2024-05-10T08:32:37-05:00 2023-06-30 842885766 ROMOLO & ASSOCIATES LLC 1700 W LUTHY DRIVE PEORIA IL 61615 990 2022-07-01 300088171 NORTH CENTRAL ILLINOIS LABORERS HEALTH & WELFARE FUND NORT 3096920860 4208 W PARTRIDGE WAY UNIT 3 PEORIA IL 61615 HOLLY BRYANT ADMINISTRATOR 3096920860 2024-04-13 1 HOLLY BRYANT 999009999 0 KRISTIN ROMOLO P01381270 3096822001 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z HOLLY BRYANT 4208 W PARTRIDGE WAY UNIT 3 PEORIA IL 61615 47692667 0 X WWW.NCILHWF.COM X 2002 IL PROVIDE HEALTH, DISABILITY & DEATH BENEFITS TO ELIGIBLE PARTICIPANTS, DEPENDENTS, & BENEFICIARIES 12 12 10 0 0 0 0 0 27028588 28349125 460409 635428 228329 140202 27717326 29124755 0 0 11844904 28586373 457415 486391 0 0 0 1412648 1470495 13714967 30543259 14002359 -1418504 55081500 52916184 7587194 5814517 47494306 47101667 TO PROVIDE HEALTH, DISABILITY AND DEATH BENEFITS TO ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS AND BENEFICIARIES 0 0 TO PROVIDE HEALTH, DISABILITY AND DEATH BENEFITS 0 0 0 0 0 0 0 0 0 1 1 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 1 4 0 10 1 0 0 0 0 0 0 0 0 X 12 12 1 1 0 0 0 0 0 1 1 0 0 0 1 1 0 1 1 0 0 0 X HOLLY BRYANT 3096920860 4208 W PARTRIDGE WAY UNIT 3 PEORIA IL 61615 GARY STEWART- PAST TRUSTEE 2.00 X 0 0 0 JOE COWAN TRUSTEE 2.00 X 0 0 0 MIKE CULLINAN TRUSTEE 2.00 X 0 0 0 RON PAUL TRUSTEE 2.00 X 0 0 0 TIM SCHMIDGALL TRUSTEE 2.00 X 0 0 0 MICHAEL W SMITH CHAIRMAN 2.00 X X 0 0 0 DAN AUSSEM TRUSTEE 2.00 X X 0 0 0 TONY PENN TRUSTEE 2.00 X 0 0 0 FORTUNATO SALAMONE TRUSTEE 2.00 X 0 0 0 DAVID ANSPAUGH TRUSTEE 2.00 X 0 0 0 JASON BREWER TRUSTEE 2.00 X 0 0 0 KEVIN DALE TRUSTEE 2.00 X 0 0 0 CARLA JOCKISCH TRUSTEE 2.00 X 0 0 0 HOLLY BRYANT PLAN ADMINISTRATOR 40.00 X 71876 0 74409 71876 0 74409 0 0 0 0 0 EMPLOYER CONTRIBUTIONS 900099 27970430 27970430 PARTICIPANT CONTRIBUTIONS 900099 378695 378695 28349125 1120551 1120551 18082789 18567912 -485123 -485123 -485123 SERVICE FEES 900099 140039 140039 MISC INCOME 900099 163 163 140202 29124755 28489327 0 635428 28586373 147326 158763 103602 52630 24070 60269 27450 82831 985942 73539 45034 29401 7447 5425 21326 HEALTH & SAFETY 107551 DUES AND SUBSCRIPTIONS 14203 PCORI FEE 10077 30543259 80 80 5163468 5211822 3468010 4195268 124497 34524 659904 640547 20623 19357 38734783 36258103 7570039 7197030 55081500 52916184 531422 971840 197252 91163 6858520 4751514 7587194 5814517 X 47494306 47101667 47494306 47101667 55081500 52916184 -1418504 1025865 0 X 0 1 X 1 0 386483 371174 15309 0 273421 269373 4048 0 19357 AMERICAN CORE REALTY 3436880 F ULLICO SEPARATE ACCOUNT W-1 3760150 F 7197030 CLAIMS PAYABLE AND INCURRED BUT NOT REPORTED 4750600 DUE TO OTHER FUNDS 914 4751514 X 30067789 1025865 1025865 29041924 82831 82831 29124755 30733428 0 30733428 82831 -273000 -190169 30543259 PART X, LINE 2: 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 (IRC), AND, ACCORDINGLY, THE TRUST'S NET INVESTMENT INCOME IS EXEMPT FROM INCOME TAXES. THE TRUST OBTAINED A FAVORABLE TAX DETERMINATION LETTER FROM THE IRS ON AUGUST 5, 2004, AND THE BOARD OF TRUSTEES BELIEVES THAT THE TRUST, AS AMENDED, CONTINUES TO QUALIFY AND TO OPERATE IN ACCORDANCE WITH APPLICABLE PROVISIONS OF THE IRC. THE TOTAL AMOUNTS OF INTEREST AND PENALTIES RECOGNIZED IN THE STATEMENTS OF CHANGES IN NET ASSETS AVAILABLE FOR BENEFITS AND THE TOTAL AMOUNTS OF INTEREST AND PENALTIES RECOGNIZED IN THE STATEMENTS OF NET ASSETS AVAILABLE FOR BENEFITS ARE $0. 