2018-11-14T10:56:19-06:00 2017-12-31 522385296 LINDQUIST LLP 5000 EXECUTIVE PARKWAY SUITE 400 SAN RAMON CA 945834210 990 2017-01-01 412261950 DISTRICT COUNCIL 16 OF NORTHERN CALIFORNIA HEALTH & WELFARE TRUST DIST 8009229902 4160 DUBLIN BLVD NO 400 DUBLIN CA 945687723 CHRIS CHRISTOPHERSEN TRUSTEE 8009229902 2018-11-14 1 JOSEPH M THIERMANN P01066616 9252779100 66.7.226.66 2018-11-14 08:56:08 PS P D85FB602DC4FA66F28A631CB81EF53DF59ECABFA 92C7F91AD246760067C653CBF66B8BF12B4D5FD1 2017 2019-02-21 02:37:17Z CHRIS CHRISTOPHERSEN 4160 DUBLIN BLVD NO 400 DUBLIN CA 945687723 136961922 0 X HTTP://WWW.DC16TRUSTFUND.ORG X 2008 CA TO PROVIDE HEALTH AND WELFARE BENEFITS. 9 0 116 0 0 0 0 0 122811763 132435747 1863574 2712118 0 142573 124675337 135290438 0 0 98481341 108217124 0 0 0 0 0 4854128 4432310 103335469 112649434 21339868 22641004 122524723 155819922 53553435 60416891 68971288 95403031 TO PROVIDE HEALTH AND WELFARE BENEFITS. 0 0 PROVIDED HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS AND THEIR BENEFICIARIES. 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 51 0 1 116 1 0 0 0 0 0 0 X 9 0 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X HEALTH SERVICES & BENEFITS ADMINISTRATORS INC 8009229902 4160 DUBLIN BOULEVARD SUITE 400 DUBLIN CA 945687756 X STEVE CASTER TRUSTEE 1.00 X 0 0 0 JOHN SHERAK TRUSTEE 1.00 X 0 0 0 JOHN MAGGIORE TRUSTEE 1.00 X 0 0 0 MARIAN BOURBOULIS TRUSTEE 1.00 X 0 0 0 CHRIS CHRISTOPHERSEN TRUSTEE 1.00 X 0 0 0 DARYL STACY TRUSTEE 1.00 X 0 0 0 ROBERT WILLIAMS ALT. TRUSTEE 1.00 X 0 0 0 THOMAS HEINZELMANN ALT. TRUSTEE - PAST 1.00 X 0 0 0 STEVE ECKSTROM TRUSTEE 1.00 X 0 0 0 FRANK NUNES ALT. TRUSTEE 1.00 X 0 0 0 MIKE WEST TRUSTEE - PAST 1.00 X 0 0 0 JEANNIE SIMPELO ALT. TRUSTEE 1.00 X 0 0 0 TIM DEAL TRUSTEE 1.00 X 0 0 0 JOSE SANTANA ALT. TRUSTEE 1.00 X 0 0 0 JAMES HEWETT TRUSTEE 1.00 X 0 0 0 SEE SCHEDULE O FOR COMPENSATION PAID BY RELATED ORGANIZATION 0.00 X 0 1 0 0 1 0 0 0 0 0 HEALTH SERVICES AND BENEFIT ADMINISTRATO 4160 DUBLIN BLVD SUITE 400 DUBLIN CA 94568 FUND ADMINISTRATION 1775802 ANTHEM BLUE CROSS 700 BROADWAY DENVER CO 80273 COST CONTAINMENT 620189 LINDQUIST LLP 5000 EXECUTIVE PARKWAY SUITE 400 SAN RAMON CA 94583 AUDITOR 519714 DELTA DENTAL 100 FIRST STREET SAN FRANCISCO CA 94105 BENEFITS ADMINISTRATOR 382033 SALTZMAN AND JOHNSON 44 MONTGOMERY STREET SUITE 2110 SAN FRANCISCO CA 94104 ATTORNEY 356852 9 EMPLOYER CONTRIBUTIONS 900099 123459637 123459637 PARTICIPANT CONTRIBUTIONS 900099 7347712 7347712 STOP