FURP.ORG / PUBLIC DATA EXPLORER

NORTHWEST IRON WORKERS HEALTH & SECURITY TRUST: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
NORTHWEST IRON WORKERS HEALTH & SECURITY TRUST (EIN 91-6068079)
Tax period
2010-07-01 to 2011-06-30
Filed
2012-05-14
IRS object ID
201221359349305712
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)
Timestamp2012-05-14T15:51:35-05:00Timestamp
Tax Period End Date2011-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1CLIFTONLARSONALLEN LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line13000 NORTHUP WAY SUITE 200AddressLine1
CityBELLEVUECity
StateWAState
ZIP Code980041446ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN916068079EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1NORTHWEST IRONWORKERS HEALTH & SECURITY TRUSTBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlNORTNameControl
Phone2064417574Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 34203AddressLine1
CitySEATTLECity
StateWAState
ZIP Code98124ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameESCOTT DAHLGRENName
TitleTRUSTEETitle
Phone2064417574Phone
Date Signed2012-05-10DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameKENNETH L CLENIN CPAName
Phone4252506100Phone
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonESCOTT DAHLGRENNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1PO BOX 34203AddressLine1
CitySEATTLECity
StateWAState
ZIP Code98124ZIPCode
FieldValueIRS element (for citing)
Gross Receipts68186452GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501cXOrganization501c
Web SiteN/AWebSite
Type Of Organization TrustXTypeOfOrganizationTrust
Year Formation1966YearFormation
State Legal DomicileWAStateLegalDomicile
Activity Or Mission DescriptionHEALTH BENEFITS FOR PARTICIPANTSActivityOrMissionDescription
Nbr Voting Members Governing Body16NbrVotingMembersGoverningBody
Nbr Independent Voting Members16NbrIndependentVotingMembers
Total Nbr Employees43TotalNbrEmployees
Total Nbr Volunteers16TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year24566247ProgramServiceRevenuePriorYear
Program Service Revenue CY25358888ProgramServiceRevenueCY
Investment Income Prior Year1828758InvestmentIncomePriorYear
Investment Income Current Year1509042InvestmentIncomeCurrentYear
Other Revenue Prior Year0OtherRevenuePriorYear
Other Revenue Current Year3266OtherRevenueCurrentYear
Total Revenue Prior Year26395005TotalRevenuePriorYear
Total Revenue Current Year26871196TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year29368047BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY27676983BenefitsPaidToMembersCY
Salaries Etc Prior Year14599SalariesEtcPriorYear
Salaries Etc Current Year12008SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year2595453OtherExpensePriorYear
Other Expenses Current Year2567810OtherExpensesCurrentYear
Total Expenses Prior Year31978099TotalExpensesPriorYear
Total Expenses Current Year30256801TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-5583094RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-3385605RevenuesLessExpensesCY
Total Assets BOY50436055TotalAssetsBOY
Total Assets EOY49464804TotalAssetsEOY
Total Liabilities BOY18422945TotalLiabilitiesBOY
Total Liabilities EOY18587742TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY32013110NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY30877062NetAssetsOrFundBalancesEOY
Mission DescriptionTO PROVIDE HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS OF THE PLAN.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
DescriptionTO PROVIDE HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS OF THE PLAN.Description
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 With10961469NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees43NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members16NbrVotingGoverningBodyMembers
Number Independent Voting Members16NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties1DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
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 CEO0CompensationProcessCEO
Compensation Process Other0CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1WELFARE & PENSION ADMIN SERVICE INCBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number2064417574TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line12815 SECOND AVEAddressLine1
CitySEATTLECity
StateWAState
ZIP Code98121ZIPCode
FieldValueIRS element (for citing)
No Listed Persons CompensatedXNoListedPersonsCompensated