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 ORGANIZATION HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY FEDERAL AND STATE TAXING AUTHORITIES. THE PLAN ADMINISTRATOR HAS ANALYZED THE TAX POSITIONS TAKEN BY THE PLAN, AND HAS CONCLUDED THAT AS OF JUNE 30, 2023 AND 2022, THERE ARE NO UNCERTAIN TAX 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 HAS NEVER HAD UNRELATED BUSINESS INCOME TAX (UBIT) NOR HAS IT FILED THE FORM 990-T. THEREFORE, ALL TAX YEARS ARE OPEN FOR EXAMINATION BY FEDERAL AND STATE TAXING AUTHORITIES RELATED TO UBIT. PART XII, LINE 4B - OTHER ADJUSTMENTS: CHANGE IN CLAIMS PAYABLE AND INCURRED BUT NOT REPORTED -273,000. FORM 990, PART VI, SECTION A, LINE 2 THERE IS A FAMILY RELATIONSHIP. FORM 990, PART VI, SECTION A, LINE 3 THE PLAN HAS CONTRACTED WITH PROFESSIONAL BENEFIT ADMINISTRATORS TO ACT AS CLAIMS ADMINISTRATORS. THE PLAN HAS CONTRACTED WITH SAVRX AS PRESCRIPTION CLAIMS ADMINISTRATOR. FORM 990, PART VI, SECTION B, LINE 11B THE ACCOUNTANT PREPARES THE 990 AND IT IS REVIEWED AND SIGNED BY THE FUND ADMINISTRATOR BEFORE ELECTRONICALLY FILING. FORM 990, PART VI, SECTION C, LINE 19 UPON REQUEST BOARD OF TRUSTEES SEE PART VII FOR LISTING SEE PARTS IV AND VII 2K COMMERCIAL CONSTRUCTION INC 4 M C CORPORATION A A CONTE & SON A & R SERVICES INC A C ENVIRONMENTAL INC A C PAVEMENT STRIPING CO A C READY MIX LLC A F E CONSTRUCTION A HORN INC A L L MASONRY CONSTR CO INC A M CONSTRUCTION A T C CONCRETE CUTTING INC A Z C O INC A1 MASONRY INC ABBEY PAVING & SEALCOATING CO INC ABERCROMBIE PIPELINE SERVICES ACCESS CONTROL CO INC ACCURATE SITE SPECIALISTS INC ACE IN THE HOLE INC ACME FIREPROOFING & INSULATN INC ADJUSTABLE FORMS INC ADVANCED ASPHALT CO ADVANTAGE PAVING SOLUTIONS ALBERICI CONSTRUCTORS INC ALDRIDGE ELECTRIC INC ALEXANDER BROS CNSTR CORP ALEXANDER CONSTR INC ALL SERVICE CONTRACTORS CORP ALLIANCE CONTRACTORS INC ALLIANCE DEMO & EXCAV SERVS INC ALLIED CONSTRUCTION SERVICES INC ALLIED POWER SERVICES LLC ALLSTATES REFRACTORY CONTRS LLC ALPINE DEMOLITION SERVICES LLC ALRIGHT CONCRETE CO AMERICAN ASPHALT SURFACE RECYCLG AMERICAN 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CONTR INC J C DILLON INC J D TRAFFIC INC J F BRENNAN COMPANY INC J G STEWART CONTRACTORS J J BRAKER & SONS INC J L ALLEN COMPANY J M I 2 CORP J P CULLEN & SON INC J SPENCER COSTRUCTION LLC J T MAGEN & COMPANY J T THORPE J W OSSOLA CONSTRUCTION JACK HALL CONSTRUCTION INC JAMES G STAAT TUCKPOINTING INC JAYNE EXCAVATING & WELDING LLC JIMAX CORP JIMMY Z MASONRY CORPORATION JOE HATZER & SON INC JOHN BURNS CONSTRUCTION JOHN POHAR & SONS JOHNCO CONSTRUCTION INC JOHNSON BROS CORP JOHNSON DOWNS CONSTR CO JUST MASONRY INC K A M SERVICES INC K C LABOR PARTNERS LLC K C M CONSTRUCTION CORP K M R CONSTR & IMPROVEMENTS INC K S ENERGY SERVICES KANKAKEE VALLEY CONSTR CO KASKASKIA ENGINEERING GROUP LLC KATS & SONS INC KEELEY CONSTRUCTION GROUP KEEN COMPANY INC KELLENBERGER INC KELSEY EXCAVATING INC KEMPER CONSTRUCTION INC KESSOR ENTERPRISES LTD KEVIN NUGENT CONSTR INC KEY INTERIORS LLC KING BLACKTOP & CONCRETE LLC KINNEY CONTRACTORS INC KINSALE CONTRG GROUP INC KIRBY & TURNER MASONRY KIRBY CABLE 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WITECH CO INC WM TONYAN & SONS WOLCOTT CONSTRUCITON CORP WOODLAND COMMERCIAL INC WOZNIAK CONCRETE FINISHNG WRIGHT WAY INTERIOR SYSTEMS LLC 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 PARTS II & IV THIS PLAN IS A VEBA EXEMPT UNDER SECTION 501(C)(9) OF THE INTERNAL REVENUE CODE. PER THE INSTRUCTIONS FOR SCHEDULE R, VEBA TRUSTS ARE ONLY REQUIRED TO LIST THE NAMES OF THE SPONOSRING ORGANIZATIONS AND CONTRIBUTING EMPLOYERS ON SCHEDULE R. THE PLAN HAS LISTED ALL SUCH PARTIES IN PART IV OF SCHEDULE R. THE PLAN DOES NOT KNOW THE TAXABLE STATUS OF EVERY CONTRIBUTING EMPLOYER AND THEREFORE IS UNABLE TO SPLIT UP THE INFORMATION BETWEEN THE VARIOUS SECTIONS OF SCHEDULE R.