2012-09-17T12:15:59-05:00 2011-12-31 208078757 SALTER & COMPANY LLC 4600 EAST WEST HIGHWAY SUITE 300 BETHESDA MD 20814 990 2011-01-01 237351551 NATIONAL AUTOMATIC SPRINKLER METAL TRADES WELFARE FUND NATI 3015771700 8000 CORPORATE DRIVE LANDOVER MD 20785 MICHAEL W JACOBSON 3015771700 2012-09-13 1 CHARLES L UNDERWOOD JR P01259271 3018307400 2012-09-17 X 2011 2016-02-24 21:20:13Z MICHAEL W JACOBSON 8000 CORPORATE DRIVE LANDOVER MD 20785 2974565 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 0 0 0 0 0 0 1611721 1784410 720503 462685 0 0 2332224 2247095 0 0 2503712 2104370 89974 114257 0 0 0 231994 226421 2825680 2445048 -493456 -197953 7065345 6490202 473790 344084 6591555 6146118 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 0 1 132 0 1 0 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 2.00 X 7882 176395 84508 JOHN EGER 1.00 X 2401 165759 67352 DAN CURRY 1.00 X 1641 109313 47287 WILLIAM SAPP 2.00 X 4609 95788 44725 16533 547255 243872 0 0 1 0 THE SEGAL COMPANY 1920 N STREET NW SUITE 400 WASHINGTON DC 200361659 ACTUARY & CONSULTANT 117885 BLUE CROSS BLUE SHEILD 300 EAST RANDOLF STREET CHICAGO IL 606015099 CLAIMS PROCESSING 109543 2 UNDER UNION AGMNT 525100 1710228 1710228 PARTICIPANT CONTR. 525100 73736 73736 LIQUIDATED DAMAGES 525100 446 446 1784410 339798 339798 850357 727470 122887 122887 122887 2247095 1907297 0 339798 2104370 16533 55002 23170 13531 6021 11629 36566 6481 4309 INSURANCE CONSULT. 117508 DATA PROCESSING EXPENSE 16584 CLAIMS COST MANAGEMENT 12324 PRINTING,STATIONARY & O 5560 15460 2445048 304357 467275 413643 247433 1485 960 6345860 5774534 7065345 6490202 473790 344084 473790 344084 X 6591555 6146118 0 0 0 0 6591555 6146118 7065345 6490202 X -197953 -247484 X X 0 1 1 X 0 0 2247095 2445048 -197953 -15650 -231834 -247484 -445437 1999611 -231834 -231834 2231445 15650 15650 2247095 2445048 0 2445048 0 2445048 PART XI, LINE 8 - OTHER ADJUSTMENTS: UNREALIZED APPRECIATION (DEPRECIATION) ON INVESTMENTS -231,834. X 0 1 0 MICHAEL W JACOBSON 7195 161024 0 0 687 15371 923 20586 2695 60304 11500 257285 0 0 JOHN EGER 2171 149849 0 0 230 15910 125 8160 843 58224 3369 232143 0 0 DAN CURRY 1641 109313 0 0 0 0 0 0 699 46588 2340 155901 0 0 PART I, LINE 4B MICHAEL JACOBSON PARTICIPATES IN A NONQUALIFIED DEFERRED COMPENSATION PLAN. BALANCE FOR ALL AFFILIATED FUNDS - $142,646. JOHN EGER PARTICIPATES IN A NONQUALIFIED DEFERRED COMPENSATION PLAN. BALANCE FOR ALL AFFILIATED FUNDS - $22,329. 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 5: INVESTMENT EXPENSES: -15,650. UNREALIZED APPRECIATION (DEPRECIATION) ON INVESTMENTS -231,834. TOTAL TO FORM 990, PART XI, LINE 5: -247,484. 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