOR CONSTRUCTORS INTERNATIONAL INC CONTRIBUTING EMPLOYER 0 J & W SEALANTS INC CONTRIBUTING EMPLOYER 0 ARMOR SEALING LLC CONTRIBUTING EMPLOYER 0 ATLAS BUILDING SERVICES CONTRIBUTING EMPLOYER 0 BULLEY & ANDREWS MASONRY CONTRIBUTING EMPLOYER 0 COBA TILE CONTRIBUTING EMPLOYER 0 INTEGRAL FLOORING SYSTEMS INC CONTRIBUTING EMPLOYER 0 SLOAN MOSIAC TILE CONTRIBUTING EMPLOYER 0 STEWART SERVICES CONTRIBUTING EMPLOYER 0 TOTAL MILL SERVICES CONTRIBUTING EMPLOYER 0 TRE SERVICES INC CONTRIBUTING EMPLOYER 0 UNLIMITED MASONRY CONTRIBUTING EMPLOYER 0 IWANSKI-PYZIK MASONRY AND BUILDERS INC CONTRIBUTING EMPLOYER 0 GUY NIELSON CO INC CONTRIBUTING EMPLOYER 0 ABLE MASONRY DEVELOPMENT CO CONTRIBUTING EMPLOYER 0 J T THORPE COMPANY CONTRIBUTING EMPLOYER 0 EXCEPTIONAL FLOORING INC CONTRIBUTING EMPLOYER 0 MASONRY ERECTORS CONTRIBUTING EMPLOYER 0 BEST BRICKWASHING INC CONTRIBUTING EMPLOYER 0 BOURBAN TILE & MARBLE INC CONTRIBUTING EMPLOYER 0 C-STONE INSTALLATION CO CONTRIBUTING EMPLOYER 0 EMPIRE REFACTORY SERVICES INC CONTRIBUTING EMPLOYER 0 FEBEL BROTHERS INC CONTRIBUTING EMPLOYER 0 GRAYCOR INDUSTRIAL CONSTRUCTORS CONTRIBUTING EMPLOYER 0 HAGERMAN CONSTRUCTION CONTRIBUTING EMPLOYER 0 ICC COMMONWEALTH CORP CONTRIBUTING EMPLOYER 0 J & E DUFF INC CONTRIBUTING EMPLOYER 0 J & J MASONRY CONTRIBUTING EMPLOYER 0 LACY CONSTRUCTION CO CONTRIBUTING EMPLOYER 0 M P BRICK CLEANING CONTRIBUTING EMPLOYER 0 MIDLAND ENGINEERING CONTRIBUTING EMPLOYER 0 MIDWEST REFACTORY INSTALLATION CONTRIBUTING EMPLOYER 0 VOGT CONSTRUCTION CO CONTRIBUTING EMPLOYER 0 YANEY MASONRY CONTRIBUTING EMPLOYER 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 0 0