MICHIGAN TROWEL TRADES HEALTH & WELFARE FUND: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization: MICHIGAN TROWEL TRADES HEALTH & WELFARE FUND (EIN 38-6238055)
Tax period: 2011-01-01 to 2011-12-31
Filed: 2012-11-15
IRS object ID: 201233209349306203
Schema version: 2011v1.2
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
Form 990
Schedule D
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2012-11-15T12:02:35-06:00	Timestamp
Tax Period End Date	2011-12-31	TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	BENDA GRACE STULZ & COMPANY PC	BusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

Field	Value	IRS element (for citing)
Address Line1	38800 VAN DYKE AVE STE 100	AddressLine1
City	STERLING HEIGHTS	City
State	MI	State
ZIP Code	48312	ZIPCode

Field	Value	IRS element (for citing)
Return Type	990	ReturnType
Tax Period Begin Date	2011-01-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	386238055	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	MICHIGAN TROWEL TRADES HEALTH AND	BusinessNameLine1
Business Name Line2	WELFARE FUND	BusinessNameLine2

Field	Value	IRS element (for citing)
Name Control	MICH	NameControl
Phone	5173217502	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	6525 CENTURION DRIVE	AddressLine1
City	LANSING	City
State	MI	State
ZIP Code	48917	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	MICHAEL STANFIELDCHAIRMAN	Name
Title	GLENN BUKOSKI/SECRETARY	Title
Phone	5173217502	Phone
Date Signed	2012-03-15	DateSigned

Preparer Preparer

Field	Value	IRS element (for citing)
Name	BRYAN STULZ	Name
Phone	5868836240	Phone
Date Prepared	2012-11-15	DatePrepared

