TY 2015 Form 990

(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)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)
(1) SCOTT GALE...................................................................... ALTERNATE LABOR TRUSTEE	1.00 ................. 0.00	X
(2) BURT JOHNSON...................................................................... LABOR TRUSTEE	1.00 ................. 0.00	X
(3) DAVE SCHRUNK...................................................................... ALTERNATE LABOR TRUSTEE	1.00 ................. 0.00	X
(4) GREG MASSEY...................................................................... LABOR TRUSTEE CO-CHAIR	1.00 ................. 0.00	X	X
(5) KENT PETERSON...................................................................... MANAGEMENT TRUSTEE CO-CHAI	1.00 ................. 0.00	X	X
(6) SCOTT WEICHT...................................................................... MANAGEMENT TRUSTEE	1.00 ................. 0.00	X
(7) TOM DEPAUW...................................................................... MANAGEMENT TRUSTEE	1.00 ................. 0.00	X
(8) DOUG OLSON...................................................................... MANAGEMENT TRUSTEE	1.00 ................. 0.00	X
(9) MICHAEL COOK...................................................................... ALTERNATE LABOR TRUSTEE	1.00 ................. 0.00	X
(10) JOHN NESSE...................................................................... ALTERNATE MANAGEMENT TRUST	1.00 ................. 0.00	X
(11) DAVE SEMERAD...................................................................... ALTERNATE MANAGEMENT TRUST	1.00 ................. 0.00	X
(12) GARY THADEN...................................................................... ALTERNATE MANAGEMENT TRUST	1.00 ................. 0.00	X
(13) MATT FAIRBANKS...................................................................... ALTERNATE LABOR TRUSTEE	1.00 ................. 0.00	X
(14) RUSS SCHERBER...................................................................... LABOR TRUSTEE	1.00 ................. 0.00	X
(15) MARK ZIEGLER...................................................................... MANAGEMENT TRUSTEE	1.00 ................. 0.00	X
(16) HEATHER GRAZZINI-SIMS...................................................................... ALTERNATE MANAGEMENT TRUST	1.00 ................. 0.00	X
(17) MICHAEL HEIDEN...................................................................... ALTERNATE LABOR TRUSTEE	1.00 ................. 0.00	X

- 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

UNION CONSTRUCTION CRAFTS WORKERS'
COMPENSATION FUND

Employer identification number

41-1835606

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 ...
e	Other ...	22,918	20,351	2,567
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				2,567

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	1,176,224
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a
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	0
3	Subtract line 2e from line 1..................		3	1,176,224
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
b	Other (Describe in Part XIII.) ...........	4b
c	Add lines 4a and 4b....................		4c	0
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......		5	1,176,224

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	1,147,364
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	1,147,364
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
b	Other (Describe in Part XIII.) ............	4b
c	Add lines 4a and 4b.....................		4c	0
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......		5	1,147,364

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 TRUST ESTABLISHED TO HOLD FUND ASSETS IS QUALIFIED 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 HAS OBTAINED A FAVORABLE TAX DETERMINATION LETTER FROM THE INTERNAL REVENUE SERVICE DATED SEPTEMBER 8, 1997. THE FUND HAS BEEN AMENDED SINCE RECEIVING THE DETERMINATION LETTER. HOWEVER, THE FUND ADMINISTRATOR AND THE FUND'S TAX COUNSEL BELIEVE THAT THE FUND IS DESIGNED AND IS CURRENTLY BEING OPERATED IN COMPLIANCE WITH THE APPLICABLE REQUIREMENTS OF THE IRC. 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 PLAN HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE IRS. THE FUND ADMINISTRATOR HAS ANALYZED THE TAX POSITIONS TAKEN BY THE PLAN, AND HAS CONCLUDED THAT AS OF DECEMBER 31, 2015 AND 2014, THERE ARE NO UNCERTAIN 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 ADMINISTRATOR BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO 2012.

