2012-03-06T13:52:14-06:00 2011-04-30 NOVAK FRANCELLA LLC ONE PRESIDENTIAL BLVD SUITE 330 BALA CYNWYD PA 19004 990 2010-05-01 223052612 PAINTERS DISTRICT COUNCIL 711 HEALTH AND WELFARE FUND PAIN 8567932501 27 ROLAND AVENUE NO 200 MOUNT LAUREL NJ 08054 HARRY HARCHETTS 8567932501 2012-03-01 LOUIS VERZELLA CPA 6106689400 2012-03-01 2010 2016-02-24 21:20:13Z HARRY HARCHETTS 26 EAST FLEMING PIKE HAMMONTON NJ 08037 32511399 0 X N/A X 1990 PA THE PLAN PROVIDES HEALTH BENEFITS (INCLUDING MAJOR MEDICAL, HOSPITAL, DENTAL, VISION AND PRESCRIPTION DRUG), LIFE INSURANCE, ACCIDENTAL DEATH AND DISMEMBERMENT AND WEEKLY DISABILITY BENEFITS TO ELIGIBLE MEMBERS AND THEIR DEPENDENTS OF THE PAINTERS DISTRICT COUNCIL 711 OF THE INTERNATIONAL UNION OF PAINTERS WHICH REPRESENTS PAINTERS AND WORKERS IN ALLIED TRADES THROUGHOUT THE STATE OF NEW JERSEY. 10 10 1 0 0 0 0 0 19566100 18537934 362806 335007 220913 146016 20149819 19018957 11000 0 20483479 18250058 33144 15875 0 0 0 1221773 930621 21749396 19196554 -1599577 -177597 19986130 19998863 115156 209165 19870974 19789698 X THE PLAN PROVIDES HEALTH BENEFITS (INCLUDING MAJOR MEDICAL, HOSPITAL, DENTAL, VISION AND PRESCRIPTION DRUG), LIFE INSURANCE, ACCIDENTAL DEATH AND DISMEMBERMENT AND WEEKLY DISABILITY BENEFITS TO ELIGIBLE MEMBERS AND THEIR DEPENDENTS OF THE PAINTERS DISTRICT COUNCIL 711 OF THE INTERNATIONAL UNION OF PAINTERS WHICH REPRESENTS PAINTERS AND WORKERS IN ALLIED TRADES THROUGHOUT THE STATE OF NEW JERSEY. 0 0 THIS IS A MULTI-EMPLOYER PLAN WHICH HAS BEEN ESTABLISHED TO PROVIDE HEALTH BENEFITS (INCLUDING MAJOR MEDICAL, HOSPITAL, DENTAL, VISION AND PRESCRIPTION DRUG), LIFE INSURANCE, ACCIDENTAL DEATH AND DISMEMBERMENT AND WEEKLY DISABILITY BENEFITS TO PARTICIPANTS WHO HAVE MET CERTAIN ELIGIBILITY REQUIREMENTS. 0 0 0 0 0 0 0 0 1 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 7 0 1 1 1 0 0 0 0 0 0 0 0 X 10 10 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 X FRANK M VACCARO & ASSOCIATES INC 8567932501 27 ROLAND AVE SUITE 200 MOUNT LAUREL NJ 08054 X HARRY HARCHETTS 1.00 X 0 0 0 KENNETH EMMONS 1.00 X 0 0 0 JOSEPH ESTEVEZ 1.00 X 0 0 0 MICHAEL KISIELEWSKI 1.00 X 0 0 0 VINCENT LANE 1.00 X 0 0 0 CLEMENT SOMMERS 1.00 X 0 0 0 JOHN ANDERSEN 1.00 X 0 0 0 THOMAS CIRIGNANO 1.00 X 0 0 0 CHARLES KOMOROSKI III 1.00 X 0 0 0 ROBERT SUCHODOLSKY 1.00 X 0 0 0 0 0 0 0 0 0 0 HORIZON BLUE CROSS BLUE SHIELD OF NEW JE PO BOX 820 NEWARK NJ 07101 HEALTH CLAIMS ADMINSTRATION 838709 FRANK M VACCARO & ASSOCIATES INC 27 ROLAND AVENUE SUITE 200 MOUNT LAUREL NJ 08054 FUND ADMINSTRATION 607429 NOVAK FRANCELLA LLC ONE PRESIDENTIAL BLVD SUITE 330 BALA CYNWYD PA 19004 ACCOUNTING 103535 3 EMPLOYER CONTRIBUTIONS 525100 17027245 17027245 PARTICIPANT AND COBRA 525100 1090752 1090752 STOP-LOSS REFUNDS 525100 419937 419937 18537934 268483 268483 