2019-12-12T09:53:27-06:00 2019-03-31 410746749 CLIFTONLARSONALLEN LLP 601 W RIVERSIDE AVE SUITE 700 SPOKANE WA 99201 990 2018-04-01 910589283 NORTHWEST SHEET METAL WORKERS WELFARE FUND NORT 5095340600 1322 NORTH POST SPOKANE WA 99201 BARON DERR CHAIRMAN 5095340600 2019-12-04 1 ANN SWINDELL P00060217 5093636300 2019-12-04 67.137.57.251 2019-12-04 17:59:31 MS P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 6F7DD1CBA986377A2476C8869E312B196BC51C72 2018 2020-04-17 16:48:07Z BARON DERR 1322 NORTH POST SPOKANE WA 99201 121755692 0 X N/A X 1952 WA HEALTH AND WELFARE BENEFITS 10 10 147 10 0 0 0 0 87470033 97165222 1777307 2635612 0 0 89247340 99800834 0 0 70587944 80283555 0 0 0 0 0 1933224 2246881 72521168 82530436 16726172 17270398 93753929 117363272 41216199 46474152 52537730 70889120 TO PROVIDE HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS AS SPECIFIED IN THE PLAN. 0 0 TO PROVIDE HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS AS SPECIFIED IN THE PLAN. 0 0 0 0 0 0 0 0 0 0 0 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 2360 0 1 147 1 0 0 0 0 0 0 0 0 0 0 X 10 10 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 0 0 0 0 0 WA X DAVID KIMMET 5095340600 1322 N POST ST SPOKANE WA 99201 X BARON W DERR CHAIRMAN 1.00 X X 0 0 0 TIM CARTER SECRETARY 1.00 X X 0 0 0 GREG HAYTER TRUSTEE 1.00 X 0 0 0 JOHN CARTER TRUSTEE 1.00 X 0 0 0 JULIE MULLER-NEFF TRUSTEE 1.00 X 0 0 0 LOREN WARD TRUSTEE 1.00 X 0 0 0 JIM REYNOLDS TRUSTEE 1.00 X 0 0 0 LANCE DEYETTE TRUSTEE 1.00 X 0 0 0 KOLBY HANSON TRUSTEE 1.00 X 0 0 0 RANDY GOLDING TRUSTEE 1.00 X 0 0 0 0 0 0 0 0 0 0 AETNA 151 FARMINGTON AVENUE HARTFORD CT 06156 PPO NETWORK 1493321 AW REHN AND ASSOCIATES 1322 N POST ST SPOKANE WA 99201 ADMINISTRATION 1165848 DELTA DENTAL OF WA PO BOX 75983 SEATTLE WA 98175 DENTAL CLAIMS ADMINISTRATOR 273988 RAEL & LETSON 999 3RD AVE 1530 SEATTLE WA 98104 CONSULTANT 270651 ENVISION PHARMACEUTICAL SERVICES 2181 E AURUORA RD STE 201 TWINSBURG OH 44087 RX CLAIMS ADMINISTRATOR 155689 5 EMPLOYER CONTRIBUTIONS 900099 83768597 83768597 SUPP. BENEFIT CONTRIBS 900099 7782523 7782523 PARTICIPANT CONTRIBUTI 900099 5272225 5272225 LIQUIDATED DAMAGES 900099 341877 341877 97165222 2386453 2386453 22204017 21954858 249159 249159 249159 99800834 97165222 0 2635612 80283555 1321537 112280 62286 87449 280019 177461 58774 10655 46013 MISCELLANEOUS 69721 AFFORDABLE CARE ACT FEE 20686 82530436 11719574 9993191 640674 613428 8423936 9236575 79188 0 72890557 97520078 93753929 117363272 214095 242280 41002104 46231872 41216199 46474152 X 0 0 0 0 52537730 70889120 52537730 70889120 93753929 117363272 17270398 1080992 0 X X 0 1 X 1 0 0 ACCUMULATED ELIGIBILITY CREDITS 19195338 ESTIMATED LIABILITY FOR INCURRED BUT UNREPORTED CLAIMS 9958000 ESTIMATED LIABILITY FOR EXTENDED MEDICAL COVERAGE 13417404 ESTIMATED LIABILITY FOR SEVERANCE BENEFITS 