LOSS REIMBURSEMENT 900099 712160 712160 LIQUIDATED DAMAGES 900099 381218 381218 RETIREE DRUG SUBSIDY 900099 322935 322935 212085 212085 132435747 1879163 1879163 2504439 1671484 832955 832955 832955 MISCELLANEOUS INCOME 900099 142573 142573 142573 135290438 132578320 0 2712118 108217124 1699332 358102 519714 98314 1555276 138265 15115 48192 112649434 23366628 35820154 8247242 9179570 12247990 14263282 5768 7033 78236108 96306737 420987 243146 122524723 155819922 1123543 450519 462452 52429892 59503920 53553435 60416891 X 0 0 0 0 68971288 95403031 68971288 95403031 122524723 155819922 22641004 3790739 0 X X 0 1 X 1 0 0 ACCUMULATED ELIGIBILITY CREDITS 17671203 BENEFIT CLAIMS PAYABLE & IBNR 10034000 EMPLOYER BOND DEPOSITS 79114 CASH BANK LIABILITY 31719603 59503920 X 138982863 3790739 3790739 135192124 98314 98314 135290438 105762042 0 105762042 98314 6789078 6887392 112649434 PART X, LINE 2: THE PLAN'S ADMINISTRATOR HAS ANALYZED THE TAX POSITIONS TAKEN BY THE PLAN, AND HAS CONCLUDED THAT, AS OF DECEMBER 31, 2017, 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 BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR THE FISCAL YEARS PRIOR TO 2014. PART XII, LINE 4B - OTHER ADJUSTMENTS: CHANGE IN BENEFIT OBLIGATIONS FORM 990, PART VI, SECTION A, LINE 3 THE ORGANIZATION HAS DELEGATED CERTAIN MANAGEMENT DUTIES TO A THIRD-PARTY ADMINISTRATOR UNDER THE SUPERVISION OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11B A COPY OF FORM 990 IS PROVIDED TO THE ORGANIZATION'S GOVERNING BODY FOR REVIEW BEFORE FILING. FORM 990, PART VI, SECTION B, LINE 12C THE BOARD OF TRUSTEES IS SUBJECT TO THE FIDUCIARY RESPONSIBILITY PROVISIONS OF THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974 (ERISA), AS AMENDED, INCLUDING THE CONFLICT-OF-INTEREST PROVISIONS OF ERISA SECTION 406. ANNUALLY AT THE BOARD OF TRUSTEES MEETING, THE TRUSTEES ARE REQUIRED TO DISCLOSE IF THERE ARE ANY CONFLICTS OF INTEREST. IF A CONFLICTING INTEREST EXISTS, THE PERSON WITH THE CONFLICT IS EXCLUDED FROM THE DISCUSSION AND APPROVAL OF SUCH TRANSACTION. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT-OF-INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990 PART VII, SECTION A, LINE 1A TRUSTEES ARE NOT COMPENSATED BY THE TRUST. COMPENSATION PAID TO TRUSTEES EMPLOYED BY OTHER ORGANIZATIONS IS REPORTED ON THE FORM 990 FILED WITH THE INTERNAL REVENUE SERVICE BY THE RELATED TAX-EXEMPT ORGANIZATION. IF YOU WOULD LIKE ADDITIONAL INFMORMATION, PLEASE CONTACT THE