Return Reference

Explanation

PART X, LINE 2:

THE TRUST ESTABLISHED TO HOLD FUND ASSETS IS QUALIFIED 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 HAS OBTAINED A FAVORABLE TAX DETERMINATION LETTER FROM THE INTERNAL REVENUE SERVICE DATED SEPTEMBER 8, 1997. THE FUND HAS BEEN AMENDED SINCE RECEIVING THE DETERMINATION LETTER. HOWEVER, THE FUND ADMINISTRATOR AND THE FUND'S TAX COUNSEL BELIEVE THAT THE FUND IS DESIGNED AND IS CURRENTLY BEING OPERATED IN COMPLIANCE WITH THE APPLICABLE REQUIREMENTS OF THE IRC. 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 PLAN HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE IRS. THE FUND ADMINISTRATOR HAS ANALYZED THE TAX POSITIONS TAKEN BY THE PLAN, AND HAS CONCLUDED THAT AS OF DECEMBER 31, 2015 AND 2014, THERE ARE NO UNCERTAIN 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 ADMINISTRATOR BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO 2012.

Schedule D (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

UNION CONSTRUCTION CRAFTS WORKERS'
COMPENSATION FUND

Employer identification number

41-1835606

Return Reference	Explanation
FORM 990, PART VI, SECTION A, LINE 1	THE TRUSTESS, AT THEIR DISCRETION, MAY APPOINT AN EXECUTIVE COMMITTEE CONSISTING OF AN EQUAL NUMBER OF UNION TRUSTEES AND EMPLOYER TRUSTEES. THE EXECUTIVE COMMITTEE SHALL ASSIST THE FUND IN CARRYING OUT THE POLICIES AND PROGRAMS ESTABLISHED BY THE BOARD OF TRUSTEES. IN ADDITION, THE EXECUTIVE COMMITTEE MAY ACT IN PLACE AND INSTEAD OF THE BOARD OF TRUSTEES BETWEEN TRUSTEE MEETINGS ON ALL MATTERS EXCEPT THOSE SPECIFICALLY RESERVED TO THE BOARD OF TRUSTEES BY THE TRUST AGREEMENT OR BY ACTION OF THE BOARD OF TRUSTEES. AN EXECUTIVE COMMITTEE MEETING MAY BE CONDUCTED, OR AN INDIVIDUAL MEMEBER MAY PARTICIPATE IN SUCH A MEETING, BY TELEPHONE OR BY ANY SIMILAR COMMUNICATIONS SYSTEM WHICH ALLOWS ALL PERSONS PARTICIPATING IN THE MEETING TO HEAR EACH OTHER AT THE SAME TIME.
FORM 990, PART VI, SECTION A, LINE 3	WILSON-MCSHANE IS THE MANAGEMENT COMPANY RESPONSIBLE FOR THE FINANCIAL OPERATIONS OF THE FUND. WMC PREPARES THE GENERAL LEDGER, MAKES JOURNAL ENTRIES, MANAGES CLAIMS AND OPERATIONAL EXPENSES.
FORM 990, PART VI, SECTION A, LINE 7A	THE FUND SHALL BE ADMINISTERED BY A BOARD OF TRUSTEES. EACH UNION THAT IS A PARTY TO THIS AGREEMENT SHALL APPOINT TWO UNION TRUSTEES. FOR EACH UNION TRUSTEE APPOINTED BY A UNION, AGC SHALL APPOINT AN EMPLOYER TRUSTEE. THE AGC MAY DESIGNATE ONE ALTERNATE EMPLOYER TRUSTEE FOR EACH UNION THAT IS A PARTY TO THIS AGREEMENT. EACH UNION WHICH IS A PARTY TO THIS AGREEMENT MAY DESIGNATE ONE ALTERNATE UNION TRUSTEE. AN ALTERNATE TRUSTEE SHALL HAVE THE RIGHT TO ACT ONLY IN THE ABSENCE OF ANY OF THE PRINCIPAL TRUSTEE OR TRUSTEES DESIGNATED BY THE PARTICULAR PARTY.
FORM 990, PART VI, SECTION B, LINE 11	WHEN THE AUDITOR HAS PREPARED THE FORM 990, IT IS GIVEN TO THE AUDIT COMMITTEE AND THE BOARD OF TRUSTEES FOR REVIEW. THE TRUSTEES ARE ALLOWED TIME IN WHICH TO EXAMINE THE FORM 990 AND COMMUNICATE WITH THE ADMINISTRATOR IN THE EVENT THE TRUSTEE HAS ANY QUESTIONS OR COMMENTS. AT THE REQUEST OF ANY TRUSTEE, OR IF THERE ARE QUESTIONS OR COMMENTS THAT CANNOT BE ADEQUATELY AND FULLY ADDRESSED, THE ADMINISTRATOR WILL ARRANGE A CONFERENCE CALL FOR ALL TRUSTEES TO DISCUSS THE FORM 990 AND WHETHER OR NOT REVISIONS ARE NEEDED BEFORE IT IS FINALIZED.
FORM 990, PART VI, SECTION B, LINE 12C	1. AT THE FIRST MEETING OF THE BOARD OF TRUSTEES OF THE UCCWCF HELD EACH YEAR, A COPY OF THE CONFLICTS OF INTEREST POLICY IS DISTRIBUTED TO THE TRUSTEES. IN ADDITION, A DISCLOSURE STATEMENT IS DISTRIBUTED TO EACH TRUSTEE. THE DISCLOSURE STATEMENT HAS BEEN PREPARED IN COMPLIANCE WITH THE CONFLICTS OF INTEREST POLICY. FUND COUNSEL EXPLAINS TO THE BOARD THE OPERATION OF THE CONFLICTS OF INTEREST POLICY, WHAT TYPES OF INTERESTS HAVE TO BE DISCLOSED AND THE ADMINISTRATIVE PROCEDURES FOR ADVISING THE ORGANIZATION REGARDING INTERESTS TO BE DISCLOSED. TRUSTEES ARE ASKED AT THAT MEETING TO COMPLETE THE DISCLOSURE FORM AND RETURN IT TO THE ADMINISTRATOR. THE FORM IS COMPLETED BY EACH OF THE BOARD OF TRUSTEES AND ANY SENIOR STAFF OF WILSON-MCSHANE CORPORATION WORKING ON THE UCCWCF. 2. THE FUND ADMINISTRATOR REVIEWS THE CONFLICT DISCLOSURES WHEN RETURNED, AND REFERS ANY WITH CONFLICTS FOR FURTHER REVIEW. 3. ANY CONFLICTS THAT ARE DISCLOSED ARE REVIEWED BY THE FUND CO-CHAIRS IN CONJUNCTION WITH FUND COUNSEL. ANY TRUSTEE THAT HAS DISCLOSED A CONFLICT OF INTEREST WOULD BE PROHIBITED FROM PARTICIPATING IN ANY DISCUSSION OR VOTING ON ANY MOTION REGARDING THE MATTER THAT GAVE RISE TO THE CONFLICT OF INTEREST.
FORM 990, PART VI, SECTION C, LINE 19	THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY OR FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC.