973207 ESTIMATED LIABILITY FOR RETIREE SUBSIDY 2687923 46231872 X 100794377 1080992 1080992 99713385 87449 87449 99800834 77213219 0 77213219 87449 5229768 5317217 82530436 PART X, LINE 2: THE TRUST ESTABLISHED UNDER THE PLAN TO HOLD THE PLAN'S ASSETS IS QUALIFIED PURSUANT TO SECTION 501(C)(9) OF THE INTERNAL REVENUE CODE AND, ACCORDINGLY, THE TRUST'S NET INVESTMENT INCOME IS EXEMPT FROM INCOME TAXES. THE PLAN OBTAINED A FAVORABLE DETERMINATION LETTER FROM THE INTERNAL REVENUE SERVICE (IRS) ON JUNE 21, 1988 AND THE PLAN SPONSOR BELIEVES THE PLAN, AS AMENDED, CONTINUES TO QUALIFY AND OPERATE AS DESIGNED. PART XII, LINE 4B - OTHER ADJUSTMENTS: INCREASE IN ACCUMULATED ELIGIBILITY CREDITS 2,315,219. DECREASE IN ESTIMATED LIABILITY FOR CLAIMS IBNR 1,684,000. INCREASE IN ESTIMATED LIABILITY FOR EXTENDED MEDICAL COVERAGE 1,013,296. INCREASE IN ESTIMATED LIABILITY FOR SEVERANCE BENEFITS -111,331. INCREASE IN ESTIMATED LIABILITY FOR RETIREE SUBSIDY 328,584. FORM 990, PART VI, SECTION A, LINE 3 THE DAY TO DAY OPERATIONS OF THE PLAN ARE MANAGED BY AW REHN & ASSOCIATES FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PRESENTED TO THE BOARD OF TRUSTEES AND LEGAL COUNSEL BEFORE SIGNATURE AND FILING FORM 990, PART VI, SECTION B, LINE 12C TRUSTEES ARE ASKED ANNUALLY IN WRITING IF ANY CONFLICTS EXIST. ANY CONFLICTS ARE BROUGHT TO THE BOARD OF TRUSTEES FOR RESOLUTION. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE NOT AVAILABLE TO THE PUBLIC. A SUMMARY ANNUAL REPORT REQUIRED BY ERISA IS SENT TO THE PARTICIPANTS ANNUALLY. ACCORDING TO THE REGULATIONS OF THE EBSA, PARTICIPANTS CAN REQUEST THE FULL ANNUAL REPORT AND FORM 5500 FROM THE PLAN ADMINISTRATOR. FORM XII, LINE 2C THE OVERSIGHT PROCESS AND METHOD FOR CHOOSING THE INDEPENDENT AUDITOR HAS NOT CHANGED FROM PRIOR YEARS. PORT OF SEATTLE SE WASHINGTON & NE OREGON JATC SEATTLE SCHOOL DISTRICT #1 SHEET METAL WORKERS LOCAL 103 SHEET METAL WORKERS LOCAL 23 SHEET METAL WORKERS LOCAL 23 JATC SHEET METAL WORKERS LOCAL 55 SHEET METAL WORKERS LOCAL 66 SHEET METAL WORKERS LOCAL 66 MKT RECOVERY WESTERN WASHINGTON SHEET METAL JATC ACCO ENGINEERED SYSTEMSAIR CONDITIONING CO ACCU DUCT MANUFACTURING ACCURATE HTG & CLG INC ADVANCED THERMAL SOLUTIONS AIR CONTROLS BILLINGS AIR CONTROLS BOZEMAN INC AIR HANDLERS INC AIRFLOW MECHANICAL INC AIRTEST COMPANY ALASKA SHEET METAL ALEUT GLOBAL SOLUTIONS ALL VALLEY SHEET METAL INC AMERICOOL HEATING & AC ANGELES HEATING INC APOLLO SHEET METAL INC ARCHITECTURAL SHEET METAL INC ARGO BLOWER MFG & CO INC ASAP INC (DBA ARROWHEAD) AUBURN MECHANICAL B & B HEATING & AC BALLARD SHEET METAL WORKS INC BANNER FURNACE & FUEL BARRON HEATING & AC INC BECHTEL NATIONAL INC BEHRENDS MECHANICAL INC BILLINGS HEATING & COOLING BLUE MOUNTAIN MECHANICAL INC BNL TECHNICAL SERVICE LLC BRENNAN HEATING & 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