TY 2015 Form 990

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
SchDMd Bullet

Attach to Form 990.
Information about Schedule D (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization

CEMENT MASONS LOCAL NO 502
RETIREE WELFARE FUND

Employer identification number

80-0967048

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.

			(a) Donor advised funds	(b) Funds and other accounts

1	Total number at end of year ....
2	Aggregate value of contributions to (during year)
3	Aggregate value of grants from (during year)
4	Aggregate value at end of year ....

Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ...........

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ............................

Yes No

Part II

Conservation Easements. Complete if the organization answered "Yes" on Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.


a	Total number of conservation easements ......................	2a
b	Total acreage restricted by conservation easements ....................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after 8/17/06, and not on a historic structure listed in the National Register ...	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............

Yes No

Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .............................

Yes No

In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" on Form 990, Part IV, line 8.

If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:

(i)

Revenue included on Form 990, Part VIII, line 1 ......................... SchDMd Bullet

(ii)

Assets included in Form 990, Part X ............................... SchDMd Bullet

If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 (ASC 958) relating to these items:

Revenue included on Form 990, Part VIII, line 1 .......................... SchDMd Bullet

Assets included in Form 990, Part X ............................... SchDMd Bullet

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 52283D

Schedule D (Form 990) 2015

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.

During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?...

Yes No

Part IV

Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No


b	If "Yes," explain the arrangement in Part XIII and complete the following table:		Amount
c	Beginning balance .............................	1c
d	Additions during the year ............................	1d
e	Distributions during the year ..........................	1e
f	Ending balance ................................	1f

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability?

Yes No

If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ........

Part V

Endowment Funds. Complete if the organization answered "Yes" on Form 990, Part IV, line 10.

		(a)Current year	(b)Prior year	(c)Two years back	(d)Three years back	(e)Four years back

1a	Beginning of year balance ....
b	Contributions ...
c	Net investment earnings, gains, and losses
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...
f	Administrative expenses ....
g	End of year balance ......

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment SchDMd Bullet

Permanent endowment SchDMd Bullet

Temporarily restricted endowment SchDMd Bullet

The percentages on lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) unrelated organizations .................

3a(i)

(ii) related organizations .................

3a(ii)

If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........

Describe in Part XIII the intended uses of the organization's endowment funds.

Part VI

Land, Buildings, and Equipment.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.

Description of property		(a) Cost or other basis (investment)	(b)Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value

1a	Land ...
b	Buildings
c	Leasehold improvements
d	Equipment ...	5,378	1,076	4,302
e	Other ...
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				4,302

Schedule D (Form 990) 2015

Page 3

Part VII

InvestmentsOther Securities. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11b. See Form 990, Part X, line 12.

(a) Description of security or category (including name of security)	(b)Book value	(c)Method of valuation: Cost or end-of-year market value
(1)Financial derivatives
(2)Closely-held equity interests
(3)Other
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

InvestmentsProgram Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.

(a) Description of investment	(b) Book value	(c) Method of valuation: Cost or end-of-year market value

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.

(a) Description				(b) Book value

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........

Part X

Other Liabilities. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.

1.(a) Description of liability	(b) Book value
(1) Federal income taxes

(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)
2. Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII

Schedule D (Form 990) 2015

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total revenue, gains, and other support per audited financial statements .......			1	5,212,847
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a	-159,407
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d .....................			2e	-159,407
3	Subtract line 2e from line 1..................			3	5,372,254
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a	6,863
b	Other (Describe in Part XIII.) ...........	4b
c	Add lines 4a and 4b....................			4c	6,863
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......			5	5,379,117

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total expenses and losses per audited financial statements ...........			1	3,248,972
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities .........	2a
b	Prior year adjustments ............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d....................			2e	0
3	Subtract line 2e from line 1...................			3	3,248,972
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a	6,863
b	Other (Describe in Part XIII.) ............	4b
c	Add lines 4a and 4b.....................			4c	6,863
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......			5	3,255,835

Part XIII

Supplemental Information

Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.

Return Reference	Explanation
PART X, LINE 2:	THE PLAN IS REQUIRED TO FILE FORM 5500, ANNUAL RETURN/REPORT OF EMPLOYEE BENEFIT PLAN AND FORM 990, RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX. THE PLAN'S RETURNS ARE SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE UNTIL THE APPLICABLE STATUTE OF LIMITATIONS EXPIRES.

Schedule D (Form 990) 2015

Additional Data

Software ID:
Software Version:

- TIN:

Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet

Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
SchJMediumBullet

Attach to Form 990.
SchJMediumBullet

Information about Schedule J (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization

CEMENT MASONS LOCAL NO 502
RETIREE WELFARE FUND

Employer identification number

80-0967048

Part I

Questions Regarding Compensation

Yes

Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain .........

Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked in line 1a? ..

Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

During the year, did any person listed on Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:

Receive a severance payment or change-of-control payment? ................

Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........

Participate in, or receive payment from, an equity-based compensation arrangement? .........

If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.

Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:

The organization? ...........................

Any related organization?

If "Yes," on line 5a or 5b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:

The organization?

Any related organization? .........................

If "Yes," on line 6a or 6b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

Were any amounts reported on Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................

If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50053T

Schedule J (Form 990) 2015

Page 2

Part II

Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.

For each individual whose compensation must be reported on Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.

(A) Name and Title		(B) Breakdown of W-2 and/or 1099-MISC compensation			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation in column(B) reported as deferred on prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1PATRICK LA CASSATRUSTEE	(i) (ii)	0 ------------- 173,680	0 ------------- 0	0 ------------- 0	0 ------------- 84,064	0 ------------- 47,254	0 ------------- 304,998	0 ------------- 0
2LAWRENCE PICARDI SRTRUSTEE	(i) (ii)	0 ------------- 166,270	0 ------------- 0	0 ------------- 0	0 ------------- 81,163	0 ------------- 45,864	0 ------------- 293,297	0 ------------- 0
3WILLIAM BEEMANADMINISTRATOR	(i) (ii)	0 ------------- 121,643	0 ------------- 0	0 ------------- 0	0 ------------- 36,220	0 ------------- 12,131	0 ------------- 169,994	0 ------------- 0
4DUANE EXLINEEMPLOYEE	(i) (ii)	0 ------------- 116,071	0 ------------- 0	0 ------------- 0	0 ------------- 37,178	0 ------------- 12,905	0 ------------- 166,154	0 ------------- 0

Schedule J (Form 990) 2015

Page 3

Part III

Supplemental Information

Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.

Return Reference	Explanation

Schedule J (Form 990) 2015

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.
MediumBullet

Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public
Inspection

Name of the organization

CEMENT MASONS LOCAL NO 502
RETIREE WELFARE FUND

Employer identification number

80-0967048

Return Reference	Explanation
FORM 990, PART VI, SECTION B, LINE 11	THE FORM 990 IS PROVIDED TO THE ENTIRE BOARD OF TRUSTEES AND FUND ADMINISTRATOR PRIOR TO FILING. AFTER THE BOARDS' REVIEW, THE FORM IS APPROVED AND FILED.
FORM 990, PART VI, SECTION B, LINE 12C	THE BOARD OF TRUSTEES AND THE FUND ADMINISTRATOR SHALL REGULARLY AND CONSISTENTLY MONITOR AND ENFORCE COMPLIANCE WITH THIS POLICY TAKING ALL STEPS THEY DEEM NECESSARY TO ENSURE SUCH MONITORING AND ENFORCEMENT.
FORM 990, PART VI, SECTION B, LINE 15	SALARIES ARE ANNUALLY REVIEWED AND APPROVED BY THE BOARD OF TRUSTEES.
FORM 990, PART VI, SECTION C, LINE 19	THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST AT THE FUND OFFICE.
FORM 990, PART VII, SECTION A, LINE 1A:	THE ORGANIZATION'S ADMINISTRATOR AND HIGHEST COMPENSATED EMPLOYEE ARE SHARED WITH NUMEROUS RELATED ORGANIZATIONS, ONE OF WHICH IS RESPONSIBLE FOR PAYROLL. THE REPORTING ORGANIZATION REIMBURSES THAT RELATED ORGANIZATION FOR ITS ALLOCATED PORTION OF THEIR SALARY AND SALARY RELATED EXPENSES.

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2015

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBullet

Attach to Form 990.
MediumBullet

Information about Schedule R (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization

CEMENT MASONS LOCAL NO 502
RETIREE WELFARE FUND

Employer identification number

80-0967048

Part I

Identification of Disregarded Entities Complete if the organization answered "Yes" on Form 990, Part IV, line 33.

(a) Name, address, and EIN (if applicable) of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity

Part II

Identification of Related Tax-Exempt Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1)PENSION FUND OF CEMENT MASONS UNION LOCAL NO 502 739 25TH AVENUE BELLWOOD,IL60104 51-6034597	PROVIDE DEATH AND RETIREMENT BENEFITS FOR ELIGIBLE PARTICIPANTS	IL	401(A)	N/A	N/A		No
(2)CEMENT MASONS LOCAL NO 502 SAVINGS FUND 739 25TH AVENUE BELLWOOD,IL60104 36-6411337	SAVINGS PLAN	IL	501(C)(9)	N/A	N/A		No
(3)CEMENT MASONS LOCAL NO 502 APPRENTICE EDUCATIONAL & TRAINING 739 25TH AVENUE BELLWOOD,IL60104 36-2487783	TO TRAIN AND EDUCATE APPRENTICES AS CEMENT MASONS.	IL	501(C)(5)	N/A	N/A		No
(4)CEMENT MASONS UNION LOCAL NO 502 739 25TH AVENUE BELLWOOD,IL60104 36-0881245	LABOR UNION	IL	501(C)(5)	N/A	N/A		No
(5)CEMENT MASONS' 502(B) PENSION FUND 739 25TH AVENUE BELLWOOD,IL60104 36-6136496	PROVIDE DEATH, DISABILITY & RETIREMENT BENEFITS FOR ELIGIBLE PARTICIPANTS	IL	401(A)	N/A	N/A		No
(6)DUPAGE COUNTY CEMENT MASONS' 502(C) ANNUITY FUND 739 25TH AVENUE BELLWOOD,IL60104 61-1705870	PROVIDE DEATH, DISABILITY & RETIREMENT BENEFITS FOR ELIGIBLE PARTICIPANTS	IL	401(A)	N/A	N/A		No
(7)CEMENT MASONS' INSTITUTE LOCAL 502 WELFARE TRUST FUND 739 25TH AVENUE BELLWOOD,IL60104 36-2196729	PROVIDE HEALTH CARE BENEFITS FOR ELIGIBLE PARTICIPANTS	IL	501(C)(9)	N/A	N/A		No
(8)INDIANAPOLIS LOCAL 692	CONTRIBUTING EMPLOYER				N/A		No

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50135Y

Schedule R (Form 990) 2015

Page 2

Part III

Identification of Related Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No
(1) AMEX NOOTER LLC	CONTRIBUTING EMPLOYER		N/A				No			No
(2) AVERY & PRYOR CONSTRUCTION LLC	CONTRIBUTING EMPLOYER		N/A				No			No
(3) BUILDERS CONCRETE SERVICES LLC	CONTRIBUTING EMPLOYER		N/A				No			No
(4) CECO CONCRETE CONSTRUCTION LLC	CONTRIBUTING EMPLOYER		N/A				No			No
(5) CHICAGO STRUCTURES LLC	CONTRIBUTING EMPLOYER		N/A				No			No
(6) CONCRETE STRATEGIES LLC	CONTRIBUTING EMPLOYER		N/A				No			No
(7) D'LAND CONSTRUCTION LLC	CONTRIBUTING EMPLOYER		N/A				No			No
(8) F N L CONSTRUCTION LLC	CONTRIBUTING EMPLOYER		N/A				No			No
(9) G A PAVING LLC	CONTRIBUTING EMPLOYER		N/A				No			No
(10) GOEBEL FORMING LLC	CONTRIBUTING EMPLOYER		N/A				No			No
(11) GRADE RC LLC	CONTRIBUTING EMPLOYER		N/A				No			No
(12) GREAT LAKES CEMENT LLC	CONTRIBUTING EMPLOYER		N/A				No			No
(13) I H C CONSTRUCTION COMPANIES LLC	CONTRIBUTING EMPLOYER		N/A				No			No
(14) KAT-KEN CONSTRUCTION LLC	CONTRIBUTING EMPLOYER		N/A				No			No
(15) K S ENERGY SERVICES LLC	CONTRIBUTING EMPLOYER		N/A				No			No
(16) K-VID CONSTRUCTION LLC	CONTRIBUTING EMPLOYER		N/A				No			No
(17) M T H UNDERLAYMENT LLC	CONTRIBUTING EMPLOYER		N/A				No			No
(18) MATRIX CONCRETE CONSTRUCTION LLC	CONTRIBUTING EMPLOYER		N/A				No			No
(19) MARTIN T CONCRETE LLC	CONTRIBUTING EMPLOYER		N/A				No			No
(20) MIDWEST FIREPROOFING LLC	CONTRIBUTING EMPLOYER		N/A				No			No
(21) NORVILLA LLC	CONTRIBUTING EMPLOYER		N/A				No			No
(22) PASCHEN F H S N NIELSEN & ASSOCIATES LLC	CONTRIBUTING EMPLOYER		N/A				No			No
(23) PENN SERVICES LLC	CONTRIBUTING EMPLOYER		N/A				No			No
(24) RABINE PAVING LLC	CONTRIBUTING EMPLOYER		N/A				No			No
(25) RAGNER BENSON CONSTRUCTION LLC	CONTRIBUTING EMPLOYER		N/A				No			No
(26) TOTAL SURFACE LLC	CONTRIBUTING EMPLOYER		N/A				No			No
(27) TRIBCO CONSTRUCTION SERVICES LLC	CONTRIBUTING EMPLOYER		N/A				No			No
(28) UNITED ENTERPRISE LLC	CONTRIBUTING EMPLOYER		N/A				No			No
(29) WALSH CONSTRUCTION COMPANY II LLC	CONTRIBUTING EMPLOYER		N/A				No			No

Part IV

Identification of Related Organizations Taxable as a Corporation or Trust Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(i) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	Yes	No
(1) A M S MECHANICAL SYSTEMS INC	CONTRIBUTING EMPLOYER		N/A					No
(2) A NEW BEGINNING CONCRETE POLISHING	CONTRIBUTING EMPLOYER		N/A					No
(3) ABARI CONST INC	CONTRIBUTING EMPLOYER		N/A					No
(4) ABBEY PAVING & SEALCOATING COINC	CONTRIBUTING EMPLOYER		N/A					No
(5) ACCU FLOW FLOORS INC	CONTRIBUTING EMPLOYER		N/A					No
(6) ACHILLES INC	CONTRIBUTING EMPLOYER		N/A					No
(7) ACTION CAULKING & SEALANT	CONTRIBUTING EMPLOYER		N/A					No
(8) ACURA INC	CONTRIBUTING EMPLOYER		N/A					No
(9) ADDISON CONCRETE INC	CONTRIBUTING EMPLOYER		N/A					No
(10) ADJUSTABLE FORMS INC	CONTRIBUTING EMPLOYER		N/A					No
(11) ALLIANCE CONTRACTORS INC	CONTRIBUTING EMPLOYER		N/A					No
(12) ALLIANCE SPECIALTY TRADES INC	CONTRIBUTING EMPLOYER		N/A					No
(13) ALLIED WATERPROOFING INC	CONTRIBUTING EMPLOYER		N/A					No
(14) ALRIGHT CONCRETE CO	CONTRIBUTING EMPLOYER		N/A					No
(15) AMERICAN CONCRETE RESTORATIONS INC	CONTRIBUTING EMPLOYER		N/A					No
(16) AMERICAN GRADING INC	CONTRIBUTING EMPLOYER		N/A					No
(17) ARAIZA CORPORATION	CONTRIBUTING EMPLOYER		N/A					No
(18) ARCHITECTURAL PRECAST SOLUTION	CONTRIBUTING EMPLOYER		N/A					No
(19) AREATHA CONSTRUCTION CO INC	CONTRIBUTING EMPLOYER		N/A					No
(20) ARTLOW SYSTEMS INC	CONTRIBUTING EMPLOYER		N/A					No
(21) ASC INSULATION & FIREPROF	CONTRIBUTING EMPLOYER		N/A					No
(22) ASPHALT CONCRETE & EXCAVATION INC	CONTRIBUTING EMPLOYER		N/A					No
(23) AUSTIN TYLER CONSTRUCTION INC	CONTRIBUTING EMPLOYER		N/A					No
(24) B & B CONCRETE INC	CONTRIBUTING EMPLOYER		N/A					No
(25) B NEXT CONSTRUCTION INC	CONTRIBUTING EMPLOYER		N/A					No
(26) B P A CONSTRUCTION CORP	CONTRIBUTING EMPLOYER		N/A					No
(27) B S T CONSTRUCTION COMPANY	CONTRIBUTING EMPLOYER		N/A					No
(28) BAILIWYCK INC	CONTRIBUTING EMPLOYER		N/A					No
(29) BARRERA CONSTRUCTION INC	CONTRIBUTING EMPLOYER		N/A					No
(30) BARRIER CORPORATION	CONTRIBUTING EMPLOYER		N/A					No
(31) BATTIS CONCRETE CONSTRUCTION INC	CONTRIBUTING EMPLOYER		N/A					No
(32) BAUMGARTNER CONSTRUCTION INC	CONTRIBUTING EMPLOYER		N/A					No
(33) BENCHMARK CONST CO INC	CONTRIBUTING EMPLOYER		N/A					No
(34) BERGER EXCAVATING	CONTRIBUTING EMPLOYER		N/A					No
(35) BERGLUND FRED & SONS INC	CONTRIBUTING EMPLOYER		N/A					No
(36) BLAST IT ALL MIDWEST	CONTRIBUTING EMPLOYER		N/A					No
(37) BLINDERMAN CONSTRUCTION CO INC	CONTRIBUTING EMPLOYER		N/A					No
(38) BOLDT COMPANY	CONTRIBUTING EMPLOYER		N/A					No
(39) BOLLER CONSTRUCTION CO INC	CONTRIBUTING EMPLOYER		N/A					No
(40) BORRE H & SONS	CONTRIBUTING EMPLOYER		N/A					No
(41) BRANDONISIO & COMPANY	CONTRIBUTING EMPLOYER		N/A					No
(42) BRAVO CONSTRUCTION CO INC	CONTRIBUTING EMPLOYER		N/A					No
(43) BROTHERS ASPHALT PAVING INC	CONTRIBUTING EMPLOYER		N/A					No
(44) BURLING BUILDERS INC	CONTRIBUTING EMPLOYER		N/A					No
(45) BURNS JOHN CONSTRUCTION CO	CONTRIBUTING EMPLOYER		N/A					No
(46) BUTLER CORING INC	CONTRIBUTING EMPLOYER		N/A					No
(47) C P M H CONSTRUCTION	CONTRIBUTING EMPLOYER		N/A					No
(48) C S I 3000 INC	CONTRIBUTING EMPLOYER		N/A					No
(49) CABO CONSTRUCTION CORP	CONTRIBUTING EMPLOYER		N/A					No
(50) CAMOSY INC	CONTRIBUTING EMPLOYER		N/A					No
(51) CAPITOL CEMENT CO INC	CONTRIBUTING EMPLOYER		N/A					No
(52) CARBO CONSTRUCTION INC	CONTRIBUTING EMPLOYER		N/A					No
(53) CARLSON ABIN & COMPANY	CONTRIBUTING EMPLOYER		N/A					No
(54) CARMICHAEL CONST INC	CONTRIBUTING EMPLOYER		N/A					No
(55) CARRERA CONCRETE CONSTRUCTION INC	CONTRIBUTING EMPLOYER		N/A					No
(56) CARTA CONCRETE CONSTRUCTION INC	CONTRIBUTING EMPLOYER		N/A					No
(57) CELLCRETE DECKS	CONTRIBUTING EMPLOYER		N/A					No
(58) CENTRAL BLACKTOP CO INC	CONTRIBUTING EMPLOYER		N/A					No
(59) CENTURY CONCRETE CONSTRUCTION CO	CONTRIBUTING EMPLOYER		N/A					No
(60) CERAMI CONSTRUCTION CO LTD	CONTRIBUTING EMPLOYER		N/A					No
(61) CHADWICK CONTRACTING	CONTRIBUTING EMPLOYER		N/A					No
(62) CHAKRA INC	CONTRIBUTING EMPLOYER		N/A					No
(63) CHICAGO HEIGHTS CONSTRUCTION CO	CONTRIBUTING EMPLOYER		N/A					No
(64) CHICAGO TOWN CONSTRUCTION	CONTRIBUTING EMPLOYER		N/A					No
(65) CIBULKA CONCRETE CONSTRUCTION INC	CONTRIBUTING EMPLOYER		N/A					No
(66) CIRCLE CONCRETE CONSTRUCTION INC	CONTRIBUTING EMPLOYER		N/A					No
(67) CLARK R & W CONSTRUCTION INC	CONTRIBUTING EMPLOYER		N/A					No
(68) CM MORRIS GROUP INC	CONTRIBUTING EMPLOYER		N/A					No
(69) COBRA CONCRETE CUTTING SERVICE	CONTRIBUTING EMPLOYER		N/A					No
(70) COLELLA CONCRETE INC	CONTRIBUTING EMPLOYER		N/A					No
(71) COMPASS CONCRETE MAINTENANCE	CONTRIBUTING EMPLOYER		N/A					No
(72) CONCRETE BY WAGNER INC	CONTRIBUTING EMPLOYER		N/A					No
(73) CONCRETE RESURFACING TECHNOLG	CONTRIBUTING EMPLOYER		N/A					No
(74) CONCRETE STRUCTURES	CONTRIBUTING EMPLOYER		N/A					No
(75) CONCRETE STRUCTURES OF THE MIDWEST INC	CONTRIBUTING EMPLOYER		N/A					No
(76) CONCRETE STRUCTURESSACHI CONSTRUCTION JV	CONTRIBUTING EMPLOYER		N/A					No
(77) CONRAD SCHMITT STUDIOS	CONTRIBUTING EMPLOYER		N/A					No
(78) CONSTRUCTION INDUSTRY WELFARE	CONTRIBUTING EMPLOYER		N/A					No
(79) COPENHAVER CONSTRUCTION	CONTRIBUTING EMPLOYER		N/A					No
(80) COST OF WISCONSIN INC	CONTRIBUTING EMPLOYER		N/A					No
