2013-04-13T11:29:57-05:00 2012-05-31 362152389 BANSLEY AND KIENER LLP 8745 WEST HIGGINS ROAD SUITE 200 CHICAGO IL 606312704 990 2011-06-01 366126628 GLAZING EMPLOYERS & GLAZIERS UNION LOCAL NO 27 HEALTH AND WELFARE FUND GLAZ 7044439000 4225 LAWNDALE AVENUE LYONS IL 60534 MICHAEL MABUS 7044439000 2013-04-08 1 PAUL A MERKEL P00420901 3122632700 2011 2016-03-07 17:11:31Z MICHAEL MABUS 4225 LAWNDALE AVENUE LYONS IL 60534 22348841 0 X N/A X 1957 IL TO PROVIDE HOSPITALIZATION, MEDICAL AND OTHER RELATED BENEFITS TO ELIGIBLE MEMBERS AND THEIR DEPENDENTS. 7 0 0 0 0 0 0 0 6860023 8510873 251782 265205 0 0 7111805 8776078 0 0 6847233 9158393 0 0 0 0 0 358280 367080 7205513 9525473 -93708 -749395 8726099 9617309 5474725 7057122 3251374 2560187 TO PROVIDE HOSPITALIZATION, MEDICAL AND OTHER RELATED BENEFITS TO ELIGIBLE MEMBERS AND THEIR DEPENDENTS. 0 0 TO PROVIDE HOSPITALIZATION, MEDICAL AND OTHER RELATED BENEFITS TO ELIGIBLE MEMBERS AND THEIR DEPENDENTS. 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 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 0 1 3 0 1 0 0 0 0 0 0 0 X 7 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 X STEWART C MILLER & CO INC 2197696944 2111 WEST LINCOLN HIGHWAY MERRILLVILLE IN 46410 ALFRED SHAPIRO 2.00 X 0 0 0 MICHAEL MABUS 2.00 X 0 1400 0 THOMAS HILL 0.50 X 0 0 0 MICHAEL O'DONNELL 0.50 X 0 1890 0 DANIEL NAUGHTON 0.50 X 0 0 0 MICHAEL COOK 0.50 X 0 11948 0 MICHAEL OHM 0.50 X 0 3108 0 ED TRAINOR 0.50 X 0 0 0 0 18346 0 0 0 0 0 BLUE CROSS BLUE SHIELD 300 E RANDOLPH CHICAGO IL 60601 HEALTH CARE PROVIDER 465041 ARNOLD & KADJAN 203 N LASALLE ST SUITE 1650 CHICAGO IL 60601 LEGAL SERVICES 182254 2 EMPLOYER CONTRIBUTIONS 900099 8377455 8377455 EMPLOYEE CONTRIBUTIONS 900099 114366 114366 COBRA SUBSIDY REIMBURS 900099 19052 19052 8510873 260971 260971 13576997 13572763 4234 4234 4234 8776078 8510873 0 265205 9158393 190754 41650 27918 84760 10694 3139 8165 9525473 53556 9823 686255 822409 7858 6884 7902291 8712321 76139 65872 8726099 9617309 81978 74500 5392747 6982622 5474725 7057122 X 0 0 0 0 3251374 2560187 3251374 2560187 8726099 9617309 X -749395 58208 X X 0 1 1 X 0 0 DUE TO AFFILIATED ORGANIZATION 2411 CLAIMS PAYABLE AND CLAIMS INCURRED BUT NOT REPORTED 1547211 ACCUMULATED ELIGIBILITY CREDITS 5433000 6982622 8776078 9525473 -749395 58208 58208 -691187 8806368 58208 58208 8748160 27918 27918 8776078 7907680 0 7907680 27918 1589875 1617793 9525473 PART XIII, LINE 4B - OTHER ADJUSTMENTS: INCREASE IN BENEFIT OBLIGATION FORM 990, PART VI, SECTION A, LINE 8B THERE ARE NO OTHER COMMITTEES WITH AUTHORITY TO ACT ON BEHALF OF THE BOARD OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11 FORM 990 IS PREPARED BY AN INDEPENDENT CPA AND IS REVIEWED AND APPROVED BY THE FUND REPRESENTATIVE PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS FORM 990 AND FORM 5500 (WHICH INCLUDES AUDITED ANNUAL FINANCIAL STATEMENTS) AND SUMMARY ANNUAL REPORT AVAILABLE FOR INSPECTION UPON REQUEST. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED GAINS ON INVESTMENTS: 58,208. FORM 990, PART XI, LINE 2C THE ORGANIZATION'S BOARD OF TRUSTEES ASSUMES THE RESPONSIBILITIES FOR THE OVERSIGHT OF THE AUDIT OF THE FINANCIAL STATEMENTS. THERE HAS BEEN NO CHANGE IN THIS PROCESS FROM THE PRIOR YEAR. GLAZIERS UNION LOCAL NO 27 PENSION & RETIREMENT PLAN 4225 LAWNDALE AVE LYONS IL 60534 366034076 DEFINED BENEFIT PLAN IL 0 GLAZIERS UNION LOCAL NO 27 OF THE BROTHERHOOD OF PAINTERS AND ALLIED TRADES 4225 LAWNDALE AVE LYONS IL 60534 361135330 LABOR UNION IL 501(C)5 0 BOARD OF TRUSTEES GLAZING EMPLOYERS& GLAZIERS UNION LOCAL NO27 WELFARE FUND 4225 LAWNDALE AVE LYONS IL 60534 366126628 PLAN SPONSOR AND ADMINISTRATOR IL 0 A C A GREENHOUSES P O BOX 9 BRIGANTINE NJ 08203 NJ ABILITY GLASS SERVICE INC 905 22ND ST ROCKFORD IL 61108 IL ACCURATE GLASS INC 814 KAY ST UNIT C ADDISON IL 60101 IL ACTION CAULKING & SEALANTS 625 EXECUTIVE DR WILLOWBROOK IL 60527 IL ACTIVE GLASS CO INC 1530 LANDMEIER RD ELK GRV VILLAGE IL 60007 IL ALL GLASS 82 BEAVERS ST NEWNAN GA 30263 GA ALL NEW GLASS INC 319 D ST N/W 104 AUBURN WA 98001 WA ALLIANCE GLASS & METAL INC 646 FORESTWOOD DR C ROMEOVILLE IL 60446 IL ALUMITAL CORP 1401 E HIGGINS RD ELK GRV VILLAGE IL 60007 IL AMERICAN GLASS & METAL CORP 865 STONEHURST DR 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HIGHLAND IN 46322 IN IL ARCH GLASS & ALUM LLC 28457 N BALLARD DR D LAKE FOREST IL 60045 IL IL CONTRACT GLAZING INC 3600 16TH ST ZION IL 60099 IL IL STEEL BLDGS INC 9132 EWING AVE SKOKIE IL 60203 IL IN ST COUNCIL OF ROOFERS P O BOX 5769 LAFAYETTE IN 47903 IN IND'L GLASS & MIRROR LTD 5662 N NORTHWEST HWY CHICAGO IL 60646 IL INNOVATIVE METAL SOLUTIONS LLC 900 E PECAN ST 300-306 PFLUGERVILLE TX 78660 TX JANECYK CONSTR CO INC P O BOX 696 ST JOSEPH MI 49085 MI KANKAKEE GLAZING CONTR CO 828 W RIVER PL KANKAKEE IL 60901 IL KLEIN-DICKERT MILWAUKEE INC P O BOX 259410 MADISON WI 53725 WI KURTZ T D GLASS CO 1101 1ST AVE ROCK FALLS IL 60171 IL LA SALLE CO GLASS & MIRROR 915 1/2 FOSSE RD A OTTAWA IL 61350 IL LAKE CITY GLASS INC 3501 E WASHINGTON AVE MADISON WI 53704 WI LAKE CO GLASS CO INC P O BOX 2548 HAMMOND IN 46323 IN LAKE SHORE GLASS & MIRROR 2150 W 32ND ST CHICAGO IL 60608 IL LAZZARO CO INC 5880 BROADWAY MERRILLVILLE IN 46410 IN LE WALT GLASS CO INC 6521 COMMERCIAL RD CRYSTAL LAKE IL 60014 IL M G M GLASS INC 1033 CAMDEN LN SOUTH ELGIN IL 60177 IL M T H INDUSTRIES ONE MTH PLZ HILLSIDE IL 60162 IL MADDEN GLASS INC 60 N GORDON