Attach to Form 990 or 990-EZ.
Information about Schedule O (Form 990 or 990-EZ) and its instructions is at| Return Reference | Explanation |
|---|---|
| FORM 990, PAGE 2, PART III, LINE 4D | TO PROVIDE HEALTH AND LIFE INSURANCE TO PARTICIPANTS |
| FORM 990, PART V | LINE 2A- 13 ISSUED W-2S REPRESENT DISABILITY PAYMENTS TO FUND PARTICIPANTS. AS NOTED IN PART I, LINE 5, THE FUND DOES NOT HAVE EMPLOYEES. |
| FORM 990, PART VI | LINE 2 - THE RELATIONSHIP BETWEEN THE TRUSTEES OF THE FUND IS A 'BUSINESS RELATIONSHIP'. THE FUND IS ESTABLISHED AND MAINTAINED PURSUANT TO ERISA. 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 12B - ANNUALLY EACH TRUSTEE MUST ANSWER THE FIDUCIARY LIABILITY INSURANCE RENEWAL QUESTIONAIRE WHICH CONTAINS QUESTIONS REGARDING POTENTIAL AND ACTUAL CONFLICTS OF INTEREST. |
| 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 REVIEW BY AND APPROVAL OF THE FUND 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. |
| FORM 990, PAGE 6, PART VI, LINE 15A | FORM 990, PART VI, LINE 15A - THE FUND DID NOT HAVE ANY EMPLOYEES IN THE PLAN YEAR. IF THE FUND DID HAVE EMPLOYEES THAT MET THE LISTED DEFINITIONS, THEN ANY COMPENSATION WOULD HAVE BEEN ESTABLISHED IN ACCORDANCE WITH THE PROCESS DESCRIBED IN PART VI, LINE 15 OF FORM 990. |
| FORM 990, PAGE 6, PART VI, LINE 15B | THE FUND DID NOT HAVE ANY EMPLOYEES IN THE PLAN YEAR. IF THE FUND DID HAVE EMPLOYEES THAT MET THE LISTED DEFINITIONS, THEN ANY COMPENSATION WOULD HAVE BEEN ESTABLISHED IN ACCORDANCE WITH THE PROCESS DESCRIBED IN PART VI, LINE 15 OF FORM 990. |
| FORM 990, PAGE 6, PART VI, LINE 19 | THE FUND IS ESTABLISHED AND AND MAINTAINED PURSUANT TO THE EMPLOYEE RETIREMENT INCOME SECURITY AND DISCLOSURE ACT OF 1974, AS AMENDED. IT OPERATES IN COMPLIANCE WITH THE REPORTING AND DISCLOSURE REQUIREMENTS OF SUBTITLE B, PART 1 OF 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 CONFLICT OF INTEREST POLICY. |
| FORM 990, PART XI, LINE 9 | DECREASE IN RESERVE FOR EXTENDED ELIGIBILITY 190,000 |
| FORM 990, PART XII | LINE 1A - THE TRUSTEES OF THE FUND SERVE WITHOUT COMPENSATION FROM THE FUND BUT ARE COMPENSATED AS EMPLOYEES OF ENTITIES THAT ARE CONSIDERED RELATED ORGANIZATIONS TO THE FUND FOR PURPOSES OF FORM 990. |
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