2015-10-13T10:59:53-05:00 2014-12-31 202122306 GBQ PARTNERS LLC 230 WEST STREET SUITE 700 COLUMBUS OH 432152663 990 2014-01-01 311040732 BURGESS & NIPLE EMPLOYEE BENEFIT TRUST BURG 6144597272 5085 REED ROAD COLUMBUS OH 432202513 PEGGY GARRISON TRUSTEE 6144597272 2015-10-02 1 GBQ PARTNERS LLC P01380769 6142211120 2014 2016-02-25 16:41:14Z PEGGY GARRISON 5085 REED ROAD COLUMBUS OH 432202513 4268947 0 X WWW.BURGESSNIPLE.COM X 1982 OH TO PROVIDE MEDICAL, DENTAL, PRESCRIPTION DRUGS, DISABILITY AND LIFE INSURANCE TO EMPLOYEES OF BURGESS & NIPLE, INC. 3 0 0 0 792 0 0 0 4142383 4268155 1270 792 0 0 4143653 4268947 0 0 3880826 3946660 0 0 0 0 0 8563 8904 3889389 3955564 254264 313383 1251432 1564815 0 0 1251432 1564815 TO PROVIDE MEDICAL, DENTAL, PRESCRIPTION DRUGS, DISABILITY AND LIFEINSURANCE TO EMPLOYEES OF BURGESS & NIPLE, INC. 0 0 TO PROVIDE MEDICAL, DENTAL, PRESCRIPTION DRUGS, DISABILITY AND LIFEINSURANCE TO PARTICIPATING EMPLOYEES AND DEPENDENTS, SERVINGAPPROXIMATELY 400 INDIVIDUALS AND FAMILIES. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 0 0 0 0 0 0 0 0 0 0 X 3 0 1 0 0 0 0 0 0 1 1 0 0 0 0 0 1 0 0 0 X PEGGY GARRISON 6144597272 5085 REED ROAD COLUMBUS OH 432202513 X PEGGY GARRISON DIRECTOR, ADMINISTRATIVE OPERATIONS 0.00 X 0 0 0 MICHELLE JENKS DIRECTOR, HUMAN RESOURCES 0.00 X 0 0 0 MARK BERNHARDT EXECUTIVE VICE PRESIDENT 0.00 X X 0 0 0 0 0 0 0 0 0 0 AETNA LIFE INSURANCE CO 7400 WEST CAMPUS BLVD NEW ALBANY OH 43054 3RD PARTY ADMINISTRATOR 171482 1 EMPLOYER CONTRIBUTIONS 525100 2771405 2771405 EMPLOYEE CONTRIBUTIONS 525100 1154709 1154709 STOP LOSS CLAIMS 525100 311908 311908 COBRA CONTRIBUTIONS 525100 30133 30133 4268155 792 792 4268947 4268155 792 0 3946660 7450 BANK FEES 1414 TAXES 40 3955564 425228 137819 758174 1358966 68030 68030 1251432 1564815 0 0 X 1251432 1564815 0 0 0 0 1251432 1564815 1251432 1564815 313383 0 X X 0 1 X 1 0 0 X 4268947 0 4268947 0 4268947 3955564 0 3955564 0 3955564 PART X, LINE 2: GAAP REQUIRES PLAN MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE PLAN AND RECOGNIZE A TAX LIABILITY IF THE PLAN HAS TAKEN UNCERTAIN TAX POSITIONS THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY APPLICABLE TAXING AUTHORITIES. THE PLAN ADMINISTRATOR HAS ANALYZED TAX POSITIONS TAKEN BY THE PLAN AND HAS CONCLUDED THAT, AS OF DECEMBER 31, 2014, THERE ARE NO UNCERTAIN TAX POSITIONS TAKEN, OR EXPECTED TO BE TAKEN, THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR THAT WOULD REQUIRE DISCLOSURE IN THE FINANCIAL STATEMENTS. THE PLAN IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS. HOWEVER, CURRENTLY NO AUDITS FOR ANY TAX PERIODS ARE IN PROGRESS. FORM 990, PART VI, SECTION A, LINE 2 OFFICERS OF THIS ORGANIZATION HAVE A BUSINESS RELATIONSHIP WITH EACH OTHER AS THEY ARE ALL OFFICERS OF THE PLAN SPONSOR. FORM 990, PART VI, SECTION B, LINE 11 THE 990 IS PREPARED USING INFORMATION FROM THE AUDITED FINANCIAL STATEMENTS. THE PREPARED 990 IS REVIEWED BY THE DIRECTOR OF THE ACCOUNTING DIVISION AT BURGESS & NIPLE, INC. AFTER THE REVIEW, THE 990 IS FORWARDED TO THE CONTROLLER OF BURGESS & NIPLE, INC. FOR REVIEW AND SIGNATURE. FORM 990, PART VI, SECTION C, LINE 19 NO DOCUMENTS AVAILABLE TO THE PUBLIC. PARTICIPANTS OF THE PLAN MAY REQUEST DOCUMENTS FROM THE DIRECTOR OF HUMAN RESOURCES. FORM 990, PART XII, LINE 2C: NO CHANGES FROM PRIOR YEAR BURGESS & NIPLE INC 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 BURGESS & NIPLE INC S 2771405 CASH