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

UNION CONSTRUCTION CRAFTS WORKERS'
COMPENSATION FUND

Employer identification number

41-1835606

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)ASSOCIATED GENERAL CONTRACTORS OF MINNESOTA INC
(2)LOCAL NO 512 OF THE INTERNATIONAL ASSOCIATION OF BRIDGE AND STRUCTURAL IRON
(3)LOCAL NO 49 OF THE INTERNATIONAL UNION OF OPERATING ENGINEERS
(4)LAKES AND PLAINS REGIONAL COUNCIL OF CARPENTERS AND JOINERS
(5)MINNESOTA CONSTRUCTION CONFERENCE OF TEAMSTERS

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

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) 3D MECHANICAL INC
(2) A J LYSNE CONTRACTING CORPORATION
(3) AE CONRAD COMPANY
(4) AG O'BRIEN PLUMBING & HEATING CO
(5) AW KUETTEL & SONS INC
(6) ABLE FENCE INC
(7) ACE ELECTRICAL CONTRACTORS INC
(8) ACME TUCKPOINTING & RESTORATION CO
(9) ADOLFSON & PETERSON CONSTRUCTION
(10) ADVANCED MASONRY RESTORATION INC
(11) AESHLIMAN PLUMBING INC
(12) AID ELECTRIC CORPORATION
(13) AIR CONDITIONING ASSOCIATES INC
(14) ALBERS MECHANICAL CONTRACTORS INC
(15) ALDO INC
(16) ALLAN MECHANICAL INC
(17) ALLIANCE MECHANICAL SERVICES INC
(18) ALLTECH ENGINEERING CORP
(19) ALVIN E BENIKE INC
(20) AMERECT INC
(21) AMERICAN MASONRY RESTORATION CORP
(22) AMG ARCHITECTURAL GLASS AND GLAZING
(23) ANDERSON GLASS CO INC
(24) ARCHITECTURAL SALES OF MN
(25) ARMSTRONG CRANE AND RIGGING CORP
(26) ARNT CONSTRUCTION COMPANY INC
(27) ARROWHEAD CONCRETE WORKS INC
(28) ASSOCIATED MECHANICAL CONTRACTORS INC
(29) AXEL H OHMAN INC
(30) BALD EAGLE ERECTORS INC
(31) BCM CONSTRUCTION INC
(32) BECKER BROTHERS INC
(33) BELAIR SITEWORK SERVICES
(34) BERG DRYWALL LLC
(35) BERG PAINTING LLC
(36) BILLMAN CONSTRUCTION INC
(37) BINDER HEATING & AIR CONDITIONING INC
(38) BITUMINOUS ROADWAYS INC
(39) BLOOMINGTON ELECTRIC COMPANY
(40) BOILER SERVICES INC
(41) BOSTROM SHEET METAL WORKS INC
(42) BRAXTON & SONS INC
(43) BRAXTON HANCOCK & SONS INC
(44) BREDAHL PLUMBING INC
(45) BRIN NORTHWESTERN GLASS COMPANY
(46) BRITE LITE ELECTRIC CO INC
(47) BUDGET PLUMBING CORP
(48) BURSCHVILLE CONSTRUCTION
(49) CR FISCHER & SONS INC
(50) CW HOULE INC
(51) CAPITAL CITY GLASS INC
(52) CARCIOFINI COMPANY
(53) CARL E JOHNSON PLUMBING & HEATING
(54) CD TILE & STONE INC
(55) CENTRAIRE HEATING & AIR CONDITIONING INC
(56) CENTURY CONSTRUCTION CO INC
(57) CHAMPION STEEL INC
(58) CIVIL AG GROUP INC
(59) CLIMATE MAKERS INC
(60) CM CONSTRUCTION COMPANY INC
(61) COMMERCIAL DRYWALL INC
(62) COMMERCIAL FLOORING SERVICES LLC
(63) COMMERCIAL PLUMBING & HEATING
(64) COMMERCIAL REFRIGERATION SYSTEMS INC
(65) COMMERCIAL ROOFING INC
(66) CONSTRUCTION RESULTS CORPORATION
(67) CONTRACT TILE & CARPET LLC
(68) COOL AIR MECHANICAL INC
(69) CORPORATE MECHANICAL INC