Form990 Part VII Section A Form990PartVIISectionA (19 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationFormerFormer
ESCOTT DAHLGREN
TRUSTEE1.00XX000
RON PIKSA
TRUSTEE1.00XX000
DENNIS CAREY
TRUSTEE1.00X000
REX SMITH
TRUSTEE1.00X000
DONNIE PATTERSON
TRUSTEE1.00X000
JOHN HIGHTOWER
TRUSTEE1.00X000
GREG KUCERA
TRUSTEE1.00X000
STEVEN LARUE
TRUSTEE1.00X000
STEVE PENDERGRASS
TRUSTEE1.00X000
JEFF ILENSTINE
TRUSTEE1.00X000
DAVE HARRISON
TRUSTEE1.00X000
KEVIN JENSEN
TRUSTEE1.00X000
BRIAN J O'NEILL
TRUSTEE1.00X000
JAMES PAULEY
TRUSTEE1.00X000
JEFF GLOCKNER
TRUSTEE1.00X000
RAYMOND TANNER
TRUSTEE1.00X000
BOB CLERIHEW
PAST TRUSTEE1.00000X
DAVE CHASE
PAST TRUSTEE1.00000X
RICK MORTON
PAST TRUSTEE1.00000X
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation0TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K0TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (4 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
WELFARE AND PENSION ADMINISTRATION SERVI
2815 2ND AVENUE STE 300SEATTLEWA98124ADMINISTRATION AND CLAIMS PROCESSING FEE758547
PREMERA BLUE CROSS
7001 220ST SW BUILDING 1MOUNTLAKE TERRACEWA98043CLAIMS PROCESSING FEES750997
QUALIS HEALTH
PO BOX 33400SEATTLEWA98133CASE MANAGEMENT154867
THE SEGAL COMPANY
100 MONTGOMERY STREET STE 500SAN FRANCISCOCA94104CONSULTING AND ACTUARIAL FEES115286
FieldValueIRS element (for citing)
Number Of Contractors GT100 K4NumberOfContractorsGT100K

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
EMPLOYER CONTRIBUTIONS5251001882782618827826
SELF PAYS52510057638395763839
COBRA REIMBURSEMENT525100454275454275
FORMULARY REBATE525100279173279173
LIQUIDATED DAMAGES5251002282722827

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

FieldValueIRS element (for citing)
Total Revenue Column10948TotalRevenueColumn
Related Or Exempt Function Income10948RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue25358888TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column1289216TotalRevenueColumn
Exclusion$1,289,216ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities41535082Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities41315256Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities219826Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column219826TotalRevenueColumn
Exclusion$219,826ExclusionAmount

Other Revenue Misc OtherRevenueMisc

FieldValueIRS element (for citing)
DescriptionREFUNDSDescription
Business Code525100BusinessCode
Total Revenue Column3266TotalRevenueColumn
Exclusion$3,266ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue3266TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column26871196TotalRevenueColumn
Related Or Exempt Function Income25358888RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$1,512,308ExclusionAmount

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total27676983Total

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total12008Total

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total260180Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total81245Total

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total48680Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total108616Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total115286Total

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total113593Total

Travel Travel

FieldValueIRS element (for citing)
Total23143Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total14340Total

Insurance Insurance

FieldValueIRS element (for citing)
Total68106Total

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotal
CLAIMS PROCESSING FEE1329255
CASE MANAGEMENT FEE170344
DRUG TEST PROGRAM EXPEN146170
EMPLOYEE ASSISTANCE PRO49369
COLLECTION COORDINATOR39483

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total30256801Total

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY154583BOY
EOY466854EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY1668749BOY
EOY696455EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY2294779BOY
EOY702453EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
BOY1747793BOY
EOY2020187EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY20249BOY
EOY19064EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis16719LandBuildingsEquipmentBasis

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY8272BOY
EOY16719EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY41580402BOY
EOY41346376EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY2961228BOY
EOY4196696EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY50436055BOY
EOY49464804EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY9980787BOY
EOY8897831EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY8442158BOY
EOY9689911EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY18422945BOY
EOY18587742EOY
FieldValueIRS element (for citing)
Do Not Follow SFAS117XDoNotFollowSFAS117

Cap Stck Trst Prin Current Funds CapStckTrstPrinCurrentFunds

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Paid In Cap Srpls Land Bldg Eqp Fund PaidInCapSrplsLandBldgEqpFund

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Retained Earnings Endowment Etc RetainedEarningsEndowmentEtc

FieldValueIRS element (for citing)
BOY32013110BOY
EOY30877062EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY32013110BOY
EOY30877062EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY50436055BOY
EOY49464804EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses-3385605ReconcilationRevenueExpenses
Reconcilation Other Changes2249557ReconcilationOtherChanges
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

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis16719OtherCostOrOtherBasis
Book Value16719BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings16719TotalOfBookValueLandBuildings

