2012-11-12T12:11:31-06:00 2011-12-31 410746749 CLIFTONLARSONALLEN LLP 220 SOUTH SIXTH STREET SUITE 300 MINNEAPOLIS MN 55402 990 2011-01-01 416023461 MINNESOTA & NORTH DAKOTA BRICKLAYERS & ALLIED CRAFTSWORKERS HEALTH FUND MINN 6512561801 2520 PILOT KNOB ROAD NO 325 MENDOTA HEIGHTS MN 55120 MICHAEL COOK 6512561801 2012-06-19 1 DOUG BERTOSSI P00637990 6123764500 2011 2016-02-24 21:20:13Z MICHAEL COOK 2520 PILOT KNOB ROAD NO 325 MENDOTA HEIGHTS MN 55120 48493801 0 X N/A X 1961 MN PROVIDE HEALTH & WELFARE BENEFITS TO UNION MEMBERS AND THEIR DEPENDENTS. 8 8 0 10 0 0 0 0 14196468 14645194 2453640 2729693 21010 7555 16671118 17382442 0 0 17571032 18292355 0 0 0 0 0 1386456 1326112 18957488 19618467 -2286370 -2236025 58465656 55472790 633005 566047 57832651 54906743 PROVIDE HEALTH AND WELFARE BENEFITS TO UNION MEMBERS AND THEIR DEPENDENTS. 0 0 PAYMENT OF HOSPITAL, MEDICAL, DENTAL, DISABILITY, DEATH, AND VISION BENEFITS FOR 1,804 UNION MEMBERS AND THEIR DEPENDENTS. 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 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 0 0 0 0 0 0 0 0 0 X 8 8 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 0 1 0 0 0 X ZENITH AMERICAN SOLUTIONS 6512561900 2520 PILOT KNOB ROAD 325 MENDOTA HEIGHTS MN 55120 X X MICHAEL COOK 1.00 X X 0 0 0 ROGER BUIRGE 1.00 X 0 0 0 MIKE HAWTHORNE 1.00 X 0 0 0 MARK CARON 1.00 X 0 0 0 PAUL WIESE 1.00 X X 0 0 0 RON RASLEY 1.00 X 0 0 0 MONICA KELLEY 1.00 X 0 0 0 MICHAEL LAPENSKY 1.00 X 0 0 0 FRANK GRAZZINI II 1.00 X 0 0 0 MICHAEL GANZ 1.00 X 0 0 0 0 0 0 0 0 0 0 ZENITH AMERICAN SOLUTIONS 2520 PILOT KNOB ROAD 325 MENDOTA HEIGHTS MN 55120 PLAN ADMINISTRATOR 680106 MEDICA DBA SELECT CARE ROUTE CP260 401 CARLSON PKWY PO BO MINNEAPOLIS MN 554409310 PPO 299267 FELHABER LARSON FENLON & VOGT 444 CEDAR STREET SUITE 2100 ST PAUL MN 551012136 LEGAL 103569 3 CONTRIBUTIONS 525100 14645194 14645194 14645194 2272263 2272263 31568789 31111359 457430 457430 457430 LEGAL FEE REIMB. 525100 6071 6071 CREDIT CARD INCOME 525100 1484 1484 7555 17382442 14645194 0 2737248 18292355 739986 189057 24772 121398 101943 127721 5643 15592 19618467 3899936 4430200 2300364 3303512 1229000 1211000 50340568 45839035 695788 689043 58465656 55472790 174865 125404 458140 440643 633005 566047 X 0 0 0 0 57832651 54906743 57832651 54906743 58465656 55472790 X -2236025 -689883 X 0 1 1 X 0 0 ADVANCE CONTRIBUTIONS FROM EMPLOYEES FOR FUTURE COVERAGE 440643 440643 17382442 19618467 -2236025 -689883 -689883 -2925908 16571161 -689883 -689883 17261044 121398 121398 17382442 19497069 0 19497069 121398 121398 19618467 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: THE TRUST ESTABLISHED UNDER THE PLAN TO HOLD THE PLAN'S ASSETS IS INTENDED TO QUALIFY PURSUANT TO SECTION 501(C)(9) OF THE INTERNAL REVENUE CODE AND, ACCORDINGLY, THE TRUST'S NET INVESTMENT INCOME IS EXEMPT FROM INCOME TAXES. THE TRUST HAS OBTAINED A TAX EXEMPTION LETTER FROM THE INTERNAL REVENUE SERVICE AND THE BOARD OF TRUSTEES BELIEVES THAT THE TRUST, AS AMENDED, CONTINUES TO QUALIFY AND TO OPERATE AS DESIGNED. ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE PLAN MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE PLAN AND RECOGNIZE A TAX LIABILITY (OR ASSET) IF THE PLAN HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE IRS. THE PLAN ADMINISTRATOR HAS ANALYZED THE TAX POSITIONS TAKEN BY THE PLAN, AND HAS CONCLUDED THAT AS OF DECEMBER 31, 2011 AND 2010, THERE ARE 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 TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. THE PLAN ADMINISTRATOR BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO 2008. FORM 990, PART VI, SECTION B, LINE 11 FORM 990 WAS REVIEWED BY THE BOARD OF TRUSTEES IN CONJUNCTION WITH THE REVIEW OF THE ANNUAL AUDIT. FORM 990, PART VI, SECTION B, LINE 12C THE POLICY IS DISCUSSED ANNUALLY BY THE BOARD OF TRUSTEES TO ENSURE THE TRUSTEES UNDERSTAND THE CONFLICT OF INTEREST POLICY AND UNDERSTANDS THE FUND IS A TAX-EXEMPT ORGANIZATION THAT MUST ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX EXEMPT PURPOSES. PER THE POLICY, ANY PERSON DISCOVERING A CONFLICT SHOULD DISCLOSE IT IMMEDIATELY TO THE CHARIMAN OF THE BOARD OF TRUSTEES. THE BOARD OF TRUSTEES DETERMINES IF A CONFLICT EXISTS AND MAY PLACE APPROPRIATE RESTRICTIONS ON THE INDIVIDUAL OR TRANSACTIONS AFFECTED AT THEIR DISCRETION. ANY CONFLICTS ARE DOCUMENTED IN MEETING MINUTES. NO SUCH CONFLICTS AROSE DURING THE YEAR. FORM 990, PART VI, SECTION C, LINE 19 THE FUND'S GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST; HOWEVER THE CONFLICT OF INTEREST POLICY IS NOT MADE AVAILABLE. DESCRIPTION OF SHARED HOURS FORM 990, PART VII, SECTION A, LINE 1A: MICHAEL COOK AND MIKE HAWTHORNE EACH WORKED A TOTAL OF 3 HOURS/WEEK FOR THE REPORTING ORGANIZATION AND THE RELATED ORGANIZATIONS AS FOLLOWS: -MN & ND BRICKLAYERS AND ALLIED CRAFTSWORKERS VACATION FUND - 1 HOUR/WEEK -MN & ND BRICKLAYERS AND ALLIED CRAFTSWORKERS PENSION FUND - 1 HOUR/WEEK -MN & ND BRICKLAYERS AND ALLIED CRAFTSWORKERS HEALTH FUND - 1 HOUR/WEEK MICHAEL GANZ WORKED A TOTAL OF 2 HOURS/WEEK FOR THE REPORTING ORGANIZATION AND THE RELATED ORGANIZATION AS FOLLOWS: -MN & ND BRICKLAYERS AND ALLIED CRAFTSWORKERS VACATION FUND - 1 HOUR/WEEK -MN & ND BRICKLAYERS AND ALLIED CRAFTSWORKERS HEALTH FUND - 1 HOUR/WEEK CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED LOSSES ON INVESTMENTS: -689,883. MN & ND BRICKLAYERS AND ALLIED CRAFTSWORKERS PENSION FUND 2520 PILOT KNOB RD MENDOTA HEIGHTS MN 55120 516029930 PROVIDE RETIREMENT BENEFITS TO UNION MEMBERS. MN N/A 0 MN & ND BRICKLAYERS AND ALLIED CRAFTSWORKERS VACATION FUND 2520 PILOT KNOB RD MENDOTA HEIGHTS MN 55120 237068471 PROVIDE VACATION BENEFITS TO UNION MEMBERS. MN 501(C)(9) N/A 0 MN & ND BRICKLAYERS AND ALLIED CRAFTSWORKERS APPRENTICE FUND 328 UNITED LABOR CTR 312 CENTRAL AV MPLS MN 55414 416319702 PROVIDE TRAINING AND RETRAINING TO CURRENT AND PROSPECTIVE UNION MEMBERS. MN 501(C)(4) N/A 0 MINNESOTA CERAMIC TILE AND ALLIED TRADES RETIREMENT FUND 2520 PILOT KNOB RD MENDOTA HEIGHTS MN 55120 416059404 PROVIDE RETIREMENT BENEFITS TO UNION MEMBERS. MN N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0