Field	Value	IRS element (for citing)
Tax Year	2011	TaxYear
Build TS	2016-02-24 21:20:13Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Name Of Principal Officer Person	SAME AS ABOVE	NameOfPrincipalOfficerPerson
Gross Receipts	5006270	GrossReceipts
Group Return For Affiliates	false	GroupReturnForAffiliates
Organization501c	X	Organization501c
Web Site	WWW.OUTSTATETROWELTRADES.ORG	WebSite
Type Of Organization Trust	X	TypeOfOrganizationTrust
Year Formation	1971	YearFormation
State Legal Domicile	MI	StateLegalDomicile
Activity Or Mission Description	PROVIDE HEALTH CARE BENEFITS TO PARTICIPANTS.	ActivityOrMissionDescription
Nbr Voting Members Governing Body	10	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	4	NbrIndependentVotingMembers
Total Nbr Employees	0	TotalNbrEmployees
Total Gross UBI	0	TotalGrossUBI
Contributions Grants Current Year	0	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	5040186	ProgramServiceRevenuePriorYear
Program Service Revenue CY	4938483	ProgramServiceRevenueCY
Investment Income Prior Year	4123	InvestmentIncomePriorYear
Investment Income Current Year	2918	InvestmentIncomeCurrentYear
Other Revenue Prior Year	180391	OtherRevenuePriorYear
Other Revenue Current Year	64869	OtherRevenueCurrentYear
Total Revenue Prior Year	5224700	TotalRevenuePriorYear
Total Revenue Current Year	5006270	TotalRevenueCurrentYear
Grants And Similar Amnts CY	0	GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year	5335477	BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY	4369176	BenefitsPaidToMembersCY
Salaries Etc Current Year	0	SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY	0	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	0	TotalFundrsngExpCurrentYear
Other Expense Prior Year	369937	OtherExpensePriorYear
Other Expenses Current Year	296592	OtherExpensesCurrentYear
Total Expenses Prior Year	5705414	TotalExpensesPriorYear
Total Expenses Current Year	4665768	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	-480714	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	340502	RevenuesLessExpensesCY
Total Assets BOY	4602576	TotalAssetsBOY
Total Assets EOY	4489013	TotalAssetsEOY
Total Liabilities BOY	2751551	TotalLiabilitiesBOY
Total Liabilities EOY	2297486	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	1851025	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	2191527	NetAssetsOrFundBalancesEOY
Mission Description	PROVIDE HEALTH CARE BENEFITS TO PARTICIPANTS.	MissionDescription
Significant New Program Services	false	SignificantNewProgramServices
Significant Change	false	SignificantChange
Description	TO PROVIDE HEALTH CARE BENEFITS TO PARTICIPANTS AND THEIR DEPENDENTS. THESE BENEFITS INCLUDED HEALTH, VISION, PRESCRIPTION DRUG, LIFE INSURANCE AND ACCIDENTAL DEATH AND DISMEMBERMENT COVERAGE.	Description
Described In501 C3	false	DescribedIn501C3
Schedule B Required	false	ScheduleBRequired
Political Activities	false	PoliticalActivities
Subject To Proxy Tax	false	SubjectToProxyTax
Donor Advised Funds	false	DonorAdvisedFunds
Conservation Easements	false	ConservationEasements
Collections Of Art	false	CollectionsOfArt
Credit Counseling	false	CreditCounseling
Term Or Permanent Endowments	false	TermOrPermanentEndowments
Report Land Bldg Equip	false	ReportLandBldgEquip
Report Invest Oth Securities	false	ReportInvestOthSecurities
Report Prog Rel Invest	false	ReportProgRelInvest
Report Other Assets	true	ReportOtherAssets
Report Other Liabilities	true	ReportOtherLiabilities
Report Fin48 Footnote	false	ReportFin48Footnote
Independent Audit Financial Stmt	true	IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt	false	ConsolidatedAuditFinancialStmt
School	false	School
Foreign Office	false	ForeignOffice
Foreign Activities	false	ForeignActivities
More Than5000 K To Organizations	false	MoreThan5000KToOrganizations
More Than5000 K To Individuals	false	MoreThan5000KToIndividuals
Professional Fundraising	false	ProfessionalFundraising
Fundraising Activities	false	FundraisingActivities
Gaming	false	Gaming
Hospital	false	Hospital
Grants To Organizations	false	GrantsToOrganizations
Grants To Individuals	false	GrantsToIndividuals
Schedule J Required	false	ScheduleJRequired
Tax Exempt Bonds	false	TaxExemptBonds
Loan To Officer Or DQP	false	LoanToOfficerOrDQP
Grant To Related Person	false	GrantToRelatedPerson
Bsnss Rltnshp With Organization	false	BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member	false	BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp	false	OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions	false	DeductibleNonCashContributions
Deductible Contributions Of Art	false	DeductibleContributionsOfArt
Terminated	false	Terminated
Partial Liquidation	false	PartialLiquidation
Disregarded Entity	false	DisregardedEntity
Related Entity	true	RelatedEntity
Related Org Controlled Entity	false	RelatedOrgControlledEntity
Transaction Related Entity	false	TransactionRelatedEntity
Activities Conducted Partnership	false	ActivitiesConductedPartnership
Schedule O Required	true	ScheduleORequired
Number Forms Transmitted With1096	0	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Number Of Employees	0	NumberOfEmployees
Unrelated Business Income	false	UnrelatedBusinessIncome
Foreign Financial Account	false	ForeignFinancialAccount
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTrans
Taxable Party Notification	false	TaxablePartyNotification
Non Deductible Contributions	false	NonDeductibleContributions
Indoor Tanning Services	false	IndoorTanningServices
Info In Schedule O Part VI	X	InfoInScheduleOPartVI
Nbr Voting Governing Body Members	10	NbrVotingGoverningBodyMembers
Number Independent Voting Members	4	NumberIndependentVotingMembers
Family Or Business Relationship	true	FamilyOrBusinessRelationship
Delegation Of Management Duties	false	DelegationOfManagementDuties
Changes To Organizing Docs	false	ChangesToOrganizingDocs
Material Diversion Or Misuse	false	MaterialDiversionOrMisuse
Members Or Stockholders	false	MembersOrStockholders
Election Of Board Members	false	ElectionOfBoardMembers
Decisions Subject To Approval	false	DecisionsSubjectToApproval
Minutes Of Governing Body	true	MinutesOfGoverningBody
Minutes Of Committees	true	MinutesOfCommittees
Officer Mailing Address	false	OfficerMailingAddress
Local Chapters	false	LocalChapters
Form990 Provided To Governing Body	false	Form990ProvidedToGoverningBody
Conflict Of Interest Policy	false	ConflictOfInterestPolicy
Whistleblower Policy	false	WhistleblowerPolicy
Document Retention Policy	false	DocumentRetentionPolicy
Compensation Process CEO	false	CompensationProcessCEO
Compensation Process Other	false	CompensationProcessOther
Investment In Joint Venture	false	InvestmentInJointVenture
Upon Request	X	UponRequest