Other Securities OtherSecurities

FieldValueIRS element (for citing)
DescriptionSHORT TERM INV UNDER SEC LENDING AGREEMENTDescription
Book Value4196696BookValue
Method Of ValuationFMethodOfValuation
FieldValueIRS element (for citing)
Total Of Book Value Securities4196696TotalOfBookValueSecurities

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescriptionAmountAmount
ESTIMATED ACCUMULATED ELIGIBILITY CREDITS$5,192,000
OBLIGATION UNDER SECURITY LENDING AGREEMENT$4,497,911
FieldValueIRS element (for citing)
Total Of Amounts9689911TotalOfAmounts
Total Revenue26871196TotalRevenue
Total Expenses30256801TotalExpenses
Excess Or Deficit For Year-3385605ExcessOrDeficitForYear
Net Unrealized GL On Investments2249557NetUnrealizedGLOnInvestments
Total Adjustments2249557TotalAdjustments
Excess Or Deficit Per FS-1136048ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt29012137TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments2249557NetUnrealizedGainsInvestments
Revenue Not Rptd F9902249557RevenueNotRptdF990
Revenue Subtotal26762580RevenueSubtotal
Investment Expenses Not Included108616InvestmentExpensesNotIncluded
Revenue Not Rptd On Fin Stmt108616RevenueNotRptdOnFinStmt
Total Revenue Per Form99026871196TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt31243733TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal31243733ExpensesSubtotal
Investment Expenses Not Included2108616InvestmentExpensesNotIncluded2
Other Expenses Not Included-1095548OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt-986932ExpensesNotRptdOnFinStmt
Total Expenses Per Form99030256801TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:PART X:THE PLAN ADMINISTRATOR HAS ANALYZED THE TAX POSITIONS TAKEN BY THE PLAN, AND HAS CONCLUDED THAT AS OF JUNE 30, 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 2007.
PART XIII, LINE 4B - OTHER ADJUSTMENTS:CHANGE IN PREMIUMS PAYABLE 101,452. CHANGE IN CLAIMS PAYABLE -446,000. CHNAGE IN INCURRED BUT NOT REPORTED CLAIMS -715,000. CHANGE IN ACCUMULATED ELIGIBILITY CREDITS -36,000.

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (6 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
FORM 990, PART VI, SECTION A, LINE 3THE DAY TO DAY OPERATIONS OF THE PLAN ARE MANAGED BY WELFARE & PENSION ADMINISTRATION SERVICE, A THIRD PARTY ADMINISTRATOR.
FORM 990, PART VI, SECTION B, LINE 11A COPY OF THE 990 IS PROVIDED TO THE PLAN'S THIRD PARTY ADMINISTRATOR FOR POSTING ON THE PLAN'S TRUSTEE WEBSITE. THE PLAN'S ATTORNEY ALSO REVIEWS THE 990 PRIOR TO FILING.
THE PLAN'S THIRD PARTY ADMINISTRATOR SENDS AN ANNUAL QUESTIONNAIRE TO EACH TRUSTEE REGARDING CONFLICTS OF INTEREST.FORM 990, PART VI, SECTION B, LINE 12C
THE GOVERNING DOCUMENTS, CONFLICT IN INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO PARTICIPANTS UPON REQUEST OF THE PLAN'S THIRD PARTY ADMINISTRATOR.FORM 990, PART VI, SECTION C, LINE 19
CHANGES IN NET ASSETS OR FUND BALANCES:NET UNREALIZED GAINS ON INVESTMENTS: 2,249,557.FORM 990, PART XI, LINE 5:
THE PLAN'S FULL BOARD OF TRUSTEES SELECTS INDEPENDENT AUDITORS AND OVERSEES THE ANNUAL AUDIT.FORM 990, PART XI, LINE 2C

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionControlled OrgControlledOrg
IRONWORKERS DIST COUNCIL OF THE PACIFIC NW FIELD IRONWORKERS ANNUITY TR FD
PO BOX 34203SEATTLEWA98124911342114TO PROVIDE RETIREMENT BENEFITS TO PARTICIPANTSWA501(A)0
NORTHWEST IRONWORKERS RETIREMENT TRUST
PO BOX 34203SEATTLEWA98124916123688TO PROVIDE RETIREMENT BENEFITS TO PARTICIPANTSWA501(A)0
NORTHWEST IRONWORKERS - EMPLOYERS VACATION PLAN
PO BOX 34203SEATTLEWA98124516029816TO PROVIDE VACATION BENEFITS TO PARTICIPANTSWA501(C)(9)0
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 Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg