2019-03-13T17:45:29-05:00 2018-05-31 522385296 LINDQUIST LLP 5000 EXECUTIVE PARKWAY SUITE 400 SAN RAMON CA 94583 990 2017-06-01 941235152 LABORERS HEALTH & WELFARE TRUST FUND FOR NORTHERN CALIFORNIA LABO 7078642800 220 CAMPUS LANE FAIRFIELD CA 945341498 OSCAR DE LA TORRE TRUSTEE 7078642800 2019-03-13 1 JASMINE S BAKER P01452246 9252779100 66.7.226.66 2019-03-13 15:45:21 PD P D85FB602DC4FA66F28A631CB81EF53DF59ECABFA D85FB602DC4FA66F28A631CB81EF53DF59ECABFA 2017 2019-02-21 02:37:17Z OSCAR DE LA TORRE 220 CAMPUS LANE FAIRFIELD CA 945341498 515255503 0 X N/A X 1953 CA TO PROVIDE HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS. 10 0 0 0 0 0 0 0 307432339 366699582 4496508 14130916 5405 20295 311934252 380850793 0 0 273703234 310787605 0 0 0 0 0 16758888 17240598 290462122 328028203 21472130 52822590 259316262 334944683 139411606 168942792 119904656 166001891 TO PROVIDE HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS COVERED UNDER THE COLLECTIVE BARGAINING AGREEMENTS BETWEEN THE EMPLOYERS AND THE UNION. 0 0 PROVIDED HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS COVERED UNDER THE COLLECTIVE BARGAINING AGREEMENTS BETWEEN THE EMPLOYERS AND THE UNION. 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 0 0 0 0 0 0 0 0 0 0 1 0 0 1 78 0 1 0 0 0 0 0 0 0 X 10 0 0 1 0 0 0 0 0 1 1 0 0 0 0 0 1 0 0 0 X BYRON C LONEY 7078642800 220 CAMPUS LANE FAIRFIELD CA 94534 BILL KOPONEN TRUSTEE 1.00 X 0 0 0 ROBERT CHRISP TRUSTEE 1.00 X 0 0 0 JERRY OVERAA TRUSTEE 1.00 X 0 0 0 MANUEL DE SANTIAGO TRUSTEE - PAST 1.00 X 0 0 0 BRIAN GARDNER TRUSTEE 1.00 X 0 0 0 OSCAR DE LA TORRE TRUSTEE 1.00 X 0 0 0 DOYLE RADFORD TRUSTEE 1.00 X 0 0 0 DAVID GORGAS TRUSTEE 1.00 X 0 0 0 FERNANDO ESTRADA TRUSTEE 1.00 X 0 0 0 RAMON HERNANDEZ TRUSTEE 1.00 X 0 0 0 JAMES TROUP TRUSTEE 1.00 X 0 0 0 SEE SCHEDULE O FOR COMPENSATION PAID BY RELATED ORGANIZATIONS 1.00 X 0 1 0 0 1 0 0 0 0 0 LABORERS FUND ADMINISTRATIVE OFFICE OF N 220 CAMPUS LANE FAIRFIELD CA 94534 ADMINISTRATOR 8865312 BLUE CROSS OF CALIFORNIA PO BOX 70000 VAN NUYS CA 914700001 CLAIMS ADMINISTRATOR 3789364 DELTA DENTAL 100 FIRST STREET SAN FRANCISCO CA 94105 CLAIMS ADMINISTRATOR 1224684 EPLAN SERVICES 4300 KITTREDGE STREET DENVER CO 80239 CLAIMS ADMINISTRATOR 924349 OPTUM RX OPO BOX 509075 SAN DIEGO CA 92150 CLAIMS ADMINISTRATOR 509454 9 EMPLOYER CONTRIBUTIONS 900099 344316344 344316344 PARTICIPANT CONTRIBUTIONS 900099 14127247 14127247 REBATES & SUBSIDIES 900099 7775697 7775697 COBRA CONTRIBUTIONS 900099 480294 480294 366699582 4949483 4949483 143586143 134404710 9181433 9181433 9181433 SETTLEMENT INCOME 900099 20295 20295 20295 380850793 366719877 0 14130916 310787605 8531036 160803 203375 497717 7656893 120342 2397 17732 AFFORDABLE CARE ACT FEE 45548 DUES & SUBSCRIPTIONS 4125 OTHER 630 328028203 -359315 -422025 27777340 45263004 34180779 40826158 30767 430988 122637775 171444152 75048916 77402406 259316262 