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UFCW UNION LOCAL 919 & CONTRIBUTING: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
UFCW UNION LOCAL 919 & CONTRIBUTING (EIN 06-0844353)
Tax period
2010-08-01 to 2011-07-31
Filed
2012-03-05
IRS object ID
201200659349300770
Schema version
2010v3.4
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2012-03-05T09:38:30-06:00Timestamp
Tax Period End Date2011-07-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1SASLOW LUFKIN & BUGGY LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1TEN TOWER LANEAddressLine1
CityAVONCity
StateCTState
ZIP Code06001ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-08-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN060844353EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1UFCW UNION LOCAL 919 & CONTRIBUTINGBusinessNameLine1
Business Name Line2EMPLOYERS' FOOD HEALTH & WELFARE FUNDBusinessNameLine2
FieldValueIRS element (for citing)
Name Control919NameControl
Phone8606778118Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line16 HYDE ROAD 2ND FLOORAddressLine1
CityFARMINGTONCity
StateCTState
ZIP Code060322830ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameMARK A ESPINOSAName
TitleCHAIRMANTitle
Phone8606778118Phone
Date Signed2012-03-03DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameRICHARD BUGGYName
Phone8606789200Phone
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonROGER BARRETTENameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line16 HYDE ROAD 2ND FLOORAddressLine1
CityFARMINGTONCity
StateCTState
ZIP Code060322830ZIPCode
FieldValueIRS element (for citing)
Gross Receipts34925512GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501cXOrganization501c
Web SiteN/AWebSite
Type Of Organization TrustXTypeOfOrganizationTrust
Year Formation1967YearFormation
State Legal DomicileCTStateLegalDomicile
Activity Or Mission DescriptionPROVIDING ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS WITH EMPLOYEE HEALTH AND WELFARE BENEFITS.ActivityOrMissionDescription
Nbr Voting Members Governing Body4NbrVotingMembersGoverningBody
Nbr Independent Voting Members4NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year28536461ProgramServiceRevenuePriorYear
Program Service Revenue CY29824154ProgramServiceRevenueCY
Investment Income Prior Year175286InvestmentIncomePriorYear
Investment Income Current Year106626InvestmentIncomeCurrentYear
Other Revenue Prior Year248472OtherRevenuePriorYear
Other Revenue Current Year7403OtherRevenueCurrentYear
Total Revenue Prior Year28960219TotalRevenuePriorYear
Total Revenue Current Year29938183TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year28508399BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY34080499BenefitsPaidToMembersCY
Salaries Etc Prior Year298532SalariesEtcPriorYear
Salaries Etc Current Year302466SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year437348OtherExpensePriorYear
Other Expenses Current Year447467OtherExpensesCurrentYear
Total Expenses Prior Year29244279TotalExpensesPriorYear
Total Expenses Current Year34830432TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-284060RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-4892249RevenuesLessExpensesCY
Total Assets BOY11050587TotalAssetsBOY
Total Assets EOY6307452TotalAssetsEOY
Total Liabilities BOY3632485TotalLiabilitiesBOY
Total Liabilities EOY3841010TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY7418102NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY2466442NetAssetsOrFundBalancesEOY
Mission DescriptionPROVIDING ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS WITH VARIOUS EMPLOYEE WELFARE BENEFITS, INCLUDING HEALTH, HOSPITALIZATION, DENTAL, PRESCRIPTION, OPTICAL, DISABILITY AND LIFE.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense34080499Expense
Revenue29831557Revenue
DescriptionTHE FUND PROVIDES ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS WITH EMPLOYEE WELFARE BENEFITS, INCLUDING HEALTH, HOSPITALIZATION, DENTAL, OPTICAL, PRESCRIPTION, DISABILITY AND LIFE INSURANCE COVERAGE.Description
Total Program Service Expense34080499TotalProgramServiceExpense
Described In501 C30DescribedIn501C3
Schedule B Required0ScheduleBRequired
Political Activities0PoliticalActivities
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities1ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt0ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required0ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With10963NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees0NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members4NbrVotingGoverningBodyMembers
Number Independent Voting Members4NumberIndependentVotingMembers
Family Or Business Relationship1FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other0CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
Other WebsiteXOtherWebsite
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1ROGER BARRETTE FUND OFFICE MANAGERBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number8606778118TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line16 HYDE ROADAddressLine1
CityFARMINGTONCity
StateCTState
ZIP Code060322830ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (7 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensation
MARK A ESPINOSA
CHAIRMAN/TRUSTEE3.00XX000
JOEL A BOONE
TRUSTEE3.00X000
JAMES R WALLACE JR
TRUSTEE3.00X000
JASON PARADIS
SECRETARY/TRUSTEE3.00XX000
MAUREEN A MAS
ALTERNATE TRUSTEE1.00X000
ROBERT SPINELLA
ALTERNATE TRUSTEE1.00X000
ROGER BARRETTE
FUND OFFICE MANAGER25.00X86643487379856
FieldValueIRS element (for citing)
Total Reportable Comp From Org86643TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs48737TotalReportableCompFrmRltdOrgs
Total Other Compensation9856TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K0TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (3 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
S & S HEALTHCARE STRATEGIES
1385 KEMPER MEADOW DRIVECINCINNATIOH45240CLAIMS ADMINISTRATION1205582
MULTIPLAN INC
115 FIFTH AVENUENEW YORKNY10003PPO NETWORK PROVIDER327557
SEGAL CO
30 WATERSIDE DRIVE SUITE 300FARMINGTONCT06032ACTUARIAL SERVICES145273
FieldValueIRS element (for citing)
Number Of Contractors GT100 K3NumberOfContractorsGT100K

