2014-01-09T13:24:42-06:00 2013-05-31 470900880 CALIBRE CPA GROUP PLLC 566 W LAKE ST SUITE 300 CHICAGO IL 60661 990 2012-06-01 366147408 FOX VALLEY & VICIN CONSTRUCTION WEL FUND FOXV 6302327166 3333 N MAYFAIR RD No 201 MILWAUKEE WI 53226 Art Sturms 6302327166 2013-12-31 COREY BILKEY P00499751 3126550037 2012 2015-11-30 17:44:51Z ART STURMS 3333 N MAYFAIR RD No 201 MILWAUKEE WI 53226 11761772 0 X N/A X 1961 WI TO PROVIDE MEDICAL, DENTAL, VISION, TEMPORARY DISABILITY, AND DEATH BENEFITS. 11 11 5 0 0 0 0 0 7065985 7463404 758803 761765 0 0 7824788 8225169 0 0 7034883 6807056 0 0 0 0 0 904336 813645 7939219 7620701 -114431 604468 19714553 21193973 3660328 4088849 16054225 17105124 X TO PROVIDE MEDICAL, DENTAL, VISION, TEMPORARY DISABILITY, AND DEATH BENEFITS 0 0 TO PROVIDE MEDICAL, DENTAL, VISION, TEMPORARY DISABILITY, AND DEATH BENEFITS TO ELIGIBLE MEMBERS TO PROVIDE MEDICAL, DENTAL, VISION, TEMPORARY DISABILITY, AND DEATH BENEFITS TO 665 ELIGIBLE MEMBERS AND THEIR DEPENDENTS. 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 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 2 0 1 5 1 0 0 0 0 1 1 0 X 11 11 0 1 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 0 0 0 X TRACY WHITE 4144761220 3333 MAYFAIR RD MILWAUKEE WI 53226 PETER CULVER 2.00 40.00 X 0 101643 61182 DONALD DEETJEN 2.00 X 0 0 0 DAN AUSSEM 2.00 X 0 0 0 RUBEN COLLAZO 2.00 40.00 X 0 75006 41442 JAMES ZUIDEMA 2.00 X 0 0 0 JOHN SZECH 2.00 X 0 0 0 JOSH BOLLER 2.00 X 0 0 0 KENNETH SANDENO 2.00 X 0 0 0 ART STURMS 2.00 40.00 X 0 100727 0 DAVE FLEURY 2.00 40.00 X 0 185625 0 ANTHONY FRESCURA JR 2.00 40.00 X 0 86592 0 ERIC RUTH 2.00 X 0 0 0 JO DEE BENOIT 2.00 40.00 X 0 16802 0 0 566395 102624 0 0 1 0 BLUE CROSS BLUE SHIELD OF IL 300 E RANDOLPH ST CHICAGO IL 60601 INSURANCE ADMIN 215446 ZENITH AMERICAN SOLUTIONS 18861-90th AVENUE SUITE A MOKENA IL 60448 ADMINISTRATOR 212691 2 EMPLOYER CONTRIBUTIONS 525100 6715802 6715802 EMPLOYEE CONTRIBUTIONS 525100 747602 747602 7463404 537385 537385 3760983 3536603 224380 224380 224380 8225169 7463404 0 761765 6807056 233836 45347 50349 46260 401077 26378 3949 6449 7620701 -58046 -74062 792591 866395 52596 34219 0 0 6988357 7215732 11858413 13070403 80642 81286 19714553 21193973 19628 37112 3640700 4051737 3660328 4088849 X 0 0 0 0 16054225 17105124 16054225 17105124 19714553 21193973 604468 446431 0 X X 0 1 X 1 0 0 COMMON COLLECTIVE TRUST FUNDS 13070403 F 13070403 EXTENDED ELIGIBILITY 3197900 EST LIAB FUT CLMS INCRRD NOT REPRTD 674500 CLAIMS PAYABLE 168600 DUE TO ASSOCIATED FUNDS 10737 4051737 X 8625340 446431 446431 8178909 46260 46260 8225169 7174141 0 7174141 46260 400300 446560 7620701 Description of Uncertain Tax Positions Under FIN 48: Part X, Line 2: AS OF MAY 31, 2013, THERE WERE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY (OR ASSET) 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 PERIOD IN PROGRESS. AT MAY 31, 2013 THE PLAN IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO THE FISCAL YEAR ENDED MAY 31, 2010. Part XII, Line 4b - Other Adjustments: CHANGE IN CURRENT BENEFIT OBLIGATIONS 400300. 0 0 0 PETER CULVER 0 101014 0 0 0 629 0 43538 0 17644 0 162825 0 0 DAVE FLEURY 0 185625 0 0 0 0 0 0 0 0 0 185625 0 0 Form 990, Part VI, Section A, line 3 Line 3 explanation - ZENITH AMERICAN SOLUTIONS IS THE THIRD PARTY ADMINISTRATOR HIRED TO ADMINISTER THE FUND'S DAY-TO-DAY OPERATIONS. Form 990, Part VI, Section B, line 11 THE TRUSTEES AUTHORIZE THE FUND'S THIRD-PARTY ADMINISTRATOR AND A DESIGNATED TRUSTEE TO REVIEW THE FORM 990 BEFORE IT IS FILED. Form 990, Part VI, Section B, line 12c THE TRUSTEES ARE GOVERNED BY THE TRUST DOCUMENT AND HAVE A FIDUCIARY RESPONSIBILITY UNDER ERISA TO ADMINISTER THE PLAN IN THE BEST INTEREST OF THE MEMBERSHIP. THE US DEPARTMENT OF LABOR REQUIRES ALL LABOR TRUSTEES TO REPORT ON FORM LM-30 POTENTIAL SITUATIONS WHERE THERE MAY BE CONFLICTS OF INTEREST. THIS INFORMATION IS OPEN TO THE PUBLIC. Form 990, Part VI, Section C, line 19 A SUMMARY ANNUAL REPORT IS DISTRIBUTED TO ALL PARTICIPANTS. PARTICIPANTS ARE ABLE TO REQUEST THE AUDITOR'S REPORT AND OTHER FINANCIAL INFORMATION FROM THE PLAN ADMINISTRATOR AND/OR THE US DEPARTMENT OF LABOR. ALSO, FORM 5500 IS OPEN TO PUBLIC INSPECTION THROUGH THE US DEPARTMENT OF LABOR. THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. 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