(81) CUBS CONSTRUCTION CO	CONTRIBUTING EMPLOYER		N/A					No
(82) CUSTOM CONCRETE CUTTING INC	CONTRIBUTING EMPLOYER		N/A					No
(83) D AND B CONSTRUCTION	CONTRIBUTING EMPLOYER		N/A					No
(84) D B M SERVICES INC	CONTRIBUTING EMPLOYER		N/A					No
(85) D CONSTRUCTION INC	CONTRIBUTING EMPLOYER		N/A					No
(86) D N D ELECTRIC	CONTRIBUTING EMPLOYER		N/A					No
(87) DAKER CORP	CONTRIBUTING EMPLOYER		N/A					No
(88) DAVIS CONCRETE CONSTRUCTION CO	CONTRIBUTING EMPLOYER		N/A					No
(89) DE GRAF CONCRETE CONSTRUCTION CO	CONTRIBUTING EMPLOYER		N/A					No
(90) DECORATORS SUPPLY CORP (H)	CONTRIBUTING EMPLOYER		N/A					No
(91) DI GIOIA CONSTRUCTION CO INC	CONTRIBUTING EMPLOYER		N/A					No
(92) DIAN INC	CONTRIBUTING EMPLOYER		N/A					No
(93) DINATALE CONSTRUCTION INC	CONTRIBUTING EMPLOYER		N/A					No
(94) DIVINE CEMENT	CONTRIBUTING EMPLOYER		N/A					No
(95) DOORN SPORLEDER CONSTRUCTION INC	CONTRIBUTING EMPLOYER		N/A					No
(96) DUNNET BAY CONSTRCUTION CO	CONTRIBUTING EMPLOYER		N/A					No
(97) DUNTEMAN R W CO	CONTRIBUTING EMPLOYER		N/A					No
(98) DYKSTRA CONCRETE CONSTRUCTION CO	CONTRIBUTING EMPLOYER		N/A					No
(99) DYNAMICX ENTERPRISES INC	CONTRIBUTING EMPLOYER		N/A					No
(100) E L S CONST INC	CONTRIBUTING EMPLOYER		N/A					No
(101) EAGLE CONCRETE INC	CONTRIBUTING EMPLOYER		N/A					No
(102) EBY & SONS	CONTRIBUTING EMPLOYER		N/A					No
(103) ELLIOT CONSTRUCTION CORP	CONTRIBUTING EMPLOYER		N/A					No
(104) ENGER-VAVRA INC	CONTRIBUTING EMPLOYER		N/A					No
(105) ENGSTROM CONSTRUCTION CO	CONTRIBUTING EMPLOYER		N/A					No
(106) EVERSTONE CONSTRUCTION INC	CONTRIBUTING EMPLOYER		N/A					No
(107) EXPRESS CONTRACTING INC	CONTRIBUTING EMPLOYER		N/A					No
(108) F N L CONSTRUCTION LLC	CONTRIBUTING EMPLOYER		N/A					No
(109) FERRO PT CONSTRUCTION CO INC	CONTRIBUTING EMPLOYER		N/A					No
(110) FOGARTY ED CONCRETE CONSTRUCTION INC	CONTRIBUTING EMPLOYER		N/A					No
(111) FOX VALLEY W & P FUNDS	CONTRIBUTING EMPLOYER		N/A					No
(112) FRANSON C L INCORPORATED	CONTRIBUTING EMPLOYER		N/A					No
(113) FUERTE SYSTEMS INC	CONTRIBUTING EMPLOYER		N/A					No
(114) G & M CEMENT CONSTRUCTION CO INC	CONTRIBUTING EMPLOYER		N/A					No
(115) G & V CONSTRUCTION CO INC	CONTRIBUTING EMPLOYER		N/A					No
(116) G C C I CONCRETE	CONTRIBUTING EMPLOYER		N/A					No
(117) G F VENTURE CONCRETE CO	CONTRIBUTING EMPLOYER		N/A					No
(118) G L I SERVICES INCGEORGE'S LANDSCAPING INC	CONTRIBUTING EMPLOYER		N/A					No
(119) GALE CONST CO OF ILL	CONTRIBUTING EMPLOYER		N/A					No
(120) GARTH CONSTRUCTION SERVICES CORP	CONTRIBUTING EMPLOYER		N/A					No
(121) GEM CONSTRUCTION	CONTRIBUTING EMPLOYER		N/A					No
(122) GENEVA CONSTRUCTION CO	CONTRIBUTING EMPLOYER		N/A					No
(123) GILL J & COMPANY	CONTRIBUTING EMPLOYER		N/A					No
(124) GLOBE CONSTRUCTION INC	CONTRIBUTING EMPLOYER		N/A					No
(125) GOEBEL FORMING INC	CONTRIBUTING EMPLOYER		N/A					No
(126) GRADE RC LLC	CONTRIBUTING EMPLOYER		N/A					No
(127) GRAFF CONCRETE INC	CONTRIBUTING EMPLOYER		N/A					No
(128) GRAYCOR IND CONSTRS INC	CONTRIBUTING EMPLOYER		N/A					No
(129) GRECO CONTRACTORS	CONTRIBUTING EMPLOYER		N/A					No
(130) H & S CONCRETE CONST INC	CONTRIBUTING EMPLOYER		N/A					No
(131) HAINES S PAVING & EXCAVATING INC	CONTRIBUTING EMPLOYER		N/A					No
(132) HARD ROCK CONCRETE CUTTERS INC	CONTRIBUTING EMPLOYER		N/A					No
(133) HARD SURFACE FINISHERS INC	CONTRIBUTING EMPLOYER		N/A					No
(134) HASSE CONSTRUCTION CO INC	CONTRIBUTING EMPLOYER		N/A					No
(135) HEITKOTTER ENTERPRISES INC	CONTRIBUTING EMPLOYER		N/A					No
(136) HENDERSON JOSEPH & SON INC	CONTRIBUTING EMPLOYER		N/A					No
(137) HENRY BROTHERS COMPANY	CONTRIBUTING EMPLOYER		N/A					No
(138) HENRY HUGH CONSTRUCTION INC	CONTRIBUTING EMPLOYER		N/A					No
(139) HERLIHY MID CONTINENT CON	CONTRIBUTING EMPLOYER		N/A					No
(140) HERRERA CONST CO	CONTRIBUTING EMPLOYER		N/A					No
(141) HOOVER CONC & CONST CO	CONTRIBUTING EMPLOYER		N/A					No
(142) HOOVER & WELLS INC	CONTRIBUTING EMPLOYER		N/A					No
(143) I H C CONST COMPANIES LLC	CONTRIBUTING EMPLOYER		N/A					No
(144) I W S INC	CONTRIBUTING EMPLOYER		N/A					No
(145) ICI IMPRESSIVE CONST CO INC	CONTRIBUTING EMPLOYER		N/A					No
(146) II IN ONE CONTRACTORS INC	CONTRIBUTING EMPLOYER		N/A					No
(147) ILLINOIS CONSTRUCTORS CORP	CONTRIBUTING EMPLOYER		N/A					No
(148) IND ST PENS COUNCIL	CONTRIBUTING EMPLOYER		N/A					No
(149) INDEPENDENT PAVING CO INC	CONTRIBUTING EMPLOYER		N/A					No
(150) IPEMA CONCRETE CONSTRUCTION INC	CONTRIBUTING EMPLOYER		N/A					No
(151) J B CONCRETE CONTRACTORS INC	CONTRIBUTING EMPLOYER		N/A					No
(152) J G DEMO INC	CONTRIBUTING EMPLOYER		N/A					No
(153) J L J CONTRACTING INC	CONTRIBUTING EMPLOYER		N/A					No
(154) JACOBS & SONS INC	CONTRIBUTING EMPLOYER		N/A					No
(155) JALPA CONSTRUCTION CORP	CONTRIBUTING EMPLOYER		N/A					No
(156) JOHANSON CARL & SON CONSTRUCTION CO INC	CONTRIBUTING EMPLOYER		N/A					No
(157) JOHNSON H CONCRETE	CONTRIBUTING EMPLOYER		N/A					No
(158) JOHNSTON W F CONSTRUCTION INC	CONTRIBUTING EMPLOYER		N/A					No
(159) JUDLAU CONTRACTING INC	CONTRIBUTING EMPLOYER		N/A					No
(160) KALSI CONSTRUCTION CO INC	CONTRIBUTING EMPLOYER		N/A					No
(161) KATS & SONS INC	CONTRIBUTING EMPLOYER		N/A					No
(162) KELLY PLASTERING	CONTRIBUTING EMPLOYER		N/A					No
(163) KENNY CONSTRUCTION CO	CONTRIBUTING EMPLOYER		N/A					No