The Books Are In Care Of TheBooksAreInCareOf

Field	Value	IRS element (for citing)
Name Person	TIC INTERNATIONAL	NamePerson
Telephone Number	5173217502	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	6525 CENTURION DR	AddressLine1
City	LANSING	City
State	MI	State
ZIP Code	48917	ZIPCode

Field	Value	IRS element (for citing)
Info In Schedule O Part VII	X	InfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (11 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Individual Trustee Or DirectorIndividualTrusteeOrDirector	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation
JOEL SANTOS
TRUSTEE	1.00	X	0	80047	14721
HENRY WILLIAMS
TRUSTEE	1.00	X	0	76450	14212
JACK MCCOOL
TRUSTEE	1.00	X	0	70429	13322
CYRIL WILSON
TRUSTEE	1.00	X	0	64756	23121
MICHAEL STANFIELD
CHAIRMAN	1.00	X	0	62026	23120
DON BOVRE
TRUSTEE	1.00	X	0	0	0
GLENN BUKOSKI
SECRETARY	1.00	X	0	0	0
SCOTT FISHER
TRUSTEE	1.00	X	0	0	0
LAWRENCE WALRAVEN
TRUSTEE	1.00	X	0	0	0
DOUGLAS NEEDHAM
TRUSTEE	1.00	X	0	0	0
DOUGLAS NOWACK
TRUSTEE	1.00	X	0	0	0

Field	Value	IRS element (for citing)
Total Reportable Comp Frm Rltd Orgs	353708	TotalReportableCompFrmRltdOrgs
Total Other Compensation	88496	TotalOtherCompensation
Formers Listed	false	FormersListed
Total Comp GT150 K	false	TotalCompGT150K
Compensation From Other Sources	false	CompensationFromOtherSources

Contractor Compensation ContractorCompensation (2 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1	CityAddressOfContractor/AddressUS/City	StateAddressOfContractor/AddressUS/State	ZIP CodeAddressOfContractor/AddressUS/ZIPCode	Description Of ServicesDescriptionOfServices	CompensationCompensation
BLUE CROSS BLUE SHIELD OF MICHIGAN
27000 W ELEVEN MILE B561	SOUTHFIELD	MI	48034	INSURANCE	246185
TIC INTERNATIONAL
6525 CENTURION DRIVE	LANSING	MI	48917	TPA	103540

Field	Value	IRS element (for citing)
Number Of Contractors GT100 K	2	NumberOfContractorsGT100K

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome
EMPLOYER CONTRIBUTIONS	230000	4515164	4515164
PARTICIPANT SELF PAYMENTS	230000	423319	423319

Field	Value	IRS element (for citing)
Total Program Service Revenue	4938483	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	2918	TotalRevenueColumn
Exclusion	$2,918	ExclusionAmount

Other Revenue Misc OtherRevenueMisc (2 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome
LIQUIDATED DAMAGES	900099	37218	37218
OTHER	900099	27651	27651

