2012-11-15T12:02:35-06:00 2011-12-31 BENDA GRACE STULZ & COMPANY PC 38800 VAN DYKE AVE STE 100 STERLING HEIGHTS MI 48312 990 2011-01-01 386238055 MICHIGAN TROWEL TRADES HEALTH AND WELFARE FUND MICH 5173217502 6525 CENTURION DRIVE LANSING MI 48917 MICHAEL STANFIELDCHAIRMAN 5173217502 2012-03-15 BRYAN STULZ 5868836240 2012-11-15 2011 2016-02-24 21:20:13Z SAME AS ABOVE 5006270 false X WWW.OUTSTATETROWELTRADES.ORG X 1971 MI PROVIDE HEALTH CARE BENEFITS TO PARTICIPANTS. 10 4 0 0 0 5040186 4938483 4123 2918 180391 64869 5224700 5006270 0 5335477 4369176 0 0 0 369937 296592 5705414 4665768 -480714 340502 4602576 4489013 2751551 2297486 1851025 2191527 PROVIDE HEALTH CARE BENEFITS TO PARTICIPANTS. false false 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. false false false false false false false false false false false false true true false true false false false false false false false false false false false false false false false false false false false false false false false false true false false false true 0 0 0 false false false false false false X 10 4 true false false false false false false true true false false false false false false false false false X TIC INTERNATIONAL 5173217502 6525 CENTURION DR LANSING MI 48917 X JOEL SANTOS 1.00 X 0 80047 14721 HENRY WILLIAMS 1.00 X 0 76450 14212 JACK MCCOOL 1.00 X 0 70429 13322 CYRIL WILSON 1.00 X 0 64756 23121 MICHAEL STANFIELD 1.00 X 0 62026 23120 DON BOVRE 1.00 X 0 0 0 GLENN BUKOSKI 1.00 X 0 0 0 SCOTT FISHER 1.00 X 0 0 0 LAWRENCE WALRAVEN 1.00 X 0 0 0 DOUGLAS NEEDHAM 1.00 X 0 0 0 DOUGLAS NOWACK 1.00 X 0 0 0 353708 88496 false false false 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 2 EMPLOYER CONTRIBUTIONS 230000 4515164 4515164 PARTICIPANT SELF PAYMENTS 230000 423319 423319 4938483 2918 2918 LIQUIDATED DAMAGES 900099 37218 37218 OTHER 900099 27651 27651 64869 5006270 5003352 2918 4369176 4369176 102000 102000 94552 94552 40631 40631 36426 36426 14384 14384 1800 1800 5125 5125 1674 1674 4665768 4369176 296592 0 3611667 3296978 325962 210967 664947 981068 4602576 4489013 97551 113486 2654000 2184000 2751551 2297486 X 1851025 2191527 1851025 2191527 4602576 4489013 340502 X false true true X false false false false false false false false false false false HEALTH CARE CLAIMS DEPOSIT 979304 PREPAID EXPENSES 955 UNEXPIRED INSURANCE PREMIUM 809 981068 BENEFIT OBLIGATIONS 2184000 2184000 5006270 4665768 340502 340502 5006270 5006270 5006270 4665768 4665768 4665768 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. SEE PART VII N/A false SEE PART VII N/A false false SEE PART VII N/A false false false false false false false false false false false false false false false false false true ADDITIONAL INFORMATION SCHEDULE R 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 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GRANGER CONSTRUCTION CO PO BOX 22187 6267 AURELIUS RD LANSING MI 48911 HACKETT CONSTRUCTION 256 N 28TH ST POB 22 BATTLE CREEK MI 49016 HOOVER WELLS LLC POB 8398 2011 SEAMAN TOLEDO OH 43605 MACRO D CONTRACTORS 56360 KIRKRIDGE TR SHELBY TWP MI 48316 NC BUILDERS INC 57199 WESTERN MATTAWAN MI 49070 ARBOR CONSTR PERSONNEL 3500 E ELLSWORTH RD ANN ARBOR MI 48108 THE AUSTIN COMPANY 8135 COXS DR SUITE 213 PORTAGE MI 49002 ADKINS ART CO INC 9485 MCAFEE RD MONTROSE MI 48457 AMERICAN EXCAVATING CONT LLC 12838 GAVEL ST DETROIT MI 48277 BARTHEL CONTRACTING CO 21095 HALSTED RD NORTHVILLE MI 49167 BOOS AA SONS INC 2015 PICKLE RD OREGON OH 43616 CORE CONCRETE CONST INC 31088 GRENNADA LIVONIA MI 48154 FERRINI CEMENT COMPANY POB 701453 PLYMOUTH MI 48170 HULL CA INC 8177 GOLDIE RD WALLED LAKE MI 48390 MAJOR CEMENT CO POB 19310 DETROIT MI 48219 NORTHERN INDUSTRIAL FLOORING POB 213 ORLAND IN 46776 PAPALAS JOHN A CO 1187 EMPIRE AVE LINCOLN PARK MI 48146 SPENCE BROTHERS 417 MCCOSKRY SAGINAW MI 48601 WESTSIDE 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