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
EMPLOYER CONTRIBUTIONS5251002873985128739851
EMPLOYEE CONTRIBUTIONS52510010843031084303
FieldValueIRS element (for citing)
Total Program Service Revenue29824154TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column93955TotalRevenueColumn
Exclusion$93,955ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities5000000Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities4987329Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities12671Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column12671TotalRevenueColumn
Exclusion$12,671ExclusionAmount

Other Revenue Misc OtherRevenueMisc

FieldValueIRS element (for citing)
DescriptionLITIGATION SETTLEMENTDescription
Business Code900099BusinessCode
Total Revenue Column7403TotalRevenueColumn
Related Or Exempt Function Income7403RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Other Revenue7403TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column29938183TotalRevenueColumn
Related Or Exempt Function Income29831557RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$106,626ExclusionAmount

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total34080499Total
Program Services34080499ProgramServices

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total243668Total
Management And General243668ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total39908Total
Management And General39908ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total18890Total
Management And General18890ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total78428Total
Management And General78428ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total28437Total
Management And General28437ManagementAndGeneral

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total8100Total
Management And General8100ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total154519Total
Management And General154519ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total68512Total
Management And General68512ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total13572Total
Management And General13572ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total23010Total
Management And General23010ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total13371Total
Management And General13371ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total23241Total
Management And General23241ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total16445Total
Management And General16445ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalManagement And GeneralManagementAndGeneral
BANK FEES1335513355
UTILITIES35043504
PROPERTY TAXES14861486
REPAIRS & MAINTENANCE747747
DUES740740

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total34830432Total
Program Services34080499ProgramServices
Management And General749933ManagementAndGeneral
Fundraising0Fundraising

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY1108515BOY
EOY680832EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY1836491BOY
EOY1811068EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY14177BOY
EOY40412EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis165070LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec90706LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY84946BOY
EOY74364EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY7953194BOY
EOY3700776EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY53264BOY
EOY0EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY11050587BOY
EOY6307452EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY77685BOY
EOY71282EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY3554800BOY
EOY3769728EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY3632485BOY
EOY3841010EOY
FieldValueIRS element (for citing)
Do Not Follow SFAS117XDoNotFollowSFAS117

Cap Stck Trst Prin Current Funds CapStckTrstPrinCurrentFunds

FieldValueIRS element (for citing)
BOY7418102BOY
EOY2466442EOY

Paid In Cap Srpls Land Bldg Eqp Fund PaidInCapSrplsLandBldgEqpFund

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Retained Earnings Endowment Etc RetainedEarningsEndowmentEtc

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY7418102BOY
EOY2466442EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY11050587BOY
EOY6307452EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses-4892249ReconcilationRevenueExpenses
Reconcilation Other Changes-59411ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule D IRS990ScheduleD

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis165070OtherCostOrOtherBasis
Depreciation90706Depreciation
Book Value74364BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings74364TotalOfBookValueLandBuildings

Other Securities OtherSecurities (2 entries)

DescriptionDescriptionBook ValueBookValueMethod Of ValuationMethodOfValuation
VANGUARD-S&P 500 INDEX FUND701979F
VANGUARD-SHORT-TERM BOND FUND2998797F
FieldValueIRS element (for citing)
Total Of Book Value Securities3700776TotalOfBookValueSecurities

Other Liabilities OtherLiabilities (4 entries)