Field	Value	IRS element (for citing)
Total Other Revenue	64869	TotalOtherRevenue

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	5006270	TotalRevenueColumn
Related Or Exempt Function Income	5003352	RelatedOrExemptFunctionIncome
Exclusion	$2,918	ExclusionAmount

Benefits To Members BenefitsToMembers

Field	Value	IRS element (for citing)
Total	4369176	Total
Program Services	4369176	ProgramServices

Fees For Services Management FeesForServicesManagement

Field	Value	IRS element (for citing)
Total	102000	Total
Management And General	102000	ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

Field	Value	IRS element (for citing)
Total	94552	Total
Management And General	94552	ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

Field	Value	IRS element (for citing)
Total	40631	Total
Management And General	40631	ManagementAndGeneral

Fees For Services Other FeesForServicesOther

Field	Value	IRS element (for citing)
Total	36426	Total
Management And General	36426	ManagementAndGeneral

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	14384	Total
Management And General	14384	ManagementAndGeneral

Information Technology InformationTechnology

Field	Value	IRS element (for citing)
Total	1800	Total
Management And General	1800	ManagementAndGeneral

Conferences Meetings ConferencesMeetings

Field	Value	IRS element (for citing)
Total	5125	Total
Management And General	5125	ManagementAndGeneral

Insurance Insurance

Field	Value	IRS element (for citing)
Total	1674	Total
Management And General	1674	ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	4665768	Total
Program Services	4369176	ProgramServices
Management And General	296592	ManagementAndGeneral
Fundraising	0	Fundraising

Savings And Temp Cash Investments SavingsAndTempCashInvestments

Field	Value	IRS element (for citing)
BOY	3611667	BOY
EOY	3296978	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	325962	BOY
EOY	210967	EOY

Other Assets Total OtherAssetsTotal

Field	Value	IRS element (for citing)
BOY	664947	BOY
EOY	981068	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	4602576	BOY
EOY	4489013	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	97551	BOY
EOY	113486	EOY

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
BOY	2654000	BOY
EOY	2184000	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	2751551	BOY
EOY	2297486	EOY

Field	Value	IRS element (for citing)
Do Not Follow SFAS117	X	DoNotFollowSFAS117

Retained Earnings Endowment Etc RetainedEarningsEndowmentEtc

Field	Value	IRS element (for citing)
BOY	1851025	BOY
EOY	2191527	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	1851025	BOY
EOY	2191527	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	4602576	BOY
EOY	4489013	EOY

Field	Value	IRS element (for citing)
Reconcilation Revenue Expenses	340502	ReconcilationRevenueExpenses
Method Of Accounting Accrual	X	MethodOfAccountingAccrual
Accountant Compile Or Review	false	AccountantCompileOrReview
FS Audited	true	FSAudited
Audit Committee	true	AuditCommittee
Financial Statement Consolidated	X	FinancialStatementConsolidated
Federal Grant Audit Required	false	FederalGrantAuditRequired

Schedule D IRS990ScheduleD

Field	Value	IRS element (for citing)
Disclosed Orgs Legal Control	false	DisclosedOrgsLegalControl
Disclosed For Charitable Purposes	false	DisclosedForCharitablePurposes
Written Policy Monitoring	false	WrittenPolicyMonitoring
Sect170h Requirements Satisfied	false	Sect170hRequirementsSatisfied
Solicited Assets For Sale	false	SolicitedAssetsForSale
Agent Trustee Etc	false	AgentTrusteeEtc
Included On FS	false	IncludedOnFS
Endowments Held By Unrelated Orgs	false	EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs	false	EndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule R	false	AreRelatedOrgsListedScheduleR

Other Assets OtherAssets (3 entries)

DescriptionDescription	Book ValueBookValue
HEALTH CARE CLAIMS DEPOSIT	979304
PREPAID EXPENSES	955
UNEXPIRED INSURANCE PREMIUM	809