ADMINISTRATOR. FORM 990, PART XII, LINE 2C: THE BOARD OF TRUSTEES ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT AND SELECTION OF THE INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED. DISTRICT COUNCIL NO 16 2705 CONSTITUTION DRIVE LIVERMORE CA 945509206 940433056 EMPLOYEE SPONSORING ORGANIZATION CA 501(C)5 N/A N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 SCHEDULE R. IDENTIFICATION OF RELATED ORGANIZATIONS. THE FILING ORGANIZATION IS A TAFT-HARTLEY MULTIEMPLOYER TRUST THAT PROVIDES HEALTH AND WELFARE BENEFITS TO ELIGIBLE EMPLOYEES AND THEIR DEPENDENTS. AS OF DECEMBER 31, 2017, THERE ARE APPROXIMATELY 384 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 (DISREGARDED ENTITY, TAX-EXEMPT ORGANIZATION, PARTNERSHIP, TAXABLE CORPORATION OR TRUST) FOR EACH CONTRIBUTING EMPLOYER IS NOT ON FILE WITH THE ADMINISTRATIVE OFFICE AND IT COULD NOT BE REASONABLY OBTAINED. AS A RESULT, THE NAMES OF THE CONTRIBUTING EMPLOYER ARE LISTED ON PART VII BELOW AND NOT ON PARTS II THROUGH IV BY FEDERAL TAX CLASSIFICATION. A & A PAINTING COMPANY A & B PAINTING INC A.J. FISTES CORPORATION ABCO RESTORATION & WATERPROOFING INC ACR GLASS AND DOORS ADERHOLT SPEC CO INC AESTHETIC MAINTENANCE CORP AHC GLASS CO(SAFECO) AJS PAINTING AKIMA CONSTRUCTION SERVICES LLC ALCAL GLASS SYSTEMS INC. ALCOSTA SHOWER DOOR ALL BAY AREA GLASS INC. ALL COUNTY FLOORING ALL NEW GLASS OF CALIFORNIA ALLIANCE GLASS COMPANY ALLIED PAINTERS INC ALPHA GLASS COMPANY AMERICAN GLASS ANCCA CORPORATION DBA NU ENTERPRISE ANDRE'S GLASS SERVICE ANNING & JOHNSON COMPANY APPLY A LINE INC ARAGON CONSTRUCTION INC. ARCHITECTURAL GLASS & ALUMINUM ARROW GLASS CO ASHRON CONSTRUCTION & REST. INC. ATHENS PAINTING & COMM. COATINGS INC ATLAS GLASS CO. INC. B & C PAINTING & DECORATING B & G GLASS INC. B J FLOORING INC B.T. MANCINI CO. INC. BACA & SONS PAINTING BAGATELOS ARCH GLASS SYSTEMS BASCO DRYWALL & PAINTING CO. BAY AREA TINTWORKS BAY CITIES PTRS & DEC BAYSIDE INTERIORS INC BELL PAINTING BENASSI'S CARPET SERVICE BENSON INDUSTRIES LLC BEST CONTRACTING SERVICES INC BLASTCO INC. BLUE SKIES PAINTING BLUE WATER GLASS INC. BORBON INC. BOWMAN PAINTING BOYETT CONSTRUCTION INC BRADY COMPANY/CENTRAL CA INC. BRAND ENERGY SVC OF CA INC BRITE PAINTING BRUCE K HALL CONSTRUCTION INC C & A FLOORING INC. C & O PAINTING INC C & S FLOOR SYSTEMS INC. C & W FACILITY SERVICES INC. C A BUCHER PTG SERVICE C-3 CONCRETE SURFACE INC. C/S ERECTORS INC CAL INC. CAL TILE COMPANY INC. CALIFORNIA CUSTOM TINTING