(164) KETELAAR BROS CONCRETE CONST	CONTRIBUTING EMPLOYER		N/A					No
(165) KEYBOARD ENTERPRISES DEV INC	CONTRIBUTING EMPLOYER		N/A					No
(166) K-FIVE CONSTR CORP	CONTRIBUTING EMPLOYER		N/A					No
(167) KIEWIT INFRASTRUCTURE COMPANY	CONTRIBUTING EMPLOYER		N/A					No
(168) KING CUT CONCRETE CUTTERS	CONTRIBUTING EMPLOYER		N/A					No
(169) KLATT ENTERPRISES INC	CONTRIBUTING EMPLOYER		N/A					No
(170) KOLE CONSTRUCTION CO INC	CONTRIBUTING EMPLOYER		N/A					No
(171) KRAMER EDWARD & SON INC	CONTRIBUTING EMPLOYER		N/A					No
(172) KREATIVE SCAPE INC	CONTRIBUTING EMPLOYER		N/A					No
(173) KUYPERS BORTHERS INC	CONTRIBUTING EMPLOYER		N/A					No
(174) L S CONTRACTING GROUP	CONTRIBUTING EMPLOYER		N/A					No
(175) LA SOTA PLASTERING	CONTRIBUTING EMPLOYER		N/A					No
(176) LAGIOIA CONSTRUCTION INC	CONTRIBUTING EMPLOYER		N/A					No
(177) LAKE PARK CEMENT INC	CONTRIBUTING EMPLOYER		N/A					No
(178) LAKES & RIVERS CONTRACTING INC	CONTRIBUTING EMPLOYER		N/A					No
(179) LAMP A CONCRETE CONTRACTORS INC	CONTRIBUTING EMPLOYER		N/A					No
(180) LAMPIGNANO & SON CONSTRUCTION CO	CONTRIBUTING EMPLOYER		N/A					No
(181) LANDMARK CONTRACTORS INC	CONTRIBUTING EMPLOYER		N/A					No
(182) LB HALL ENTERPRISES	CONTRIBUTING EMPLOYER		N/A					No
(183) LEINWEBER F H COMPANY INC	CONTRIBUTING EMPLOYER		N/A					No
(184) LEON CONSTRUCTION INC	CONTRIBUTING EMPLOYER		N/A					No
(185) LEVY COMPANY	CONTRIBUTING EMPLOYER		N/A					No
(186) LINDBLAD CONSTRUCTION CO OF JOLIET	CONTRIBUTING EMPLOYER		N/A					No
(187) LITE CONSTRUCTION INC	CONTRIBUTING EMPLOYER		N/A					No
(188) LIVEWIRE ELECTRICAL SYSTEMS	CONTRIBUTING EMPLOYER		N/A					No
(189) LOGISTICS CONCRETE	CONTRIBUTING EMPLOYER		N/A					No
(190) LOOTENS ARTHUR J & SONS INC	CONTRIBUTING EMPLOYER		N/A					No
(191) LORIG CONSTRUCTION CO	CONTRIBUTING EMPLOYER		N/A					No
(192) LORUSSO CEMENT CONTRACTORS INC	CONTRIBUTING EMPLOYER		N/A					No
(193) M & J ASPHALT PAVING CO INC	CONTRIBUTING EMPLOYER		N/A					No
(194) M & Q CONSTRUCTION CO	CONTRIBUTING EMPLOYER		N/A					No
(195) M F D CONSTRUCTION CO	CONTRIBUTING EMPLOYER		N/A					No
(196) M J T J CONTRACTORS & BUILDERS INC	CONTRIBUTING EMPLOYER		N/A					No
(197) M P S MARTIN PRECAST SERVICES	CONTRIBUTING EMPLOYER		N/A					No
(198) M3 CONSTRUCTION CORP	CONTRIBUTING EMPLOYER		N/A					No
(199) MACK ALLAN & SONS INC	CONTRIBUTING EMPLOYER		N/A					No
(200) MANUSOS GENERAL CONTRACTING	CONTRIBUTING EMPLOYER		N/A					No
(201) MARKET CONTRACTING SEVICES	CONTRIBUTING EMPLOYER		N/A					No
(202) MARTAM CONSTRUCTION INC	CONTRIBUTING EMPLOYER		N/A					No
(203) MARTIN CEMENT COMPANY	CONTRIBUTING EMPLOYER		N/A					No
(204) MARTIN MECHANICAL CORP	CONTRIBUTING EMPLOYER		N/A					No
(205) MARTINEZ FROGS INC	CONTRIBUTING EMPLOYER		N/A					No
(206) MARVEL CONSTRUCTION CORP	CONTRIBUTING EMPLOYER		N/A					No
(207) MATRIX CONCRETE CONST	CONTRIBUTING EMPLOYER		N/A					No
(208) MAUL PAVING INC	CONTRIBUTING EMPLOYER		N/A					No
(209) MAVERICK POOLS INC	CONTRIBUTING EMPLOYER		N/A					No
(210) MAXIM CONST CORP INC	CONTRIBUTING EMPLOYER		N/A					No
(211) MC HUGH JAMES CONSTRUCTION CO INC	CONTRIBUTING EMPLOYER		N/A					No
(212) MEADE ELECTRIC CO	CONTRIBUTING EMPLOYER		N/A					No
(213) MECCOR INDUSTRIES LTD	CONTRIBUTING EMPLOYER		N/A					No
(214) MERU CORPORATION	CONTRIBUTING EMPLOYER		N/A					No
(215) MEYER C R & SONS CONSTRUCTION	CONTRIBUTING EMPLOYER		N/A					No
(216) MID VALLEY CONCRETE INC	CONTRIBUTING EMPLOYER		N/A					No
(217) M-J-T-J CONTRACTORS INC	CONTRIBUTING EMPLOYER		N/A					No
(218) MONDI CONSTRUCTION INC	CONTRIBUTING EMPLOYER		N/A					No
(219) MONSON-NICHOLAS INC	CONTRIBUTING EMPLOYER		N/A					No
(220) NARDULLI J CONCRETE INC	CONTRIBUTING EMPLOYER		N/A					No
(221) NATOLA CONCRETE INC	CONTRIBUTING EMPLOYER		N/A					No
(222) NEWELL J & J CONC CONTRACTORS	CONTRIBUTING EMPLOYER		N/A					No
(223) NOLAN PLASTERING	CONTRIBUTING EMPLOYER		N/A					No
(224) NORTHWEST CONTRACTORS INC	CONTRIBUTING EMPLOYER		N/A					No
(225) O NEIL W E CONST COMPANY	CONTRIBUTING EMPLOYER		N/A					No
(226) O'CONNOR CONTRACTORS INC	CONTRIBUTING EMPLOYER		N/A					No
(227) OGDEN HILL CEMENT INC	CONTRIBUTING EMPLOYER		N/A					No
(228) OLSON R CONSTRUCTION COMPANY CONTRACTORS INC	CONTRIBUTING EMPLOYER		N/A					No
(229) ORANGE CRUSH	CONTRIBUTING EMPLOYER		N/A					No
(230) ORNELAS CONSTRUCTION CO	CONTRIBUTING EMPLOYER		N/A					No
(231) OSMAN CONSTRUCTION CORPORATION	CONTRIBUTING EMPLOYER		N/A					No
(232) P L M CEMENT CONST INC	CONTRIBUTING EMPLOYER		N/A					No
(233) P S I PROFESSIONAL SURFACE INSTALLATIONS INC	CONTRIBUTING EMPLOYER		N/A					No
(234) PACIFIC COMPANY	CONTRIBUTING EMPLOYER		N/A					No
(235) PALMER HOUSE HOTEL	CONTRIBUTING EMPLOYER		N/A					No
(236) PALOS BUILDERS	CONTRIBUTING EMPLOYER		N/A					No
(237) PAN AMERICAN CONCRETE CO	CONTRIBUTING EMPLOYER		N/A					No
(238) PAN AMERICAN CONSTRUCTION CO INC	CONTRIBUTING EMPLOYER		N/A					No
(239) PAN OCEANIC ENGINEERING CO	CONTRIBUTING EMPLOYER		N/A					No
(240) PARIS CONSTRUCTION CO INC	CONTRIBUTING EMPLOYER		N/A					No
(241) PARKWAY FORMING INC	CONTRIBUTING EMPLOYER		N/A					No
(242) PASCHEN FHNIELSEN SN & ASSOC	CONTRIBUTING EMPLOYER		N/A					No
(243) PATH CONSTRUCTION COMPANY INC	CONTRIBUTING EMPLOYER		N/A					No
(244) PELAGIO & SONS CO	CONTRIBUTING EMPLOYER		N/A					No
(245) PENN SERVICES LLC	CONTRIBUTING EMPLOYER		N/A					No