Field	Value	IRS element (for citing)
Total Book Value Other Assets	981068	TotalBookValueOtherAssets

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
Description	BENEFIT OBLIGATIONS	Description
Amount	$2,184,000	Amount

Field	Value	IRS element (for citing)
Total Of Amounts	2184000	TotalOfAmounts
Total Revenue	5006270	TotalRevenue
Total Expenses	4665768	TotalExpenses
Excess Or Deficit For Year	340502	ExcessOrDeficitForYear
Excess Or Deficit Per FS	340502	ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt	5006270	TotRevenueEtcAuditedFinclStmt
Revenue Subtotal	5006270	RevenueSubtotal
Total Revenue Per Form990	5006270	TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt	4665768	TotExpensesEtcAuditedFinclStmt
Expenses Subtotal	4665768	ExpensesSubtotal
Total Expenses Per Form990	4665768	TotalExpensesPerForm990

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (4 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
ADDITIONAL INFORMATION	FORM 990, PART VI	LINE 2 - FAMILY RELATIONSHIP OR BUSINESS RELATIONSHIP - THE RELATIONSHIP BETWEEN THE TRUSTEES OF THE FUND IS A 'BUSINESS RELATIONSHIP'. THE FUND IS ESTABLISHED AND MAINTAINED PURSUANT TO THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974, AS AMENDED. THE FUND, AS A TAFT-HARTLEY FUND, IS ADMINISTERED BY A BOARD OF TRUSTEES WHICH IS COMPOSED OF AN EQUAL NUMBER OF UNION AND EMPLOYER REPRESENTATIVES. BECAUSE OF THIS ORGANIZATIONAL REQUIREMENT, THERE IS A BUSINESS RELATIONSHIP BETWEEN THE TRUSTEES. LINE 12 - ANNUALLY, EACH TRUSTEE MUST ANSWER THE FIDUCIARY LIABILITY INSURANCE RENEWAL QUESTIONAIRE, WHICH CONTAINS QUESTIONS REGARDING POTENTIAL AND ACUTAL CONFLICTS OF INTEREST. LINE 15 - THE FUND DID NOT HAVE A CEO, EXECUTIVE DIRECTOR, OR TOP MANAGEMENT OFFICIAL, OR OTHER OFFICERS OR KEY EMPLOYEES, AS THOSE TERMS ARE DEFINED.
ORGANIZATION'S PROCESS USED TO REVIEW FORM 990	FORM 990, PAGE 6, PART VI, LINE 11B	THE FORM 990 IS PRESENTED AND APPROVED AT A MEETING OF THE BOARD OF TRUSTEES, SUBJECT TO APPROVAL BY AND REVIEW OF THE FUND'S LEGAL COUNSEL. IN ADDITION, EACH TRUSTEE IS PROVIDED A COPY OF THE FUND'S FINAL FORM 990 (INCLUDING REQUIRED SCHEDULES), AS ULTIMATELY FILED WITH THE IRS, PRIOR TO ITS FILING WITH THE IRS.
GOVERNING DOCUMENTS DISCLOSURE EXPLANATION	FORM 990, PAGE 6, PART VI, LINE 19	THE FUND IS ESTABLISHED AND MAINTAINED PURSUANT TO THE EMPLOYEE RETIREMENT SECURITY ACT OF 1974, AS AMENDED. IT OPERATES IN COMPLIANCE WITH THE REPORTING AND DISCLOSURE REQUIREMENTS OF SUBTITLE B, PART 1 ERISA WITH RESPECT TO DISCLOSURE OF ITS GOVERNING DOCUMENTS AND FINANCIAL INFORMATION. IT OPERATES IN COMPLIANCE WITH THE FIDUCIARY RESPONSIBILITY REQUIREMENTS OF SUBTITLE B, PART 4 OF ERISA. THE FUND DOES NOT HAVE A CONFLICTS OF INTEREST POLICY.
ADDITIONAL INFORMATION	FORM 990, PART VII	LINE 1A - CYRIL WILSON, JACK MCCOOL, DOUGLAS NOWACK, JOEL SANTOS, MICHAEL STANFIELD AND HENRY WILLIAMS SERVED AS TRUSTEES OF THE FUND WITHOUT COMPENSATION FROM THE FUND FOR THOSE SERVICES. HOWEVER, THEY WERE COMPENSATED AS EMPLOYEES OF EITHER LOCAL 16, LOCAL 67 OR LOCAL 514, WHICH WERE CONTRIBUTING EMPLOYERS TO THE FUND AND, AS SUCH, " RELATED ORGANIZATIONS" AS THAT TERM IS DEFINED IN THE INSTRUCTIONS.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII

Name Of Disregarded Entity NameOfDisregardedEntity

Field	Value	IRS element (for citing)
Business Name Line1	SEE PART VII	BusinessNameLine1

Field	Value	IRS element (for citing)
Direct Controlling Entity NA	N/A	DirectControllingEntityNA
Controlled Org	false	ControlledOrg

Form990 Schedule R Part III Form990ScheduleRPartIII

Name Of Related Org NameOfRelatedOrg

Field	Value	IRS element (for citing)
Business Name Line1	SEE PART VII	BusinessNameLine1

Field	Value	IRS element (for citing)
Direct Controlling Entity NA	N/A	DirectControllingEntityNA
Disproportionate Allocations	false	DisproportionateAllocations
General Or Managing Partner	false	GeneralOrManagingPartner

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

Field	Value	IRS element (for citing)
Business Name Line1	SEE PART VII	BusinessNameLine1

Field	Value	IRS element (for citing)
Direct Controlling Entity NA	N/A	DirectControllingEntityNA

Field	Value	IRS element (for citing)
Receipt Of Int Ann Rents Royalties	false	ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org	false	GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org	false	GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org	false	LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org	false	LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org	false	SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org	false	PurchaseOfAssetsFromOtherOrg
Exchange Of Assets	false	ExchangeOfAssets
Rental Of Facilities To Other Orgs	false	RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs	false	RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs	false	PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs	false	PerformOfServicesByOtherOrgs
Sharing Of Facilities	false	SharingOfFacilities
Sharing Of Paid Employees	false	SharingOfPaidEmployees
Reimbursement Paid To Other Org	false	ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org	false	ReimbursementPaidByOtherOrg
Other Transfer To Other Org	false	OtherTransferToOtherOrg
Other Transfer From Other Org	true	OtherTransferFromOtherOrg