334944683 25061606 45332792 114350000 123610000 139411606 168942792 X 0 0 0 0 119904656 166001891 119904656 166001891 259316262 334944683 52822590 -6725355 0 X X 0 1 X 1 0 0 COMMON COLLECTIVE FUNDS 77402406 F 77402406 ACCUMULATED ELIGIBILITY CREDITS 123610000 123610000 X 373697870 -6725355 -6725355 380423225 427568 427568 380850793 296720588 0 296720588 427568 30880047 31307615 328028203 PART X, LINE 2: THE PLAN'S ADMINISTRATOR HAS ANALYZED THE TAX POSITIONS TAKEN BY THE PLAN AND HAS CONCLUDED THAT, AS OF MAY 31, 2018, THERE ARE NO UNCERTAIN POSITIONS TAKEN, OR EXPECTED TO BE TAKEN, THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE FINANCIAL STATEMENTS. THE PLAN IS SUBJECT TO ROUTINE AUDITS BY THE TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. THE PLAN'S ADMINISTRATOR BELIEVES THE PLAN IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR THE FISCAL YEARS PRIOR TO 2015. PART XII, LINE 4B - OTHER ADJUSTMENTS: CHANGE IN BENEFIT OBLIGATION 30,880,047. FORM 990, PART VI, SECTION A, LINE 3 THE ORGANIZATION HAS CONTRACTED WITH THE LABORERS FUNDS ADMINISTRATIVE OFFICE OF NORTHERN CALIFORNIA, INC. TO PROVIDE ADMINISTRATIVE SERVICES FOR THE ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 11B A COMPLETE COPY OF THE FORM 990 HAS NOT BEEN PROVIDED TO ALL MEMBERS OF THE GOVERNING BODY BEFORE FILING THE FORM, HOWEVER THE FORM 990 WAS PROVIDED TO THE ADMINISTRATIVE OFFICE FOR REVIEW PRIOR TO FILING THE FORM. COMPLETE COPIES ARE PROVIDED TO THE GOVERNING BODY MEMBERS UPON REQUEST. FORM 990, PART VI, SECTION B, LINE 12 ALTHOUGH THE ORGANIZATION DOES NOT HAVE A CONFLICT OF INTEREST POLICY, THE ADMINISTRATIVE OFFICE DOES HAVE A CONFLICT OF INTEREST POLICY IN PLACE. THE ADMINISTRATIVE OFFICE EMPLOYEES AND THE ADMINISTRATIVE OFFICE BOARD OF DIRECTORS ARE REQUIRED TO ADHERE TO THAT POLICY. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 992, PART VI, SECTION B, LINE 13: ALTHOUGH THE ORGANIZATION DOES NOT HAVE A WHISTLEBLOWER POLICY, THE ADMINISTRATIVE OFFICE DOES HAVE A WHISTLEBLOWER POLICY IN PLACE. THE ADMINISTRATIVE OFFICE EMPLOYEES AND THE ADMINISTRATIVE OFFICE BOARD OF DIRECTORS ARE COVERED BY THAT POLICY. FORM 990, PART XI, LINE 2C THE BOARD OF TRUSTEES OF THE ORGANIZATION ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF THE ORGANIZATION'S FINANCIAL STATEMENTS AND THE SELECTION OF THE INDEPENDENT AUDITOR. THIS PROCESS HAS NOT CHANGED. FORM 990, PART VII, SECTION A, LINE 1A: TRUSTEES ARE NOT COMPENSATED BY THE TRUST. 