(246) PEPPER CONSTRUCTION CO	CONTRIBUTING EMPLOYER		N/A					No
(247) PERFORMANCE CONSTRUCTION SERVICES INC	CONTRIBUTING EMPLOYER		N/A					No
(248) PERFORMANCE TANK INC	CONTRIBUTING EMPLOYER		N/A					No
(249) PETERS MM CONSTRUCTION INC	CONTRIBUTING EMPLOYER		N/A					No
(250) PETERSON HARRY S INC	CONTRIBUTING EMPLOYER		N/A					No
(251) PLAINFIELD CONSTRUCTION CO INC	CONTRIBUTING EMPLOYER		N/A					No
(252) PLASTER DESIGN INC	CONTRIBUTING EMPLOYER		N/A					No
(253) PLOTE CONSTRUCTION INC	CONTRIBUTING EMPLOYER		N/A					No
(254) POWER CONTRACTING & ENGINEERING CORP	CONTRIBUTING EMPLOYER		N/A					No
(255) PRECISION CEMENT CO INC	CONTRIBUTING EMPLOYER		N/A					No
(256) PREFERRED CONCRETE & EXCAVATING INC	CONTRIBUTING EMPLOYER		N/A					No
(257) PREMIUM CONCRETE INC	CONTRIBUTING EMPLOYER		N/A					No
(258) PRESTA CONSTRUCTION INC	CONTRIBUTING EMPLOYER		N/A					No
(259) PULLARA INC	CONTRIBUTING EMPLOYER		N/A					No
(260) R C CAST RESTORATION & CLEANG	CONTRIBUTING EMPLOYER		N/A					No
(261) R C SMITH CONCRETE COMPANY	CONTRIBUTING EMPLOYER		N/A					No
(262) R G CONSTRUCTION SERVICES INC	CONTRIBUTING EMPLOYER		N/A					No
(263) R N R CONTRACTORS INC	CONTRIBUTING EMPLOYER		N/A					No
(264) RAE'S CONCRETE	CONTRIBUTING EMPLOYER		N/A					No
(265) RAFFIN CONSTRUCTION CO	CONTRIBUTING EMPLOYER		N/A					No
(266) RAFY'S CONCRETE INC	CONTRIBUTING EMPLOYER		N/A					No
(267) RAI CONCRETE INC	CONTRIBUTING EMPLOYER		N/A					No
(268) RAUSCH CONST CO	CONTRIBUTING EMPLOYER		N/A					No
(269) REYES GROUP LTD	CONTRIBUTING EMPLOYER		N/A					No
(270) RITEWAY CONSTRUCTION SERVICES	CONTRIBUTING EMPLOYER		N/A					No
(271) RIZZA CONCRETE	CONTRIBUTING EMPLOYER		N/A					No
(272) ROCK SOLID PAVING & EXC INC	CONTRIBUTING EMPLOYER		N/A					No
(273) ROSE CONCRETE	CONTRIBUTING EMPLOYER		N/A					No
(274) ROSSI CONTRACTORS INC	CONTRIBUTING EMPLOYER		N/A					No
(275) ROYAL CONCRETE INC	CONTRIBUTING EMPLOYER		N/A					No
(276) RUANE CONSTRUCTION INC	CONTRIBUTING EMPLOYER		N/A					No
(277) RULA'S ENTERPRISE	CONTRIBUTING EMPLOYER		N/A					No
(278) S C Y CONCRETE CONST INC	CONTRIBUTING EMPLOYER		N/A					No
(279) S GL EXCAVATING INC	CONTRIBUTING EMPLOYER		N/A					No
(280) SANCHEZ CONSTRUCTION SERVICES	CONTRIBUTING EMPLOYER		N/A					No
(281) SCANLON EXCAVATING & CONC INC	CONTRIBUTING EMPLOYER		N/A					No
(282) SCHAEFGES BROTHERS INC	CONTRIBUTING EMPLOYER		N/A					No
(283) SCHROEDER & SCHROEDER INC	CONTRIBUTING EMPLOYER		N/A					No
(284) SCIORTINO GROUP INC	CONTRIBUTING EMPLOYER		N/A					No
(285) SCOTT RANDOLPH CONSTRS INC	CONTRIBUTING EMPLOYER		N/A					No
(286) SCURTO CEMENT CONST LTD	CONTRIBUTING EMPLOYER		N/A					No
(287) SEVEN-D CONST CO	CONTRIBUTING EMPLOYER		N/A					No
(288) SHERRY-K CORP CONSTRUCTION	CONTRIBUTING EMPLOYER		N/A					No
(289) SKYLINE PLASTERING INC	CONTRIBUTING EMPLOYER		N/A					No
(290) SMITH PLASTERING	CONTRIBUTING EMPLOYER		N/A					No
(291) SMUDDE J	CONTRIBUTING EMPLOYER		N/A					No
(292) SOLLITT GEORGE CONST CO	CONTRIBUTING EMPLOYER		N/A					No
(293) SOLO CONSTRUCTION INC	CONTRIBUTING EMPLOYER		N/A					No
(294) SONOMA-UNDERGROUND SERVICES	CONTRIBUTING EMPLOYER		N/A					No
(295) SPRAY INSULATIONS	CONTRIBUTING EMPLOYER		N/A					No
(296) STEPPO SUPPLY & CONSTRUCTION INC	CONTRIBUTING EMPLOYER		N/A					No
(297) STRADA CONST	CONTRIBUTING EMPLOYER		N/A					No
(298) STRATA CONTRACTORS LTD	CONTRIBUTING EMPLOYER		N/A					No
(299) SUBURBAN CONC INC	CONTRIBUTING EMPLOYER		N/A					No
(300) SUMIT CONST CO INC	CONTRIBUTING EMPLOYER		N/A					No
(301) T A C CONST CO	CONTRIBUTING EMPLOYER		N/A					No
(302) T B S CONC INC	CONTRIBUTING EMPLOYER		N/A					No
(303) T B S CONSTRUCTION INC	CONTRIBUTING EMPLOYER		N/A					No
(304) T K CONCRETE INC	CONTRIBUTING EMPLOYER		N/A					No
(305) TAG-THE AMER GROUP OF CONSTRS	CONTRIBUTING EMPLOYER		N/A					No
(306) TAKAO NAGAI CONCRETE RESTORATIONBULLEY & ANDREWS	CONTRIBUTING EMPLOYER		N/A					No
(307) TERRELL MATERIALS CORP	CONTRIBUTING EMPLOYER		N/A					No
(308) THORNE ASSOCIATES INC	CONTRIBUTING EMPLOYER		N/A					No
(309) TONYAN & SON	CONTRIBUTING EMPLOYER		N/A					No
(310) TRIAD CONCRETE INC	CONTRIBUTING EMPLOYER		N/A					No
(311) TRIALTA CONSTRUCTION CO INC	CONTRIBUTING EMPLOYER		N/A					No
(312) TRICE CONSTRUCTION CO	CONTRIBUTING EMPLOYER		N/A					No
(313) TRIGGI CONSTRUCTION INC	CONTRIBUTING EMPLOYER		N/A					No
(314) UNICOR COLORIZED PLAYGROUND	CONTRIBUTING EMPLOYER		N/A					No
(315) VAN DER LAAN BROTHERS	CONTRIBUTING EMPLOYER		N/A					No
(316) VENETIAN ART INC	CONTRIBUTING EMPLOYER		N/A					No
(317) VIXEN CONSTRUCTION INC	CONTRIBUTING EMPLOYER		N/A					No
(318) WALSH CONSTRUCTION COMPANY	CONTRIBUTING EMPLOYER		N/A					No
(319) WARD ROBERT H & ASSOCIATES INC	CONTRIBUTING EMPLOYER		N/A					No
(320) WESTERN UTILITY CONTRACTORS INC	CONTRIBUTING EMPLOYER		N/A					No
(321) WHITELINE CONSTRUCTION INC	CONTRIBUTING EMPLOYER		N/A					No
(322) WILKIN INSULATION	CONTRIBUTING EMPLOYER		N/A					No
(323) WILLIAMS BROS CONST INC	CONTRIBUTING EMPLOYER		N/A					No
(324) WILLIAMS J M CONST CO	CONTRIBUTING EMPLOYER		N/A					No
(325) XTREME EDGE EXCAVATING	CONTRIBUTING EMPLOYER		N/A					No
(326) YOUNG CONCRETE ENTERPRISES INC	CONTRIBUTING EMPLOYER		N/A					No
(327) Z MARTIN PLASTERING	CONTRIBUTING EMPLOYER		N/A					No
(328) ZERA CONSTRUCTION CO INC	CONTRIBUTING EMPLOYER		N/A					No

