2013-09-05T10:34:38-05:00 2012-12-31 208078757 SALTER & COMPANY LLC 4600 EAST WEST HIGHWAY SUITE 300 BETHESDA MD 20814 990 2012-01-01 237351551 NATIONAL AUTOMATIC SPRINKLER METAL TRADES WELFARE FUND NATI 3015771700 8000 CORPORATE DRIVE LANDOVER MD 20785 MICHAEL W JACOBSON 3015771700 2013-09-05 1 CHARLES L UNDERWOOD JR P01259271 3018307400 2013-08-28 X 2012 2016-02-24 21:20:13Z MICHAEL W JACOBSON 8000 CORPORATE DRIVE LANDOVER MD 20785 4195397 0 X NASIFUND.ORG X 1973 MD TO PROVIDE HEALTH AND WELFARE BENEFITS TO ELIGIBLE EMPLOYEES UNDER COLLECTIVE BARGAINED AGREEMENTS AND PARTICIPATION AGREEMENTS. 6 6 21 0 0 0 0 0 1784410 2561331 462685 391633 0 0 2247095 2952964 0 0 2104370 3258210 114257 106998 0 0 0 226421 265627 2445048 3630835 -197953 -677871 6490202 6189462 344084 588344 6146118 5601118 TO PROVIDE HEALTH AND WELFARE BENEFITS TO ELIGIBLE EMPLOYEES UNDER COLLECTIVE BARGAINED AGREEMENTS AND PARTICIPATION AGREEMENT. 0 0 N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1 378 0 1 21 1 0 0 0 0 0 0 0 0 X 6 6 1 0 0 0 0 1 0 1 1 1 0 1 0 0 0 1 0 0 X MICHAEL W JACOBSON ADMINISTRATOR 3015771700 8000 CORPORATE DRIVE LANDOVER MD 20785 JOHN D BODINE SR 1.00 X 0 0 0 JAMES F LYNCH 1.00 X 0 0 0 CORNELIUS J CAHILL 1.00 X 0 0 0 JAMES E TUCKER 1.00 X 0 0 0 FRED BARALL 1.00 X 0 0 0 SHAWN BROADRICK 1.00 X 0 0 0 MICHAEL W JACOBSON 1.00 X 5486 190031 87836 JOHN EGER 1.00 X 2485 172505 72764 DAN CURRY 1.00 X 2172 111551 47395 WILLIAM SAPP 3.00 X 6690 96216 44769 LINDA DAVIS 1.00 X 100 100296 44161 16933 670599 296925 0 0 1 0 THE SEGAL COMPANY 1920 N STREET NW SUITE 400 WASHINGTON DC 200361659 ACTUARY & CONSULTANT 159896 BLUE CROSS BLUE SHEILD 300 EAST RANDOLF STREET CHICAGO IL 606015099 CLAIMS PROCESSING 133549 2 UNDER UNION AGMNT 525100 2520673 2520673 PARTICIPANT CONTR. 525100 38430 38430 LIQUIDATED DAMAGES 525100 2228 2228 2561331 234066 234066 1400000 1242433 157567 157567 157567 2952964 2718898 0 234066 3258210 16933 52665 19747 12849 4804 15618 35040 5489 2857 INSURANCE CONSULT. 159896 DATA PROCESSING EXPENSE 19631 CLAIMS COST MANAGEMENT 14578 POSTAGE 4071 8447 3630835 467275 643876 247433 740016 960 4155 5774534 4801415 6490202 6189462 344084 588344 344084 588344 X 6146118 5601118 0 0 0 0 6146118 5601118 6490202 6189462 X -677871 -15808 148679 X X 0 1 X 1 0 0 3085835 148679 148679 2937156 15808 15808 2952964 3630835 0 3630835 0 3630835 X 0 1 0 MICHAEL W JACOBSON 5038 174517 0 0 448 15514 1246 27877 1648 57065 8380 274973 0 0 JOHN EGER 2257 156664 0 0 228 15841 180 12406 855 59323 3520 244234 0 0 DAN CURRY 2172 111551 0 0 0 0 0 0 905 46490 3077 158041 0 0 PART I, LINE 4B MICHAEL JACOBSON PARTICIPATES IN A NONQUALIFIED DEFERRED COMPENSATION PLAN. BALANCE FOR ALL AFFILIATED FUNDS - $171,769. JOHN EGER PARTICIPATES IN A NONQUALIFIED DEFERRED COMPENSATION PLAN. BALANCE FOR ALL AFFILIATED FUNDS - $34,914. FORM 990, PART VI, SECTION A, LINE 2 LOCAL 669 OFFICERS ARE TRUSTEES FOR THE NATIONAL AUTOMATIC SPRINKLER METAL TRADES WELFARE FUND. FORM 990, PART VI, SECTION A, LINE 7A THE NATIONAL FIRE SPRINKLER ASSOCIATION APPOINTS MANAGEMENT TRUSTEES. OFFICERS OF LOCAL 669, ELECTED BY MEMBERS OF LOCAL 669, WHICH INCLUDE PARTICIPANTS IN THIS PLAN, ARE TRUSTEES OF THE NATIONAL AUTOMATIC SPRINKLER METAL TRADES WELFARE FUND. FORM 990, PART VI, SECTION B, LINE 11 JOINT BOARD OF TRUSTEES REVIEWS FILING AT TRUSTEES MEETING. FUND ADMINISTRATOR HAS BEEN DESIGNATED BY THE JOINT BOARD OF TRUSTEES TO REVIEW AND SIGN THE FORM 990 FILING. FORM 990, PART VI, SECTION B, LINE 12 THE TRUST IS GOVERNED BY ERISA AND THE BOARD OF TRUSTEES COMPLY WITH THE CONFLICTS OF INTEREST REQUIREMENTS OF ERISA. FORM 990, PART VI, SECTION B, LINE 15A THE INDEPENDENT BOARD OF TRUSTEES REVIEWS AND APPROVES THE ADMINISTRATORS SALARY ANNUALLY FORM 990, PART VI, SECTION C, LINE 19 AVAILABLE UPON REQUEST AND THROUGH THE FORM 5500 FILING WITH THE DEPARTMENT OF LABOR. CONTACT ADDRESSES FOR OFFICERS, DIRECTORS, ETC FORM 990, PART VII JOHN D. BODINE, SR - 7050 OAKLAND MILLS ROAD STE. 200, COLUMBIA, MD 21046. JAMES F. LYNCH - 40 JON BARRETT ROAD, PATTERSON, NY 12563. CORNELIUS J. CAHILL - 40 JON BARRETT ROAD, PATTERSON, NY 12563. JAMES E. TUCKER - 7050 OAKLAND MILLS ROAD STE. 200, COLUMBIA, MD 21046. FRED BARALL - 40 JON BARRETT ROAD, PATTERSON, NY 12563. SHAWN BROADRICK - 7050 OAKLAND MILLS ROAD STE. 200, COLUMBIA, MD 21046. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 9: UNREALIZED APPRECIATION (DEPRECIATION) ON INVESTMENTS 148,679. 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