CALIFORNIA DRYWALL COMPANY CALIFORNIA ENGINEERING CAPITOL GLASS COMPANY CARPET DIMENSION INC. CDCR REGIONAL ACCTING OFFICE-PAINTERS CDCR REGIONAL ACCTING OFFICE-TAPERS CEE GEE PKG LOT STRIPING CENTER GLASS COMPANY CENTERLINE STRIPING CENTRAL STRIPING SERVICE INC CENTURY CARPET CERTIFIED COATING OF CALIFORNIA CHAMPION PAINTING SPECIALTY SERVICES CHINO GLASS & GLAZING CHRISP COMPANY CITY PAINTING CO CLASSIC GLASS INC CLIFT HOTEL CLIFTON ARCHITECTURAL GLASS & METAL C CNJ ENTERPRISES INC. COAST COUNTIES GLASS COFFEY BUILDING GROUP INC. COMMERCIAL GLASS & ALUM INC COMPONENT WEST INC. CONCORD DRYWALL INC CONKLIN BROS S F CONKLIN BROS-SANTA ROSA COOL PAINTING COX COMMERCIAL FLOORING INC CREATIVE CEILINGS INC. CREATIVE SHOWER DOOR CROWN CORR INC. CROWN SHEET METAL & SKYLIGHTS CTG CONSTRUCTION INC. CUSTOM DRYWALL INC CYC COMMERCIAL INTERIORS INC. D & B PAINTING COMPANY D & C GLASS D C VIENT INC D P R CONSTRUCTION INC D ZELINSKY & SON INC D&B/JTS PAINTING INC. JV D.S. BAXLEY INC. DBA DSB+ EAST BAY D2 SQUARED INDUSTRIAL SERVICES LLC DALEYS DRYWALL INC DARDEN PAINTING INC DASCO CONSTRUCTION & DR DDPD INC DELTA CITY DRYWALL INC DENHAM CONTRACTING INC DESIGN WORKSHOPS DIETLIN PNTG & DEC DIVERSIFIED FLOORING SERV DON FRANK CO DONALD E MC NABB CO DONALD E. MCNABB CO. DOTTO GLASS INC DOWNEY AND SON DSM CONSTRUCTION INC. DYNAMIC COATINGS INC. ELADIO R GUTIERREZ ELITE PAINTING & WALLCOVERING INC. ENCLOS CORP/ HARMON ERIC STARK INTERIORS EUREKA FLOOR-TRAINING FUND EVAN PATTERSON CONSTRUCTION EXCLUSIVELY DOORS EXPERT DRYWALL SYS INC EXTERIOR CLADDING SYSTEMS INC. F D THOMAS INC F.D. THOMAS INC. FAIRMONT HOTEL SAN JOSE FDR DRYWALL INC. FEDOR WALL SYSTEMS INC. FIELDTURF USA INC FIERRO PAINTING FISHER DESIGN + BUILD INC. FIX PAINTING CO FLOOR SEAL TECH ATTN:LETICIA FLORES DRYWALL INC. FORTSON FLOORS INC. FREEMAN CONSTRUCTION COMPANY FREY PLASTERING INC FUENTES PAINTING & DECORATING G & B PAINTING GAIDANO & SONS PTG & DECORATING INC GARAKANI PROFESSIONAL GROUP INC. GENESIS FLOORING INC. GEORGE MULLINS PAINTING GLASS & SASH CO GLASS CONCEPTS BY CLINE GOLDEN GATE DRYWALL GOLDEN GATE GLASS & MIRROR CO GOLDEN STATE CARPET SERVC GRAND HYATT GRAND PRIX GLASS GREATER BAY FLOORING INC GUGEL/TODAY PTG & DEC INC H.V. WELKER CO. INC. HALSTEAD DRYWALL INC HANSAN FLOORING HARDMAN GLAZING HAROLD W. THOMPSON HARRISON DRYWALL INC HARRY L MURPHY HARTLEY CONST INC. HASSON PAINTING CONTRACTORS INC. HENRYS PAINTING INC HERLACHE & SONS PAINTING HOEM & ASSOCIATES INC. HULSEY CONTRACTING