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. IF YOU WOULD LIKE ADDITIONAL INFORMATION PLEASE CONTACT THE TRUST OFFICE. LABORERS PENSION TRUST FUND FOR NORTHERN CALIFORNIA 220 CAMPUS LANE FAIRFIELD CA 94534 946277608 TO PROVIDE RETIREMENT TO ELIGIBLE PARTICIPANTS 501(A) 0 LABORERS VACATION-HOLIDAY TRUST FUND FOR NORTHERN CALIFORNIA 220 CAMPUS LANE FAIRFIELD CA 94534 946092198 TO PROVIDE VACATION AND HOLIDAY BENEFITS TO ELIGIBLE PARTICIPANTS 501(C)(9) 0 LABORERS TRAINING AND RETRAINING TRUST FUND FOR NORTHERN CALIFORNIA 220 CAMPUS LANE FAIRFIELD CA 94534 941688279 TO PROVIDE TRAINING SERVICES TO ELIGIBLE PARTICIPANTS 501(C)(3) 0 LABORERS FUND ADMINISTRATIVE OFFICE FOR NORTHERN CALIFORNIA 220 CAMPUS LANE FAIRFIELD CA 94534 941688279 TO PROVIDE TRAINING SERVICES TO ELIGIBLE PARTICIPANTS N/A C 0.33000 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 LABORERS FUND ADMINISTRATIVE OFFICE FOR NORTHERN CALIFORNIA P 8531036 BASED ON TIME AND COSTS SPENT. FORM 990, SCHEDULE R, IDENTIFICATION OF RELATED ORGANIZATIONS: THE FILING ORGANIZATION IS A TAFT-HARTLEY MULTIEMPLOYER TRUST THAT PROVIDES HEALTH AND WELFARE BENEFITS TO ELIGIBLE EMPLOYERS AND THEIR DEPENDENTS. AS OF MAY 31, 2018, THERE ARE APPROXIMATELY 1515 EMPLOYERS THAT CONTRIBUTE TO THE TRUST. THE ADMINISTRATIVE OFFICE MAINTAINS A DATABASE OF THESE CONTRIBUTING EMPLOYERS, INCLUDING NAMES, ADDRESSES AND OTHER CONTACT INFORMATION. THE FEDERAL TAX CLASSIFICATION (DISREGARD ENTITY, TAX EXEMPT ORGANIZATION, PARTNERSHIP, TAXABLE CORPORATION OR TRUST) FOR EACH CONTRIBUTING EMPLOYER IS NOT ON FILE WITH THE ADMINISTRATIVE OFFICE AND IT COULD BE REASONABLY OBTAINED. AS A RESULT, THE NAMES OF THE CONTRIBUTING EMPLOYERS ARE LISTED ON PART VII BELOW AND NOT ON PART II THROUGH IV BY FEDERAL CLASSIFICATION. ASTA CONSTRUCTION COMPANY ANTIOCH PAVING CO INC ARGONAUT CONSTRS INC AMERICAN PAVING COMPANY AMOROSO S J CONST CO INC ALBANESE JOSEPH J INC ACME CONSTRUCTION CO INC ARCHIBALD C F PAVING INC ANNING JOHNSON COMPANY ARB INC BROWN VANCE INC BRANAGH INC BIANCHI GEO CONSTR INC BOGARD CONSTRUCTION BERKELEY READY MIX CO BRAY J L & SON INC BALDWIN CONT KNIFE RIVER LABORERS LOCAL 304 CONCO COMPANIES COLLINS ELECTRICAL CO CALIFORNIA DRILL & BLAST CUPERTINO ELECTRIC INC CONTRA COSTA ELECTRIC INC COLLISHAW C SPRINKLERS IN CLARK G R INC DELTA CONSTRUCTION CO DE SILVA GATES CONSTR DOLAN CONCRETE CONSTR DEL MONTE ELECTRIC CO INC FITZMAURICE J H FERRABEE G CO CLEAR CHANNEL OUTDOOR FERRANDO F & CO GRANITE CONSTRUCTION CO GRIFFIN JAMES R INC HARRIS CONSTR CO INC HICKEY W L SONS INC HERRERO BUILDERS INC AERCO-PACIFIC INC INDEPENDENT CONSTR CO JONES O C & SONS INC JOHNSON AA & SON INC L J KRUSE CO LANDAVAZO BROS INC LATHROP CONST ASSOC INC LABORERS LOCAL 073 LAMON CONSTRUCTION CO INC LESCURE CO INC LABORERS LOC #1130 LABORERS LOCAL 324 LUND CONSTRUCTION COMPANY MC GUIRE & HESTER MERCER FRASER CO INC MILL CONSTRUCTION MCDONALD O C CO INC MERLO LEWIS M INC MONTEREY MECHANICAL MIHOLOVICH CONCR CO INC E MITCHELL INC MECH CONTR NICHOLSON D W CORP NO CAL DISTRICT COUNCIL OVERAA C & COMPANY OTTO CONSTRUCTION O'GRADY PAVING INC PRESSURE GROUT CO KAISER FOUNDATION HOSPITA PELETZ C M COMPANY HARSCO INFRASTRUCTURE AME PACIFIC MECHANICAL CORP RANSOME COMPANY ROUNTREE PLUMBING & HEAT ROEN C W CONSTR CO REDGWICK