2014-07-15T09:42:56-05:00 2013-12-31 310800053 CLARK SCHAEFER HACKETT & CO 4449 EASTON WAY SUITE 400 COLUMBUS OH 43219 990 2013-01-01 311040732 BURGESS & NIPLE EMPLOYEE BENEFIT TRUST BURG 6144597272 5085 REED ROAD COLUMBUS OH 432202513 PEGGY GARRISON TRUSTEE 6144597272 2014-07-11 1 JOHN E BOYER P00218741 6148852208 2014-07-11 2013 2015-11-30 17:44:51Z PEGGY GARRISON 5085 REED ROAD COLUMBUS OH 432202513 4143653 0 X WWW.BURGESSNIPLE.COM X 1982 OH TO PROVIDE MEDICAL, DENTAL, PRESCRIPTION DRUGS, DISABILITY AND LIFE INSURANCE TO EMPLOYEES OF BURGESS & NIPLE. 3 0 0 0 0 270 0 0 3226839 4142383 1712 1270 0 0 3228551 4143653 0 0 3306915 3880826 0 0 0 0 0 8202 8563 3315117 3889389 -86566 254264 997168 1251432 0 0 997168 1251432 TO PROVIDE MEDICAL, DENTAL, PRESCRIPTION DRUGS, DISABILITY AND LIFE INSURANCE TO EMPLOYEES OF BURGESS & NIPLE, INC. 0 0 TO PROVIDE MEDICAL, DENTAL, PRESCRIPTION DRUGS, DISABILITY AND LIFE INSURANCE TO PARTICIPATING EMPLOYEES AND DEPENDENTS, SERVING APPROXIMATELY 400 INDIVIDUALS AND FAMILIES. 0 0 0 0 0 0 0 0 0 0 0 0 1 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 1 1 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 PATRICIA DOODY DIRECTOR, HUMAN RESOURCES 0.00 X 0 0 0 BARRY DIXON EXECUTIVE VICE PRESIDENT 0.00 X 0 0 0 0 0 0 0 0 0 0 AETNA LIFE INSURANCE CO 7400 WEST CAMPUS ROAD NEW ALBANY OH 43054 THIRD PARTY ADMINISTRATION 191706 1 EMPLOYER CONTRIBUTIONS 525100 2833092 2833092 EMPLOYEE CONTRIBUTIONS 525100 1309291 1309291 4142383 1270 1270 4143653 4143653 0 0 3880826 7200 BANK FEES 1363 3889389 172234 425228 756904 758174 68030 68030 997168 1251432 0 0 X 997168 1251432 0 0 0 0 997168 1251432 997168 1251432 254264 0 X X 0 1 X 1 0 0 DEPOSIT 68030 68030 X 4143653 0 4143653 0 4143653 3889389 0 3889389 0 3889389 PART X, LINE 2: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE 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, 2013, 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. THE PLAN ADMINISTRATOR BELIEVES THAT THE PLAN IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO DECEMBER 31, 2010. 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 HUMAN RESOURCES 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 18 DOCUMENTS ARE AVAILABLE UPON REQUEST. 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. 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 2833092 CASH BASIS OF ACCOUNTING