INC. HYATT REGENCY INTERIOR GLASS SYSTEM IRONWOOD COMMERCIAL BLDRS INC J & J ACOUSTICS INC J & R FLOORING DBA J PICINI FLOORING J & R THOMPSON INC JACKSON QUALITY DRYWALL JAMES HAGUE WALLCOVERINGS JAMES L. HARRIS PAINTING INC JANGHO CURTAIN WALL AMERICAS CO JANGHO CURTAIN WALL AMERICAS CO LTD JEFFCO PAINTING & COATING INC. JERRY THOMPSON & SONS INC JJJ FLOOR COVERING INC JMW CARPET & FLOORING INC. JOHN JORY CORPORATION JPK SOLUTIONS INC. JR CONSTRUCTION KAISER FOUNDATION HOSP CPFC KARSYN CONSTRUCTION INC KBI PAINTING INC. KEENAN HOPKINS AND SUDER KIM'S FLOORING INC KINGDOM DRYWALL INC. KIRK BUILDERS KLW CONSTRUCTION INC. KOVACH BUILDING ENCLOSURES KYO-YA HOTELS & RESORTS LP LARRY SILVESTRI INC LEDEIT & SONS GLASS INC LEVEL 5 INC. LIBERTY MAINTENANCE INC. LINCOLN GLASS & MIRROR CO LINOLEUM LARRY'S INC. LINOLEUM SALES CO INC LINOLEUM SALES CO. INC LISA DE LA SOL RESTORATION LUCAS PAINTING CO. M & R PAINTING M S F INC MADDEN AND NELSON INC MADSEN BUILDERS MAGNUM DRYWALL INC MAJESTIC CONSTRUCTION MAJESTIC FLOORS INC. MAR CON COMPANY MASON PAINTING INC MASTER PAINTING & DECORATING MASTERPIECE PAINTING MASTRIA INCORPORATED MISSION BAY FLOORING CONTRACTORS MISSION GLASS CO MIURA BUILDING ENCLOSURES MOLINA'S PTG WALLCOVERING MONTICELLI PTG & DEC INC MUEHLHAN CERTIFIED COATINGS MURPHY INDUSTRIAL COATINGS NAHIDI CORPORATION DBA KAISER GLASS NATIONAL COATING & LINING COMPANY NC FLOORING GROUP INC NEIGHBORHOOD GLASS NETWORK NELSONS PAINTING NEVELL GROUP INC. NEW WEST PARTITIONS NOR CAL GLASS & ALUMINUM NOR-CAL GLASS NORTH COUNTIES DRYWALL INC NORTHERN PACIFIC DRYWALL INC NU-GLASS SYSTEM OAKLAND HILTON HOTEL OAKLAND HOUSING AUTHORITY OGDEN CONTRACT INTERIORS ONEILL GLASS INC OREILLY & FAINA GLASS CO INC PACE INC PACIFIC GLAZING CONTRACTORS PACIFIC PERFORMANCE DRYWALL INC. PACIFIC RACING ASSN PACIFIC SEALANTS PACIFIC SHORES CONSTRUCTION PACIFIC WATERPROOFING & REST. INC. PAIGE STRUCTURAL GLASS PARADA PAINTING INC. PATRICK J RUANE INC PATRIOT CONTRACTING INC. PAW ARCHITECTURAL WOODWORK INC. PERFORMANCE CONTRACTING INC. PERFORMANCE WATERPROOFING PERMASTEELISA NORTH AMERICA CO PICONE PAINTERS PICTURE PAINTING & DECORATING INC. PINGUELO CONSTRUCTION PINNACLE INSTALLATIONS INC. PLATINUM CONSTRUCTION PREMIUM GLASS PRO INSTALLATION INC DBA PROSPECTRA PRODUCTS SERVICE & LABOR INC. PROGRESS GLASS PVBS INC. PYRAMID PAINTING INC PYRAMID PAINTING INC. QOL CORP. QUALITY GLASS CO R & I GLASSWORKS R & S GLAZING SPECIALTIES R BROTHERS PAINTING R M R CONSTRUCTION