(70) CRAWFORD MERZ LLC
(71) CROSSTOWN MASONRY INC
(72) CROSSTOWN MECHANICAL INC
(73) CURB MASTERS INC
(74) CUSTOM DRYWALL INC
(75) DJ KRANZ CO INC
(76) DANNY'S CONSTRUCTION CO INC
(77) DAYCO CONCRETE COMPANY INC
(78) DCOR TEC INC
(79) DEL'S CONSTRUCTION INC
(80) DIVISION V SHEET METAL INC
(81) DOBOSZENSKI & SONS INC
(82) DONALD R FRANTZ CONCRETE CONSTRUCTION
(83) DONLAR CONSTRUCTION COMPANY
(84) DRESEL CONTRACTING INC
(85) DULUTH READY MIX CONCRETE INC
(86) DZIEDZIC CAULKING INC
(87) E&J REBAR INC
(88) ELLIOTT CONTRACTING CORPORATION
(89) EMERALD BUILDERS INC
(90) ENEBAK CONSTRUCTION COMPANY
(91) ENERVATION INC (ENERGY CONSERVATION INC)
(92) ENGELSMA CONSTRUCTION INC
(93) ENGINEERED CONCRETE PLACER OF MN INC
(94) ENVIROBATE INC
(95) EVEREST STEEL INC
(96) FEHN COMPANIES INC
(97) FITOL HINTZ CONSTRUCTION INC
(98) FLANNERY CONSTRUCTION
(99) FORCED AIR INC DBA WENZEL HEAT & AC
(100) FOREST LAKE CONTRACTING INC
(101) FPD POWER DEVELOPMENT LLC
(102) FPI PAVING CONTRACTORS INC
(103) FRASER MORRIS ELECTRIC
(104) FRATTALONE COMPANIES INC
(105) FRERICHS CONSTRUCTION COMPANY
(106) GF JEDLICKI INC
(107) GL CONTRACTING INC
(108) GAGE BROTHERS CAULKING INC
(109) GAGNON INC
(110) GEISLINGER & SONS INC
(111) GEORGE SIEGFRIED CONSTRUCTION CO
(112) GEPHART ELECTRIC CO INC
(113) GILBERT MECHANICAL CONTRACTORS INC
(114) GRAHAM CONSTRUCTION SERVICES INC
(115) GRAZZINI BROTHERS AND COMPANY
(116) GREINER CONSTRUCTION INC
(117) GRESSER COMPANIES INC
(118) GUNNAR ELECTRIC INC
(119) HAMMERLUND CONSTRUCTION INC
(120) HARBOR CITY MASONRY INC
(121) HARDRIVES INC
(122) HARRIS MECHANICAL
(123) HARRISON TILE COMPANY
(124) HEYMANN CONSTRUCTION COMPANY INC
(125) HIGH FIVE ERECTORS II
(126) HOFFMAN CONCRETE INC
(127) HOLLENBACK & NELSON INC
(128) HOMECO INSULATION INC
(129) HOOVER CONSTRUCTION COMPANY
(130) HORWITZ INC
(131) HOVLAND INC
(132) IMPERIAL WALL INC
(133) INSULATION MIDWEST INC
(134) J BECHER & ASSOCIATES INC
(135) J&K BUILDERS INC
(136) J&K MASONRY INC
(137) JR JENSEN CONSTRUCTION CO
(138) JAMES STEELE CONSTRUCTION CO
(139) JOHNSON-NELSON MASONRY INC
(140) JOHNSON-WILSON CONSTRUCTORS INC
(141) JONES & OTTENWELLER INC
(142) JORGENSON CONSTRUCTION INC
(143) JULIUS B NELSON & SON INC
(144) K&H EXTERIORS INC
(145) K PEARSON MECHANICAL LLC
(146) KB SERVICE COMPANY
(147) KAS INVESTMENT COMPANY
(148) KELLEHER CONSTRUCTION INC
(149) KELLINGTON CONSTRUCTION INC
(150) KERN & TABERY INC
(151) KGM CONTRACTORS INC
(152) KIFFMEYER INC
(153) KILLMER ELECTRIC CO INC
(154) KLAMM MECHANICAL CONTRACTORS INC
(155) KMH ERECTORS INC
(156) KNUTSON CONSTRUCTION SERVICES INC
(157) KRAEMER CONSTRUCTION INC
(158) KRAUS ANDERSON COMPANIES INC
(159) KUECHLE UNDERGROUND INC
(160) KUNZ CONSTRUCTION CO
(161) KUSSKE CONSTRUCTION COMPANY INC