DescriptionDescriptionAmountAmount
ESTIMATED CLAIMS INCURRED BUT NOT REPORTED$1,558,399
HEALTH CLAIMS PAYABLE$2,010,301
DEPOSIT FROM STOP & SHOP$200,000
DUE TO AFFILIATES$1,028
FieldValueIRS element (for citing)
Total Of Amounts3769728TotalOfAmounts
Total Revenue29938183TotalRevenue
Total Expenses34830432TotalExpenses
Excess Or Deficit For Year-4892249ExcessOrDeficitForYear
Net Unrealized GL On Investments154489NetUnrealizedGLOnInvestments
Other-$213,900OtherAmount
Total Adjustments-59411TotalAdjustments
Excess Or Deficit Per FS-4951660ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt30091072TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments154489NetUnrealizedGainsInvestments
Revenue Not Rptd F990154489RevenueNotRptdF990
Revenue Subtotal29936583RevenueSubtotal
Investment Expenses Not Included1600InvestmentExpensesNotIncluded
Revenue Not Rptd On Fin Stmt1600RevenueNotRptdOnFinStmt
Total Revenue Per Form99029938183TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt34828832TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal34828832ExpensesSubtotal
Investment Expenses Not Included21600InvestmentExpensesNotIncluded2
Expenses Not Rptd On Fin Stmt1600ExpensesNotRptdOnFinStmt
Total Expenses Per Form99034830432TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:PART X:THE FUND ACCOUNTS FOR UNCERTAIN TAX POSITIONS IN ACCORDANCE WITH CERTAIN PROVISIONS OF FASB ASC 740, INCOME TAXES, WHICH PROVIDES A FRAMEWORK FOR HOW COMPANIES SHOULD RECOGNIZE, MEASURE, PRESENT AND DISCLOSE UNCERTAIN TAX POSITIONS IN THEIR FINANCIAL STATEMENTS. UNDER FASB ASC 740, THE FUND MAY RECOGNIZE THE TAX BENEFIT FROM AN UNCERTAIN TAX POSITION ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITION WILL BE SUSTAINED ON EXAMINATION BY THE TAXING AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. THE TAX BENEFITS RECOGNIZED IN THE FINANCIAL STATEMENTS FROM SUCH POSITION ARE MEASURED BASED ON THE LARGEST BENEFIT THAT HAS A GREATER THAN 50% LIKELIHOOD OF BEING REALIZED UPON ULTIMATE SETTLEMENT. THE FUND DID NOT RECORD ANY UNRECOGNIZED TAX BENEFITS FOR THE YEARS ENDED JULY 31, 2011 AND 2010. THEREFORE, FASB ASC 740 HAD NO IMPACT ON THE 2011 AND 2010 FINANCIAL STATEMENTS. THE FUND ANTICIPATES THAT IT WILL NOT HAVE A CHANGE IN UNRECOGNIZED TAX BENEFITS DURING THE NEXT TWELVE MONTHS THAT WOULD HAVE A MATERIAL IMPACT ON THE FUNDS FINANCIAL STATEMENTS. THE FUND'S POLICY IS TO RECOGNIZE INTEREST AND PENALTIES RELATED TO INCOME TAXES AS A COMPONENT OF INTEREST AND PENALTY EXPENSE. AS OF AND FOR THE YEARS ENDED JULY 31, 2011 AND 2010, THE FUND DID NOT RECORD ANY PENALTIES OR INTEREST ASSOCIATED WITH UNRECOGNIZED TAX BENEFITS. THE FUNDS PRIOR THREE TAX YEARS ARE OPEN AND SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE.
PART XI, LINE 8 - OTHER ADJUSTMENTS:CHANGE ATTRIBUTABLE TO HEALTH BENEFITS OBLIGATIONS: -213,900.