Schedule R (Form 990) 2015

Page 3

Part V

Transactions With Related Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.

Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.

Yes

1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?

a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................

b Gift, grant, or capital contribution to related organization(s) ............................

c Gift, grant, or capital contribution from related organization(s) ............................

d Loans or loan guarantees to or for related organization(s) ............................

e Loans or loan guarantees by related organization(s) ............................

f Dividends from related organization(s) ............................

g Sale of assets to related organization(s) ............................

h Purchase of assets from related organization(s) ............................

i Exchange of assets with related organization(s) ............................

j Lease of facilities, equipment, or other assets to related organization(s) .......................

k Lease of facilities, equipment, or other assets from related organization(s) ......................

l Performance of services or membership or fundraising solicitations for related organization(s) .....................

m Performance of services or membership or fundraising solicitations by related organization(s) .................

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................

Yes

o Sharing of paid employees with related organization(s) ............................

Yes

p Reimbursement paid to related organization(s) for expenses ............................

Yes

q Reimbursement paid by related organization(s) for expenses ............................

Yes

r Other transfer of cash or property to related organization(s) ............................

Yes

s Other transfer of cash or property from related organization(s) ............................

Yes

If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved

Schedule R (Form 990) 2015

Page 4

Part VI

Unrelated Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 37.

Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.

(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(e) Are all partners section 501(c)(3) organizations?		(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Schedule R (Form 990) 2015

Page 5

Part VII

Supplemental Information

Provide additional information for responses to questions on Schedule R (see instructions).