Form990 Schedule R Part VII Form990ScheduleRPartVII

Field	Value	IRS element (for citing)
Identifier	ADDITIONAL INFORMATION	Identifier
Return Reference	SCHEDULE R	ReturnReference
Explanation	SCHEDULE R PARTS III IV AND V IDENTIFICATION OF RELATED ORGANIZATIONS THE FILING ORGANIZATION IS A MULTIEMPLOYER TRUST FUND AS DEFINED IN THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974 AS AMENDED THE FUND PROPVIDES HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS AS OF DECEMBER 31 2011 THERE WERE 160 CONTRIBUTING EMPLOYERS TO THE FUND UNDER THE INSTRUCTIONS TO SCHEDULE R THOSE EMPLOYERS ARE CONSIDERED RELATED ORGANIZATIONS THE FUNDS ADMINISTRATIVE OFFICE MAINTAINS A DATABASE OF ALL CONTRIBUTING EMPLOYERS INCLUDING NAMES ADDRESSES AND OTHER CONTACT INFORMATION HOWEVER THE FUND DOES NOT HAVE AND HAS NO REASONABLE WAY TO OBTAIN MUCH OF THE INFORMATION TO BE REPORTED ON SCHEDULE R SUCH AS EMPLOYER IDENTIFICATION NUMBERS AND THE EMPLOYERS LEGAL STRUCTUREEG CORPORATION OR PARTNERSHIP THE FOLLOWING IS A LISTING OF THOSE CONTRIBUTING EMPLOYERS WITH ADDRESSES WHICH IS THE EXTENT OF THE INFORMATION THE FUND HAS WITH RESPECT TO EACH EMPLOYER CONTRIBUTING EMPLOYERS ANDREWS MICHAEL CONCRETE LLC 709 BROOKS STREET TECUMSEH MI 49286 CEMENT MASONS PENSION TRUST FUND 30700 TELEGRAPH RD SUITE 2400 BINGHAM FARMS MI 48025 HOLLY JC CONTRACTING INC 30211 ECORSE ROAD ROMULUS MI 48174 FLORLINE GROUP 800 VISTA AVE SE MASSILLON OH 44646 G V CEMENT CONTRACTING CO 20000 DIXTOLEDO BROWNSTOWN MI 48183 GIBSONLEWIS 1001 W 11TH STREET MISHAWAKA IN 46544 IMPERIAL CONSTRUCTION 13507 HELEN ST DETROIT MI 48212 SINELLI CHARLES AND SONS INC 389 MOON RIDGE DR MILFORD MI 48380 TRE TORRI CONSTRUCTION 22391 SHEFFIELD COURT FARMINGTON HILLS MI 48335 RIETH RILEY CONSTLANSING 450 S CREYTS RD LANSING MI 48917 ROCKHARD CONSTRUCTION 43253 NORTH AVE CLINTON TWP MI 48036 SIWEK CONSTRUCTION CO 5020 PILGRIM RD FLINT MI 48507 WCI CONSTRUCTION INC 1283 S OLD US HWY 23 BRIGHTON MI 48114 OCP CONTRACTORS INC 1740 COMMERCE RD HOLLAND OH 43528 DENNCO CONSTRUCTION 6421 FRENCH RD DETROIT MI 48213 AMALIO CORPORATION 6655 COTTER AVE STERLING HEIGHTS MI 48314 FLUOR CONSTRUCTORS INTL INC 13501 SANDERS ST DETROIT MI 48217 D P SONS CONSTRUCTION CO 9485 MCAFEE RD MONTROSE MI 48457 HARTWELL CEMENT CO 21650 FERN AVENUE OAK PARK MI 48237 DEVON INDUSTRIAL GROUP 777 WOODWARD AVE 300 DETROIT MI 48226 HALL WILL H SON INC POB165 FLINT MI 48501 OPERATIVE PLTERS CM LU16 3815 WEST ST JOSEPH SUITE B200 LANSING MI 48917 POLLOCK PLASTERING INC 9911 SECOR RD TEMPERANCE MI 48182 POSEN CONSTRUCTION INC 50500 DESIGN LN SHELBY TWP MI 48315 RIETH RILEY CONST WALTON DIV 4435 S M37 GRAWN MI 49637 WEST SIDE CONSTRUCTION ADDRESS NOT AVAILABLE TISEO BROTHERS INC 68660 HILLSIDE WASHINGTON TWP MI 48905 ADM CONSTRUCTION 11191 CONCORD RD JONESVILLE MI 49250 ARISTEO CONSTRUCTION 12811 FARMINGTON RD LIVONIA MI 48150 BARNEY JJ CONSTRUCTION LLC 2397 DEVONDALE SUITE 101 ROCHESTER HILLS MI 48309 BROADCAST DESIGN CONSTR 345 GROSEBECK HWY MT CLEMENS MI 48043 EPIC ONE INC 19166 JAMES COUZENS DETROIT MJI 48235 DELISIO CONTRACTING INC 23525 LAKEPOINTE DRIVE CLINTON TWP MI 48036 FLORENCE CEMENT CO 12585 23 MILE 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C COMPANY 5715 RIVARD STREET DETRO	Explanation