(162) LAKE AREA ROOFING AND CONSTRUCTION INC
(163) LAKEHEAD CONSTRUCTORS INC
(164) LAMETTI & SONS INC
(165) LANDMARK CONCRETE INC
(166) LATOUR CONSTRUCTION INC
(167) LBP MECHANICAL INC
(168) LEGACY COMPANIES
(169) LEGEND MECHANICAL INC
(170) LEGENDS CONCRETE INC
(171) LENCI ENTERPRISES INC
(172) LINCO FAB INC
(173) LINDSTROM ENVIRONMENTAL INC
(174) LLOYD'S CONSTRUCTION SERVICES INC
(175) LS BLACK CONSTRUCTORS INC
(176) MP JOHNSON CONSTRUCTION
(177) MAGNEY CONSTRUCTION INC
(178) MAJOR MECHANICAL INC
(179) MARATHON GROUP
(180) MARCY CONSTRUCTION COMPANY
(181) MASTER ELECTRIC COMPANY INC
(182) MASTER MECHANICAL INC
(183) MAVEN CONSTRUCTION LLC
(184) MAX GRAY CONSTRUCTION INC
(185) MAX STEININGER
(186) MAYER ELECTRIC CORPORATION
(187) MCNAMARA CONTRACTING INC
(188) MEDINA ELECTRIC INC
(189) MEISINGER CONSTRUCTION CO INC
(190) MERIT ELECTRIC COMPANY
(191) METRO SHEET METAL INC
(192) MEYER CONTRACTING INC
(193) MG MCGRATH INC
(194) MICS CONSTRUCTION SERVICES
(195) MID-CITY MECHANICAL CORP
(196) MIDWEST ASPHALT CORPORATION
(197) MIDWEST CONCRETE SPECIALTIES INC
(198) MINERAL SERVICE PLUS LLC
(199) MINGER CONSTRUCTION COMPANIES INC
(200) MINNEAPOLIS GLASS COMPANY
(201) MINNESOTA UTILITIES & EXCAVATING
(202) MINT ROOFING INC
(203) MODERN HEATING AND AIR CONDITIONING
(204) MORCON CONSTRUCTION INC
(205) MULCAHY NICKOLAUS LLC
(206) MURPHY RIGGING & ERECTING INC
(207) MUSKA ELECTRIC
(208) NAC MECHANICAL & ELECTRICAL SERVICES
(209) NASSEFF MECHANICAL CONTRACTORS
(210) NEW LOOK CONTRACTING INC
(211) NORTH COUNTRY CONCRETE INC
(212) NORTH PINE AGGREGATE INC
(213) NORTH VALLEY INC
(214) NORTHDALE CONSTRUCTION
(215) NORTHERN DEWATERING INC
(216) NORTHERN GLASS & GLAZING INC
(217) NORTHERN INDUSTRIAL ERECTORS
(218) NORTHLAND CONCRETE & MASONRY COMPANY LLC
(219) NORTHLAND GROUP OF CO - DULUTH INC
(220) NORTHLAND MECHANICAL CONTRACTORS
(221) NORTHWEST ASPHALT INC
(222) NORTHWEST SHEETMETAL CO OF ST PAUL INC
(223) OLYMPIATECH ELECTRICAL CONTRACTORS INC
(224) OLYMPIC COMPANIES INC
(225) OWENS COMPANIES INC
(226) PAAPE COMPANIES INC
(227) PAINTING BY NAKASONE
(228) PALMER-SODERBERG INC
(229) PARKOS CONSTRUCTION COMPANY INC
(230) PATRIOT ERECTORS INC
(231) PCI ROADS LLC
(232) PENN CONTRACTING INC
(233) PEOPLES ELECTRIC COMPANY INC
(234) PETERSON BROTHERS ROOFING & CONSTRUCTION
(235) PETERSON COMPANIES INC
(236) PETERSON SHEET METAL
(237) PHILLIPPI EQUIPMENT CO INC
(238) PINE BEND PAVING INC
(239) PINNACLE WALL SYSTEMS
(240) PLATINUM FLOORCOVERING
(241) PRAIRIE ELECTRIC COMPANY
(242) PREFERRED ELECTRIC INC
(243) PREMIER ELECTRICAL CORPORATION
(244) PREMIUM CARPET INSTALLATION INC
(245) PRESTIGE DRYWALL
(246) PRIOR LAKE AGGREGATES INC
(247) PRISM COMMERCIAL & INDUSTRIAL PAINTING
(248) PROGRESSIVE BUILDING SYSTEMS