Return Reference	Explanation

Schedule R (Form 990) 2015

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: PROVIDE HEALTH BENEFITS
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	12
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	6
5	Total number of individuals employed in calendar year 2015 (Part V, line 2a) ......	5	0
6	Total number of volunteers (estimate if necessary) .............	6	0
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	0
b	Net unrelated business taxable income from Form 990-T, line 34 .........	7b	0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	0	0
9	Program service revenue (Part VIII, line 2g) .........	4,536,324	5,238,855
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	107,322	140,262
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	0	0
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	4,643,646	5,379,117
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	0	0
14	Benefits paid to or for members (Part IX, column (A), line 4).....	1,876,140	3,029,771
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	0	0
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	178,584	226,064
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	2,054,724	3,255,835
19	Revenue less expenses. Subtract line 18 from line 12.......	2,588,922	2,123,282
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	7,644,535	9,471,994
21	Total liabilities (Part X, line 26).............	253,925	117,509
22	Net assets or fund balances. Subtract line 21 from line 20.....	7,390,610	9,354,485

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )
	TO PROVIDE MEDICAL AND LIFE INSURANCE TO PARTICIPANTS.

4b	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4c	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)			(D) Reportable compensation from the organization (W- 2/1099-MISC)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and Title
(1) PATRICK LA CASSA...................................................................... TRUSTEE	2.00 ................. 70.00	X			0	173,680	131,318
(2) LAWRENCE PICARDI SR...................................................................... TRUSTEE	2.00 ................. 60.00	X			0	166,270	127,027
(3) SANDRA HUNT...................................................................... TRUSTEE	2.00 ................. 2.00	X			0	4,881	2,296
(4) STEVE BAUMGARTNER...................................................................... TRUSTEE - NEW	2.00 ................. 2.00	X			0	0	0
(5) DONALD DEETJEN...................................................................... TRUSTEE	2.00 ................. 2.00	X			0	0	0
(6) MICHAEL PIRRON...................................................................... TRUSTEE	2.00 ................. 2.00	X			0	0	0
(7) ANTONIO ACEVEDO...................................................................... TRUSTEE	2.00 ................. 2.00	X			0	3,701	2,296
(8) GARY LUNDSBERG...................................................................... TRUSTEE - PAST	2.00 ................. 2.00	X			0	0	0
(9) ROBERT KRUG...................................................................... TRUSTEE	2.00 ................. 2.00	X			0	0	0
(10) MICHAEL KOLBERG...................................................................... TRUSTEE	2.00 ................. 2.00	X			0	0	0
(11) PHIL DIEKEMPER...................................................................... TRUSTEE	2.00 ................. 2.00	X			0	0	0
(12) JAY LA SALA...................................................................... TRUSTEE	2.00 ................. 2.00	X			0	3,307	2,048
(13) ADAM HIGGINS...................................................................... TRUSTEE	2.00 ................. 2.00	X			0	3,701	2,296
(14) WILLIAM BEEMAN...................................................................... ADMINISTRATOR	5.00 ................. 35.00		X		0	121,643	48,351
(15) DUANE EXLINE...................................................................... EMPLOYEE	2.00 ................. 38.00			X	0	116,071	50,083

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	0	593,254	365,715

(A) Name and business address	(B) Description of services	(C) Compensation





2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization 0

1a	Federated campaigns..	1a
b	Membership dues..	1b
c	Fundraising events..	1c
d	Related organizations	1d
e	Government grants (contributions)	1e

f	All other contributions, gifts, grants, and similar amounts not included above	1f

g	Noncash contributions included in lines 1a-1f:$
h Total.Add lines 1a-1f.......

			Business Code
2a	CONTRACTOR CONTRIBUTIO	900099	5,132,025	5,132,025
b	PRESCRIPTION DRUG REBA	900099	59,912	59,912
c	PARTICIPANT SELF-CONTR	900099	28,093	28,093
d	MEDICARE PART D SUBSID	900099	18,825	18,825
e
f	All other program service revenue.
g Total.Add lines 2a–2f.....			5,238,855

3 Investment income (including dividends, interest, and othersimilar amounts) ..........			140,262			140,262
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
		(ii) Personal	(i) Real
6a	Gross rents
b	Less: rental expenses
c	Rental income or (loss)
d	Net rental income or (loss)......
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory
b	Less: cost or other basis and sales expenses
c	Gain or (loss)
d	Net gain or (loss).....
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
	a
b	Less: direct expenses ...b
c	Net income or (loss) from fundraising events..
9a	Gross income from gaming activities. See Part IV, line 19 ...
	a
b	Less: direct expenses ...b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
	a
b	Less: cost of goods sold ..b
c	Net income or (loss) from sales of inventory..
Business Code			Miscellaneous Revenue
11a
b
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......
12	Total revenue. See Instructions......			5,379,117	5,238,855	0	140,262

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21
2	Grants and other assistance to individuals in the United States. See Part IV, line 22
3	Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16
4	Benefits paid to or for members	3,029,771
5	Compensation of current officers, directors, trustees, and key employees ....
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....
7	Other salaries and wages
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....
9	Other employee benefits .......
10	Payroll taxes ...........
11	Fees for services (non-employees):
a	Management ......
b	Legal .........	27,989
c	Accounting ...........	25,156
d	Lobbying ...........
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......	6,863
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	17,259
12	Advertising and promotion ....
13	Office expenses .......	3,630
14	Information technology ......	7,923
15	Royalties ..
16	Occupancy ...........
17	Travel ............
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	5,539
20	Interest ...........
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	538
23	Insurance ...	2,795
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	SHARED EXP. ALLOCATED F	126,602
b	FEES MANDATED BY ACA	1,770
c
d
e	All other expenses
25	Total functional expenses. Add lines 1 through 24e	3,255,835
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........			16,078	1	888,072
2	Savings and temporary cash investments .........			657,631	2	300,604
3	Pledges and grants receivable, net ......				3
4	Accounts receivable, net .............			496,888	4	707,931
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L
					5
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
					6
7	Notes and loans receivable, net ....			5,157	7	55,988
8	Inventories for sale or use ........				8
9	Prepaid expenses and deferred charges ......				9
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	5,378
b	Less: accumulated depreciation	10b	1,076	4,840	10c	4,302
11	Investments—publicly traded securities .			5,713,941	11	7,515,097
12	Investments—other securities. See Part IV, line 11 .....				12
13	Investments—program-related. See Part IV, line 11 ..				13
14	Intangible assets ...............				14
15	Other assets. See Part IV, line 11 ...........			750,000	15	0
16	Total assets. Add lines 1 through 15 (must equal line 34)...			7,644,535	16	9,471,994

17	Accounts payable and accrued expenses .....	253,925	17	117,509
18	Grants payable ...		18
19	Deferred revenue .........		19
20	Tax-exempt bond liabilities .........		20
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21
22	Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..		22
23	Secured mortgages and notes payable to unrelated third parties ..		23
24	Unsecured notes and loans payable to unrelated third parties ..		24
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D		25
26	Total liabilities. Add lines 17 through 25..	253,925	26	117,509

	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets		27
28	Temporarily restricted net assets ...........		28
29	Permanently restricted net assets		29
	Organizations that do not follow SFAS 117 (ASC 958), check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds .....	0	30	0
31	Paid-in or capital surplus, or land, building or equipment fund ...	0	31	0
32	Retained earnings, endowment, accumulated income, or other funds	7,390,610	32	9,354,485
33	Total net assets or fund balances ...........	7,390,610	33	9,354,485
34	Total liabilities and net assets/fund balances ........	7,644,535	34	9,471,994