13558966 13492442 66524 66524 66524 EXPRESS SCRIPTS REBATE 900099 146016 146016 146016 19018957 18537934 0 481023 18250058 15875 92212 103535 63762 607429 24798 23312 11373 DUES AND MEMBERSHIP FEE 4200 19196554 0 77165 2187752 3130321 2866272 2889035 14092 12644 14341124 13280510 576890 609188 19986130 19998863 66975 160984 48181 48181 115156 209165 X 0 0 0 0 19870974 19789698 19870974 19789698 19986130 19998863 X -177597 96321 X X 0 1 1 X 0 0 DUE TO RELATED FUNDS 48181 48181 19018957 19196554 -177597 96321 96321 -81276 18905500 96321 96321 18809179 63762 146016 209778 19018957 18986776 0 18986776 63762 146016 209778 19196554 PART XII, LINE 4B - OTHER ADJUSTMENTS: REBATE INCOME PART XIII, LINE 4B - OTHER ADJUSTMENTS: REBATE INCOME FORM 990, PART VI, SECTION B, LINE 11 PAINTERS DISTRICT COUNCIL 711 HEALTH AND WELFARE FUND'S FORM 990 IS PREPARED BY ITS INDEPENDENT PUBLIC ACCOUNTANT. THE FORM IS FORWARDED TO THE FUND'S THIRD PARTY ADMINISTRATOR FOR REVIEW. THE ADMINISTRATOR THEN PRESENTS THE RETURN TO THE BOARD OF TRUSTEES FOR SIGNATURE. FORM 990, PART VI, SECTION C, LINE 19 PAINTERS DISTRICT COUNCIL 711 HEALTH AND WELFARE FUND MAKES ITS GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. CONTACT ADDRESSES FOR OFFICERS, DIRECTORS, ETC FORM 990, PART VII HARRY HARCHETTS - 26 EAST FLEMING PIKE, HAMMONTON, NJ 08037. KENNETH EMMONS - 26 EAST FLEMING PIKE, HAMMONTON, NJ 08037. JOSEPH ESTEVEZ - 9-B FADEM ROAD, SPRINGFIELD, NJ 07081. MICHAEL KISIELEWSKI - 14 HIGH STREET, GLASSBORO, NJ 08028. VINCENT LANE - 122 DRUMMOND AVENUE, NEPTUNE, NJ 07753. CLEMENT SOMMERS - 41 SENECA PLACE, OCEANPORT, NJ 07757. JOHN ANDERSEN - 368 PASSAIC AVENUE, FAIRFIELD, NJ 07004. THOMAS CIRIGNANO - 750 W CALIFORNIA AVENUE, ABSECON, NJ 08201. CHARLES KOMOROSKI III - 1050 ELIZABETH AVENUE, ELIZABETH, NJ 07201. ROBERT SUCHODOLSKY - 125 CLEARVIEW ROAD, EDISON, NJ 08818. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED GAINS ON INVESTMENTS: 96,321. PAINTERS DISTRICT COUNCIL 711 HEALTH AND WELFARE FUND'S BOARD OF TRUSTEES IS RESPONSIBLE FOR OVERSEEING THE FINANCIAL STATEMENT AUDIT AND SELECTION OF THE INDEPENDENT ACCOUNTANT WHO PERFORMS THE AUDIT. PAINTERS DISTRICT COUNCIL 711 VACATION FUND 27 ROLAND AVENUE SUITE 200 MOUNT LAUREL NJ 08054 223168980 VACATION BENEFITS NJ 501(C)(9) 0 PAINTERS DISTRICT COUNCIL 711 FINISHING TRADES INSTITUTE OF NJ 27 ROLAND AVENUE SUITE 200 MOUNT LAUREL NJ 08054 223051963 EDUCATION AND TRAINING NJ 501(C)(3) 170(B)(1)(A)(II) 0 PAINTERS DISTRICT COUNCIL 711 JOINT TRADE BOARD 2116 OCEAN HEIGHTS AVENUE EGG HARBOR TWP NJ 08234 223052615 LABOR ORGANIZATION NJ 501(C)(5) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 PAINTERS DISTRICT COUNCIL 711 VACATION FUND Q 2093167 FMV PAINTERS DISTRICT COUNCIL 711 FINISHING TRADES INSTITUTE OF NEW JERSEY Q 1530267 FMV