Attach to Form 990 or 990-EZ.| Identifier | Return Reference | Explanation |
|---|---|---|
| REVIEW PROCESS OF FORM 990 | PART VI, SECTION B, LINE 11B | THE BOARD OF TRUSTEES HAS DELEGATED THE RESPONSIBILITY TO REVIEW THE FORM 990 PRIOR TO FILING TO THE MANAGER OF ADMINISTRATIVE SERVICES AND THE EXECUTIVE DIRECTOR. |
| SELECTION OF TRUSTEES | PART VI, SECTION A, LINE 7A | THE TRUSTEES ARE APPOINTED BY THE UNIONS AND EMPLOYERS, WHO PARTICIPATE IN THE HEALTH BENEFIT PLAN. EACH GROUP HAS THE RIGHT TO SELECT UP TO EIGHT TRUSTEES TO SERVE ON THE BOARD. |
| PUBLIC AVAILABILITY OF GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS | PART VI, SECTION C, LINE 19 | THE BENEFIT PLAN DOES MAKE ITS PLAN DOCUMENT, TRUST DOCUMENT AND SUMMARY PLAN DESCRIPTION AVAILABLE TO THE PUBLIC UPON REQUEST. THE FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. |
| OTHER COMMITTEES | PART VI, SECTION A, LINE 8B | THE BENEFIT PLAN HAS NO OTHER COMMITTEE THAT CAN ACT ON THE BEHALF OF THE GOVERNING BODY. |
| MAILING ADDRESSES FOR TRUSTEES DIFFERENT FROM FUND ADDRESS | PART VI, SECTION A, LINE 11 | LIST OF TRUSTEES THAT ARE REACHED AT AN ADDRESS DIFFERENT FROM THE TRUST: ------------------------------------------------------------------------- Steven V. Bertelli International Vice President, BCTGM International Union PO Box 199, Loami, IL 62661-0199 Richard B. Cook Secretary, Board of Trustees Cook Labor Relations Consultants, LLC 6205 West 127th Terrace, Overland Park, KS 66209 Anthony L. Johnson International Vice President, BCTGM International Union 8415 King William Street, Cordova, TN 38016 Art Montminy International Vice President, BCTGM International Union P. O. Box 628, Douglas, MA 01516 Robert Oakley International Vice President, BCTGM International Union 706 Stelwood Road, Philadelphia, PA 19115 Randy D. Roark International Vice President, BCTGM International Union 12506 37th Ave Court, N.W., Gig Harbor, WA 98332 Dan Craig Vice President, Labor & Employee Relations Sara Lee North America 3500 Lacey Road, Downers Grove, IL 60515 Thomas G. Kirchner Sr. Director of Labor Relations Kraft Foods 3 Lakes Drive, Northfield, IL 60093 Jon McPherson Vice President, Labor Relations Kellogg Company One Kellogg Square, Battle Creek, MI 49017 Lou Minella Vice President, Labor Relations Stroehmann Bakeries 255 Business Center Drive, #200, Horsham, PA 19044 John Wagner Vice President of Labor Relations The Kroger Company 1014 Vine Street, Cincinnati, OH 45202-1100 |
| NONCASH OUTLAYS INCLUDED IN COMPENSATION | PART VII, SECTION A, COLUMN E & F | $112,299 OF COLUMN F REPRESENT AMOUNTS CALCULATED BY THE PLAN ACTUARY AS TO THE INCREASE IN ACTUARIAL VALUE IN DEFINED BENEFITS. THESE AMOUNTS REPORTED ARE NOT ACTUAL OUTLAYS OF COMPENSATION TO THE OFFICERs AND HIGHLY COMPENSATED EMPLOYEES. |
| OTHER CHANGE IN NET ASSETS | PART XI, LINE 5 | UNREALIZED LOSSES FROM INVESTMENTS (4,942,996). EFFECT OF ADOPTION OF ASC 715 (1,876,076). ------------ OTHER CHANGE IN NET ASSETS (6,819,072). ============ |
| CONTRIBUTING EMPLOYER RECEIVABLES AT YEAR-END | PART X | Contributions receivable outstanding at the plan's year-end from contributing employers represent amounts due for the last month of the fiscal year. These contributions are requirements, as stipulated under terms of written agreements and, approved by the governing board, with the employers that must be remitted to the plan on a timely basis. These amounts constitute receivables that were created in the ordinary course of the plan's business. |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:FRANK HURT TITLE:CHAIRMAN/UNION TRUSTEE HOURS:1 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:DAVID B DURKEE TITLE:UNION TRUSTEE HOURS:1 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:STEVEN V BERTELLI TITLE:UNION TRUSTEE HOURS:1 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:ANTHONY L JOHNSON TITLE:UNION TRUSTEE HOURS:1 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:ART MONTMINY TITLE:UNION TRUSTEE HOURS:1 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:ROBERT OAKLEY TITLE:UNION TRUSTEE HOURS:1 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:RANDY D ROARK TITLE:UNION TRUSTEE HOURS:1 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:JOSEPH THIBODEAU TITLE:UNION TRUSTEE HOURS:1 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:RICHARD B COOK TITLE:SECRETARY/EMPLOYER TRUSTEE HOURS:1 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:THOMAS G KIRCHNER TITLE:EMPLOYER TRUSTEE HOURS:1 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:LOU MINELLA TITLE:EMPLOYER TRUSTEE HOURS:1 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:JON MCPHERSON TITLE:EMPLOYER TRUSTEE HOURS:1 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:JOHN WAGNER TITLE:EMPLOYER TRUSTEE HOURS:1 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:DAN CRAIG TITLE:EMPLOYER TRUSTEE HOURS:1 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:ROBERT J BERGIN TITLE:EXECUTIVE DIRECTOR HOURS:32 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:STEVEN BROCK TITLE:MANAGER OF ADMIN SERVICES HOURS:32 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:HILTON BRAKE TITLE:MANAGER OF INFORMATION TECH HOURS:26 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:MICHAEL KIDD TITLE:OPERATIONS & DATA CNTRL SUPER. HOURS:26 |
| Software ID: | |
| Software Version: |