R T WESTERN CONSTRUCTION SERVICES RAFAEL FLOOR COVERING INC RAINBOW WATERPROOFING & RESTORATION RANKER AMG INC RAYMOND-NORTHERN CALIFORNIA INC RECORD AUTOMATIC DOORS INC. SCHEDULE R. IDENTIFICATION OF RELATED ORGANIZATIONS. - CONTINUED REDHAWK GLASS INC. REGAL INDUSTRIES INC. RENO'S FLOOR COVERING RENO'S FLOORCOVERING RETAIL STOREFRONT GROUP RFJ INC. DBA MEISWINKEL CO RHODES PAINTING RICHLEN CONSTRUCTION RLM ENTERPRISES ROBERTSON INDUSTRIES/TOT TURF ROCKAWAY CONSTRUCTION INC ROMANO'S PAINTING & HANGING ROYAL GLASS CO INC ROYAL GLASS COMPANY INC ROYALTY PRO PAINTING RT WESTERN INC. RUDOLPH COMMERCIAL INTERIORS RUIZ PAINTING & WALLCOVERING RUSCONI FLOOR CO RUSSELL HINTON COMPANY RUTHERFORD CO. INC. RYNOCLAD INC DBA RYNOCLAD TECHNOLOGI S & R DRYWALL INC S D FLOORING INC. S F HOUSING AUTHORITY S F HOUSING MAINTENANCE S F HOUSING-FORCE ACCOUNT SAMAP USA CORP SAN FRANCISCO HILTON & TOWERS SAN JOAQUIN GLASS SATELLITE PAINTING INC SDV SERVICES INC. SEELE INC. SILICON VALLEY GLASS INC SILVER GLASS & MIRROR CO SIMPSON SANDBLASTING SKYLIGHT TECHNOLOGIES INC. SLATER CUSTOM PAINTING SLING - SHOT DRYWALL SME STEEL CONTRACTORS INC. SMG SOUTHWEST COATINGS INC. SPACETONE ACOUSTICS INC. SPECIALTY FLOORING INC. ST FRANCIS SQUARE APTS INC ST OF CAL DSTR AG ASSN STANDARD DRYWALL INC. STANFORD COURT STAR GLASS CO STAR WALLCOVERINGS STEWARD FLOOR COVERING STOCKHAM CONSTRUCTION STS INC. STUART DEAN SUNSHINE COMMERCIAL CONST INC. SUPERIOR CONTRACTING SVC INC. SURBER DRYWALL CONSTRUCTION SWINERTON BUILDERS T & J FLOORS T & M PAINTING & CONSTRUCTION INC. TEAM GLASS INC TECHNO COATINGS INC THE GLASS MAN THE WESTIN ST FRANCIS THE WRIGHT SOLUTION LLC. TISYS CONSTRUCTION TROYER'S DOOR CONTROL INC. TWIN POST PAINTING & DECORATING LLC U S GLASS & ALUM INC-NEVADA U-NEAC FRAMING & DRYWALL INC. U.S. GLASS INC. U.S.G.A. INC UNION ROLLING DOOR CO. INC UNITED CALIF ACCESS & SEC SYS UNITED CALIFORNIA GLASS & DOOR US NATIONAL CORP US NATIONAL CORP DBA JIMENEZ PTG. CO. VALDEZ PAINTING INC. VALLEY FLOOR COVERING VALLEY GLASS CO VALLEY PRECISION GRADING INC. VALLEY WATERPROOFING INC VETERANS PAINTING CONTRACTOR INC. VPM GENERAL BUILDING LLC WALTERS & WOLF GLASS COMPANY WALTERS & WOLF INTERIORS WEBCOR CONSTRUCTION LP WEISS SHEET METAL/METCOE SKYLIGHT WEST COAST DRYWALL WEST COAST INDUSTRIAL COATINGS INC. WESTERN PARTITIONS INC WESTLAKE VILLAGE APARTMENTS WESTPAC ARCHITECTURAL WHITING GLASS WILSON & HAMPTON PAINTING CONTRACTORS WOODBRIDGE GLASS INC. WORK PRESERVATION FUND INC.