(249) Q3 CONTRACTING INC
(250) QUALITY DRYWALL MIDWEST INC
(251) R&R EXCAVATING INC
(252) RW CARLSTROM CONSTRUCTION CO
(253) RACHEL CONTRACTING INC
(254) RADOTICH INC
(255) RAINBOW INC
(256) RAINVILLE-CARLSON INC
(257) RAMSEY EXCAVATING COMPANY INC
(258) RAY RIIHILUOMA INC
(259) REINER CONTRACTING INC
(260) RESTORATION SYSTEMS INC
(261) RICE LAKE CONSTRUCTION GROUP
(262) RIES ELECTRIC COMPANY
(263) RIESGRAF'S INSTALLATION CO INC
(264) ROBERT R SCHROEDER CONSTRUCTION INC
(265) ROCKET CRANE SERVICE INC
(266) RON KASSA CONSTRUCTION INC
(267) ROYL MASONRY
(268) RTL CONSTRUCTION INC
(269) RYAN COMPANIES US INC
(270) RYAN CONTRACTING CO
(271) S A JORDAN CONSTRUCTION INC
(272) SGO ROOFING & CONSTRUCTION LLC
(273) SM HENTGES & SONS INC
(274) SR WEIDEMA INC
(275) SCHADEGG MECHANICAL INC
(276) SCHAMMEL ELECTRIC INC
(277) SCHNEIDER COMPANY INC
(278) SCHURCON INC
(279) SEPPI BROTHERS CONCRETE PRODUCTS CORP
(280) SERICE CONSTRUCTION INC
(281) SHANK CONSTRUCTORS INC
(282) SHANNON'S INC
(283) SHAW-LUNDQUIST ASSOCIATES INC
(284) SHEET METAL CONNECTORS INC
(285) SILVER TREE PLUMBING & HEATING LLC
(286) SOLBERG AGGREGATE INC
(287) SOLID REFRIGERATION LLC
(288) SONUS INTERIORS INC
(289) SOUTHSIDE PLUMBING & HEATING
(290) SPRIGGS PLUMBING & HEATING INC
(291) ST GERMAIN'S CABINET INC
(292) ST PAUL LINOLEUM & CARPET
(293) STAPF CONCRETE CONSTRUCTION INC
(294) STEENBERG-WATRUD CONSTRUCTION LLC
(295) STEINHAGEN ENTERPRISES INC
(296) STEINKRAUS PLUMBING INC
(297) STERLING ELECTRIC CORPORATION
(298) STERN DRYWALL INC
(299) STONE CONSTRUCTION INC
(300) STRETAR MASONRY & CONCRETE INC
(301) STRUCTURES HARDSCAPES SPECIALISTS INC
(302) SUMMIT CONCRETE & MASONRY CONSTRUCTION
(303) SUNRAM CONSTRUCTION INC
(304) SUPERIOR PAINTING & DECORATING INC
(305) TA SCHIFSKY & SONS INC
(306) TARRAF CONSTRUCTION INC
(307) TARRAF ROLL OFF SERVICES INC
(308) TED KENNE CONSTRUCTION
(309) TEKTON CONSTRUCTION CO (STAHL)
(310) THE CAULKERS COMPANY INC
(311) THOMAS AND SONS CONSTRUCTION INC
(312) THOMAS FINN COMPANY
(313) THOR CONSTRUCTION INC
(314) TIMCO CONSTRUCTION INC
(315) TORRINI COMPANIES
(316) TOTAL MECHANICAL SERVICES INC
(317) TRADE ACCESS LLC
(318) TRI-CONSTRUCTION INC
(319) TWIN CITY GLASS CONTRACTORS INC
(320) TWIN CITY TILE AND MARBLE COMPANY
(321) UNITED GLASS INC
(322) UNITED REFRACTORIES INC
(323) UNITED STATES MECHANICAL INC
(324) VALLEY-RICH CO INC
(325) VCI ENVIRONMENTAL INC
(326) VEIT COMPANIES
(327) VIC'S CRANE & HEAVY HAUL INC
(328) VOGEL MECHANICAL INC
(329) WAGNER CONSTRUCTION INC
(330) WASCHE COMMERCIAL FINISHES INC
(331) WATSON-FORSBERG CO
(332) WEISE MASONRY INC
(333) WENZEL PLYMOUTH PLUMBING LLC
(334) WOODY'S REBAR CO INC
(335) WTG TERRAZZO & TILE INC
(336) YALE MECHANICAL
(337) ZINTL INC