CONSTRUCTION CO ROSENDIN ELECTRIC INC REED GEORGE INC ROSSI BUILDERS INC SWINERTON BUILDERS SANCO PIPELINES INC SHEA J F CONSTRUCTION INC SPENCER F W & SON INC SIGNATURE CONSTR CO INC SCOTT EDWARD W ELECTRIC C SMITH WALTER C CO INC RINKER MATERIALS LLC STOCKTON FENCE & MATERIAL GRIFFIN CONTRACT DEWATER LLC TEICHERT A & SONS TALINI LANDSCAPING THORNTON PAVING INC TORRES J G CONC CONSTR CO TAKEHARA LANDSCAPE INC UNGER CONSTR CO VALHALLA BLDRS & DEV INC WATTIS CONSTR CO INC WILSON GEORGE H INC WEST VALLEY CONSTR CO MC LELLAN W K COMPANY LABORERS FUNDS ADM OFFICE RAYMOND - 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INC BAKER W JAXON INC ROBYN CONSTRUCTION INC AL'S LANDCLEARING INC THOMPSON BUILDERS CORP LABORERS LOCAL 67 SHAW PIPELINE INC RESTEC CONTRACTORS INC SOLANO CONSTR CO INC GOODFELLOW TOP GRADE CON THIRD GENERATION DRILLING DUTRA MATERIALS RGW CONSTRUCTION INC SIGNAL ELECTRIC CONST INC COZART BROTHERS INC PERFORMANCE CONTRACTING SHIMMICK CONSTR CO INC STEPHENS A M CONST CO INC DIVERSIFIED CONCR CUTTING-LEBP DEL SECCO DIAMOND CORE HI-LITE JANITORIAL SVC LAB LEGISLATIVE DEPT D P R CONSTRUCTION WAHLUND CONSTRUCTION HERRICK CORPORATION RAINBOW WATERPROOFING CARPENTER GREG CONCR INC BELLCORE CONSTRUCTION INC PERFORMANCE ABATEMENT SVC D'ARCY & HARTY CONSTR INC RYAN ENGINEERING INC CAHILL CONSTR SVCS INC LAWLER & STANZ INC P T S MASONRY BRAHMA CONSTRUCTION INC NCD DBA CONE ENGINEERING AGEE CONSTRUCTION CORP R B CONSTRUCTION INC CAPITAL BLDG MAINT & CLEA BCCI CONSTRUCTION COMPANY SCOTT F INDUSTRIES STEVENS CREEK QUARRY INC GHILOTTI BROTHERS INC BALL GORDON N INC GHILOTTI CONSTR COMPANY MASON DANIEL W ENGINEERING A & B CONSTRUCTION INC LARSEN C V COMPANY UESUGI FARMS INC SHIMMICK-OBAYASHI JV HORIZON CONSTRUCTION CO CUSTOM SPRAY SYSTEMS INC SHCCA J.J.R. 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GENERAL BLDG MAINT T L ELECTRIC SKYLINE COMM'L INTERIORS BIG J CONSTRUCTION INC HEAVEY MICHAEL CONSTR BIG B CONSTRUCTION INC RADIANT ELECTRIC INC ORGANIZING DEPT INC NEILS CONTROLLED BLASTING DEMO MASTERS INC PRECISE CONCRETE SAWING R H CONCRETE ROEBUCK CONSTRUCTION SELBY'S SOIL EROSION CONT BASS ELECTRIC DIANI A J CONSTRUCTION CO RISER CONSTRUCTION CO INC FORM 990, SCHEDULE R, IDENTIFICATION OF RELATED ORGANIZATIONS:CONT'D BELTRAMO ELECTRIC INC KHS & S CONTRACTORS INC MOSTO CONSTRUCTION ANDES CONSTRUCTION INC CMC TRAFFIC CONTROL SPEC SACRAMENTO BLDG PRODUCTS INNER CITY DEMOLITION RUBECON GEN CONTRACTING GRAND INDUSTRIES ROCKAWAY CONSTRUCTION STONEY MASONRY SAN FRANCISCO COMMERCIAL YERBA BUENA ENG & CONSTR PHOENIX ELECTRIC CO BLUEWATER ENV SERV INC RUDOLPH COMM INTERIORS TERRACON PIPELINES INC MENDOCINO CONSTR SVCS INC ROSAS BROTHERS CONSTR BRADLEY W ELECTRIC LC GEN ENG & CONSTR INC CANYON SPRINGS ENTERPRISE K C K BUILDERS INC EAST BAY CONSTR CO INC QUIMU CONTRACTING INC AVISON CONSTRUCTION INC R J & J CONSTRUCTION INC OAKRIDGE