AVE ELK GRV VILLAGE IL 60007 IL MADISON HGTS GLASS CO 2020 BURDETTE ST FERNADALE MI 48220 MI MAGG'S GLAZING CONTR INC 19820 S WOLF RD MOKENA IL 60448 IL MANGRUM GLASS & MIRROR LTD 1880 W FULLERTON AVE CHICAGO IL 60614 IL MARK INDUSTRIES LTD 1605 DUNDEE AVE UNIT A ELGIN IL 60120 IL MCHENRY CO GLASS & MIRROR INC 2809 BARNEY CT MCHENRY IL 60050 IL MEYER GLASS & MIRROR CO INC 202 W HARRISON ST MICHIGAN CITY IN 46360 IN MID-AMER GLAZING SYS 3750 W RIVER DR DAVENPORT IA 52802 IA MIDWEST ARCH GLASS 1007 PLAINFIELD RD JOLIET IL 60435 IL MIDWEST BLDG SVCS INC 3014 W FILLMORE CHICAGO IL 60612 IL MODERN MIRROR & GLASS CO 20809 KRAFT BLVD ROSEVILLE MI 48066 MI NOBAR ERECTORS 2381 HWY 430 NICHOLS SC 29581 SC NORTHERN GLASS INC 800 LEE ST ELK GRV VILLAGE IL 60007 IL OLDCASTLE BLDG ENVELOPE 4161 S MORGAN ST CHICAGO IL 60609 IL PAINTERS DIST COUNCIL 14 1456 W ADAMS ST CHICAGO IL 60607 IL PAULWIN ASSOC INC 2801 OLD HIGGINS RD ELK GRV VILLAGE IL 60007 IL PETERSON GLASS CO 5535 N MILWAUKEE AVE CHICAGO IL 60630 IL PINTO GLASS & MIRROR CO INC 1005 INDUSTRIAL DR NEW LENOX IL 60451 IL PRECISION WALL SYS INC 3801 S MAIN ST SOUTH BEND IN 46614 IN PRISM GLAZING INC 30W460 ARBOR LN WEST CHICAGO IL 60185 IL PROSPECT GLASS CO 1290 JARVIS AVE ELK GRV VILLAGE IL 60007 IL QUINT G INC 725 SCHNEIDER DR 4 SOUTH ELGIN IL 60177 IL R W S INC 3900 W 159TH PL MARKHAM IL 60426 IL RAREFORM ARCH PRODUCTS LLC 1908 JANKE DR NORTHBROOK IL 60062 IL RETAIL STOREFRONT GROUP P O BOX 1070 LEEDS AL 35094 AL ROCK VALLEY GLASS OF ROCKFORD 1398 HUNTWOOD DR CHERRY VALLEY IL 61016 IL SCHAAF GLASS CO 7212 W 90TH ST BRIDGEVIEW IL 60455 IL SCHNEIDERS-VETTER GLASS CO 2224 S 162ND ST NEW BERLIN WI 53151 WI SKYLIGHT CONSULT OF AMERICA 3409 W PERRY ST INDIANAPOLIS IN 46221 IN SUPER SKY CONSTR INC 10301 N ENTERPRISE DR MEQUON WI 53092 WI TRAINOR GLASS CO 760 IN HWY 212 MICHIGAN CITY IN 46360 IN TRIUMPH RESTORATION INC 18822 S 82ND AVE MOKENA IL 60448 IL TROUT GLASS & MIRROR INC 1579 S CALUMET RD CHESTERTON IN 46304 IN VALLEY GLASS CO 1630 COMMERCE DR BOURBONNAIS IL 60914 IL VENTURA ENTERPRISES INC 1925 S WESTERN AVE CHICAGO IL 60608 IL WAUKEGANGURNEE GLASS INC 1200 N ESTES DEPT 200 GURNEE IL 60031 IL WERNTZ J W SUPPLY 1002 KERR ST SOUTH BEND IN 46601 IN WOOD RIVER GLASS CO 243 S 6TH ST WOOD RIVER IL 62095 IL 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 FORM 990, SCHEDULE R, PART IV THE ORGANIZATION IS A MULTIEMPLOYER COLLECTIVELY BARGAINED EMPLOYEE BENEFIT PLAN THAT IS SUBJECT TO THE PROVISIONS OF THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974 (ERISA). THE ORGANIZATION HAS MADE A REASONABLE EFFORT TO PROVIDE INFORMATION REQUIRED. ALL CONTRIBUTING EMPLOYERS OF THE ORGANIZATION ARE LISTED IN PART IV OF SCHEDULE R.