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) ...................

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

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

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

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

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

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: TO PROVIDE A WORKER'S COMP. COLLECTIVELY-BARGAINED PROGRAM AUTHORIZED UNDER MINNESOTA STATUTES.
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	12
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	26
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) .........	1,008,436	1,175,469
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	243	193
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	155	562
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	1,008,834	1,176,224
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).....	0	0
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)....	1,009,067	1,147,364
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	1,009,067	1,147,364
19	Revenue less expenses. Subtract line 18 from line 12.......	-233	28,860
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	207,173	252,639
21	Total liabilities (Part X, line 26).............	34,537	51,143
22	Net assets or fund balances. Subtract line 21 from line 20.....	172,636	201,496

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )
	TO PROVIDE A WORKER'S COMPENSATION COLLECTIVELY-BARGAINED PROGRAM AUTHORIZED UNDER MINNESOTA STATUTES: TO PROVIDE ALTERNATIVE DISPUTE RESOLUTION RULES AND REGULATIONS WHICH WILL PROVIDE A METHOD OF RESOLVING CONTESTED WORKERS' COMPENSATION CASES WITHIN THE STATE OF MINNESOTA' TO IMPROVE THE SAFETY AND WELFARE OF WORKERS WHO ARE COVERED UNDER THE PROGRAM.