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (10 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
FORM 990, PART VI, SECTION A, LINE 2MARK A. ESPINOSA, JAMES R. WALLACE, JR., AND MAUREEN A. MAS ARE OFFICERS OF THE UNITED FOOD & COMMERCIAL WORKERS UNION LOCAL 919, WHICH IS A SPONSORING ORGANIZATION FOR THE UFCW UNION LOCAL 919 & CONTRIBUTING EMPLOYERS' FOOD HEALTH & WELFARE FUND.
FORM 990, PART VI, SECTION A, LINE 7AAS A SPONSORING ORGANIZATION, THE UNITED FOOD & COMMERCIAL WORKERS UNION LOCAL 919 HAS THE AUTHORITY TO APPOINT TWO TRUSTEES AND ONE OR MORE ALTERNATE TRUSTEES TO THE ORGANIZATION'S BOARD. SIMILARLY, AS A SPONSORING ORGANIZATION AND A PARTICIPATING EMPLOYER, THE STOP & SHOP SUPERMARKET COMPANY HAS THE AUTHORITY TO APPOINT TWO TRUSTEES AND ONE OR MORE ALTERNATE TRUSTEES TO THE ORGANIZATION'S BOARD.
FORM 990, PART VI, SECTION B, LINE 11FORM 990 IS REVIEWED BY THE FULL BOARD, APPROVED AND ACCEPTED AT THE FIRST BOARD MEETING SUBSEQUENT TO THE PREPARATION AND FILING OF THE RETURN.
THE BOARD REQUIRES ALL TRUSTEES TO REPORT ANY POTENTIAL CONFLICTS OF INTEREST AT LEAST ANNUALLY. ANY POTENTIAL CONFLICTS OF INTEREST ARE BROUGHT TO THE BOARD FOR DISCUSSION AND RESOLUTION.FORM 990, PART VI, SECTION B, LINE 12C
COMPENSATION FOR THE FUND OFFICE MANAGER IS DETERMINED ANNUALLY BY TAKING INTO ACCOUNT PERFORMANCE AND CONTEMPORANEOUS MARKET DATA FOR SIMILAR POSITIONS AND LEVELS OF RESPONSIBILITY.FORM 990, PART VI, SECTION B, LINE 15A
THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, TAX RETURNS AND AUDITED FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST TO THE FUND OFFICE.FORM 990, PART VI, SECTION C, LINE 19
CHANGES IN NET ASSETS OR FUND BALANCES:NET UNREALIZED GAINS ON INVESTMENTS: 154,489. CHANGE ATTRIBUTABLE TO HEALTH BENEFITS OBLIGATIONS: -213,900. TOTAL TO FORM 990, PART XI, LINE 5: -59,411.FORM 990, PART XI, LINE 5:
THE BOARD OF TRUSTEES ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF THE ORGANIZATION'S FINANCIAL STATEMENTS, AND FOR THE SELECTION OF AN INDEPENDENT AUDITING FIRM. THE ORGANIZATION HAS NOT CHANGED ITS PROCESS FOR AUDITOR SELECTION OR FINANCIAL STATEMENT AUDIT OVERSIGHT FROM THE PRIOR YEAR.FORM 990, PART XI, LINE 2C:
THE ORGANIZATION REIMBURSES A RELATED TAX-EXEMPT PENSION FUND FOR THE SERVICES OF CERTAIN EMPLOYEES WHO PROVIDE SERVICES TO THE ORGANIZATION. THESE EMPLOYEES ARE INCLUDED ON FORMS W-2 AND FORM W-3 ISSUED BY THE RELATED PENSION FUND. ALTHOUGH A PORTION OF THE SALARIES OF THESE EMPLOYEES IS CHARGED TO THE ORGANIZATION, THE ORGANIZATION DOES NOT ISSUE FORMS W-2 TO ANY EMPLOYEE. HOWEVER, THE ORGANIZATION DOES ISSUE FORMS W-2 TO THE RECIPIENTS OF SHORT-TERM (TEMPORARY) DISABILITY INCOME PAYABLE TO ELIGIBLE COLLECTIVELY BARGAINED EMPLOYEES OF PARTICIPATING EMPLOYERS.FORM 990, PART V, LINE 2A:
THE ORGANIZATION SHARES CERTAIN ADMINISTRATIVE COSTS SUCH AS PAYROLL, PAYROLL TAXES, ACCOUNTING, LEGAL AND CERTAIN OTHER EXPENSES WITH RELATED TAX-EXEMPT MULTIEMPLOYER PENSION FUND ORGANIZATIONS OCCUPYING THE SAME OFFICE SPACE AND UTILIZING THE SAME OFFICE PERSONNEL. SUCH COSTS ARE ALLOCATED TO EACH ORGANIZATION IN PROPORTION TO ESTIMATED USE AND PERSONNEL TIME EXPENDED. THE TOTAL AMOUNT OF SHARED EXPENSES ALLOCATED TO THE ORGANIZATION FOR THE YEAR ENDED JULY 31, 2011 WAS $413,644.FORM 990, SCHEDULE R, PART V, LINE 2A:

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1UFCW LOCAL 919 & CONTRIB EMPLOYERS' FOOD PENSION FUNDBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line16 HYDE ROAD 2ND FLOORAddressLine1
CityFARMINGTONCity
StateCTState
ZIP Code060322830ZIPCode
FieldValueIRS element (for citing)
EIN061065206EIN
Primary ActivitiesMULTIEMPLOYER PENSION PLANPrimaryActivities
Legal Domicile StateCTLegalDomicileState
Exempt Code Section401(A) & 501(A)ExemptCodeSection
Public Charity StatusN/APublicCharityStatus
Direct Controlling Entity NAN/ADirectControllingEntityNA
Controlled Org0ControlledOrg
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities1SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (4 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
UFCW LOCAL 919 & CONTRIBUTING EMPLOYERS' FOOD PENSION FUND
M23010ACTUAL CASH PAID
UFCW LOCAL 919 & CONTRIBUTING EMPLOYERS' FOOD PENSION FUND
N271368ACTUAL CASH PAID
UFCW LOCAL 919 & CONTRIBUTING EMPLOYERS' FOOD PENSION FUND
O119266ACTUAL CASH PAID
(SEE SCHEDULE O FOR ADDITIONAL DISCLOSURE)

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