INDUSTRIES INC GONSALVES & STRONCK INC M K PIPELINES INC BOHM ENVIRONMENTAL DECKER LANDSCAPING INC GIAMPOLINI/COURTNEY ROLLING PLAINS CONSTR INC E & F DEMOLITION BAILEY'S TRENCHLESS INC KROEKER INC DEMOLITION YAMAGUCHI RBT LANDSCAPE EMMETT'S EXCAVATION INC PENGILLY MASONRY INC SPENCON CONSTRUCTION NORTHWEST PAVING PONTE GEN ENGNRG CORP ACACIA EROSION CONTROL PARC ENVIRONMENTAL ALARCON BOHM KCI ENVIRONMENTAL INC FERGUSON WELDING SERVICE BOYETT CONSTRUCTION INC ZOLMAN CONSTR & DEVELOPMT MARQUES PIPELINE INC WESTERN WATER FEATURES BOTHMAN ROBERT A CONSTR NEARY LANDSCAPE INC PRINCIPAL BUILDERS INC STAR CONSTRUCTION INC POMS LANDSCAPE INC AMERICAN SANDBLASTING PAULS PLUMBING HESS CONCRETE CONSTR INC STRIPING GRAPHICS JOHNSON CONCRETE SAWING AHLBORN FENCE & STEEL INC G S E CONSTR. CO INC - LEBPCT ADVANCED DRILLING WORKS HAZARD CONCRETE CONSTR HUDSON EXCAVATION AUBURN GARDEN AND LNDSCPE G & N CONSTRUCTION R T WESTERN MAINTENANCE MICHAM ORAL E INC RELIANCE ENGINEERING TCG BUILDERS INC TNT INDUSTRIAL CONTR INC BROCK G & L CONST CO INC NEWTRON INC CA CAISSONS & SHORING INC CORNERSTONE MASONRY INC CIARI STEPHEN PLBG & HTG HERNANDEZ M CONSTRUCTION MARTIN GENERAL ENG INC ALTEN CONSTRUCTION INC CAL-WEST LIGHTING & SIGN ABLE FENCE COMPANY CLEARWATER LANDSCAPE SVCS BOCKMON & WOODY ELECT CO GOLDEN STATE BRIDGE INC LEE ANDREW L INC SOTTO VIC LANDSCAPING DAWSON-MAULDIN CONSTRUC PRECISION DIRECTNL BORING ALL COMMERCIAL FENCE BENTANCOURT BROS CONS INC N T K CONSTRUCTION INC ARROW FENCING ESP SURVEYING INC EXARO TECHNOLOGIES CORP IRON CONSTRUCTION INC G & M APPLIANCE SUPPLY MANNING STEVE CONSTR INC MCENTIRE LANDSCAPING J & M LAND RESTORATION GLOBAL ROAD SEALING INC WESTERN PARTITIONS INC HIDDEN VALLEY LAKE ASSOC DISNEY CONSTRUCTION INC BEALS MARTIN & ASSOCS INC K L W CONSTRUCTION INC BALFOUR BEATTY INFRASTRUC CAL STATE CONSTRUCTORS IN IMPEC GROUP DIANI BUILDING CORP PULLMAN SST INC XL CONSTRUCTION SHOWTIME CONCRETE INC TUCKER ENGINEERING INC M SQUARED CONSTRUCTION A M S ELECTRIC ALPHA & OMEGA PAVERS INC SPENCER MASONRY CENTRAL STRIPING SVC INC COMPASS ENGINEERING CONTR TRICON AQUATICS PRECISION ENGINEERING INC EMPIRE ENGINEERING & CONS PACIFIC COAST DRILLING CO CONTRACT INSTALLATIONS HAYWARD BAKER INC EXPRESS CONCR BRKG & CUT OUTFRONT MEDIA MISSION VALLEY ROCK CO LANWAY CONSTRUCTION SOLORZANO LANDSCAPE CONST SHIMMICK-BALFOUR BEATTY MERTZ S W MASONRY SPEC PLANT HAZARDOUS SVCS INC ALL STEEL FENCE INC SIERRA NEVADA CONST INC SIERRA MOUNTAIN CONST INC DORFMEIER MASONRY INC TURNER GROUP CONSTRUCTION CALIFORNIA TRENCHLESS INC R N R CONSTRUCTION INC ALERT MAINTENANCE SYS INC TRI-VALLEY EXCAVATING TEAM GHILOTTI INC DEPT OF CORR - REG ACCTG TRUESDELL CORP OF CAL INC COX & COX CONST INC MASTERSON ENTERPRISES BROWN GARY ELECTRIC INC CLIPPER INTERNATIONAL CALIFORNIA CUT & CORE INC PACIFIC COAST GEN ENG INC NGUYEN J.J. 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