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
(18) STEVE PIPER........................................................................ LABOR TRUSTEE	1.00 .......................0.00	X	0	0	0
(19) BARRY DAVIES........................................................................ LABOR TRUSTEE	1.00 .......................0.00	X	0	0	0
(20) MICHAEL TUBBS........................................................................ MANAGEMENT TRUSTEE	1.00 .......................0.00	X	0	0	0
(21) TODD PUFAHL........................................................................ LABOR TRUSTEE	1.00 .......................0.00	X	0	0	0
(22) RON VON BANK........................................................................ MANAGEMENT TRUSTEE	1.00 .......................0.00	X	0	0	0
(23) SEAN CONRAD........................................................................ MANAGEMENT TRUSTEE	1.00 .......................0.00	X	0	0	0
(24) RYAN MIMS........................................................................ LABOR TRUSTEE	1.00 .......................0.00	X	0	0	0
(25) JOHN QUARNSTROM........................................................................ MANAGEMENT TRUSTEE	1.00 .......................0.00	X	0	0	0
(26) JAMIE HERMANSEN........................................................................ LABOR TRUSTEE	1.00 .......................0.00	X	0	0	0
(27) MARK HUBBARD........................................................................ MANAGEMENT TRUSTEE	1.00 .......................0.00	X	0	0	0

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

(A) Name and business address	(B) Description of services	(C) Compensation
WILSON - MCSHANE CORPORATION 3001 METRO DRIVE BLOOMINGTON,MN55425	PLAN ADMINISTRATOR	951,087




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 1

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	EMPLOYER CONTRIBUTIONS	900099	1,018,375	1,018,375
b	PHYSICIAN OPINIONS	900099	115,137	115,137
c	MEDIATION/ARBITRATION	900099	41,957	41,957
d
e
f	All other program service revenue.
g Total.Add lines 2a–2f.....			1,175,469

3 Investment income (including dividends, interest, and othersimilar amounts) ..........			193			193
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	LIQUIDATED DAMAGES		900099	562			562
b
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......			562
12	Total revenue. See Instructions......			1,176,224	1,175,469	0	755

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
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 ......	951,087
b	Legal .........	8,112
c	Accounting ...........	8,950
d	Lobbying ...........
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)
12	Advertising and promotion ....
13	Office expenses .......	8,384
14	Information technology ......
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 ....	789
20	Interest ...........
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	2,799
23	Insurance ...	7,796
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	DISPUTE RESOLUTION EXAM	112,808
b	MEDIATION & ARBITRATION	40,642
c	EXCLUSIVE PROVIDER FEE	3,700
d	OTHER EXPENSE	2,297
e	All other expenses
25	Total functional expenses. Add lines 1 through 24e	1,147,364
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 ........				1
2	Savings and temporary cash investments .........			171,615	2	216,872
3	Pledges and grants receivable, net ......				3
4	Accounts receivable, net .............			28,307	4	31,831
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 ....				7
8	Inventories for sale or use ........				8
9	Prepaid expenses and deferred charges ......			1,885	9	1,369
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	22,918
b	Less: accumulated depreciation	10b	20,351	5,366	10c	2,567
11	Investments—publicly traded securities .				11
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 ...........				15
16	Total assets. Add lines 1 through 15 (must equal line 34)...			207,173	16	252,639

17	Accounts payable and accrued expenses .....	16,230	17	19,985
18	Grants payable ...		18
19	Deferred revenue .........	18,307	19	31,158
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..	34,537	26	51,143

	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 .....	172,636	30	201,496
31	Paid-in or capital surplus, or land, building or equipment fund ...	0	31	0
32	Retained earnings, endowment, accumulated income, or other funds	0	32	0
33	Total net assets or fund balances ...........	172,636	33	201,496
34	Total liabilities and net assets/fund balances ........	207,173	34	252,639