Form990
Click to see attachment
Department of the TreasuryInternal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations)
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OMB No. 1545-0047
2019
Open to Public Inspection
A For the 2019 calendar year, or tax year beginning 01-01-2019 , and ending 12-31-2019
BCheck if applicable:
CName of organization
KENTUCKY LABORERS DISTRICT COUNCIL
HEALTH & WELFARE FUND
 
Doing business as
 
 
Number and street (or P.O. box if mail is not delivered to street address)
1996 BY-PASS SOUTH
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
LAWRENCEBURG, KY40342
D Employer identification number

23-7017526
E Telephone number

G Gross receipts $ 59,124,737
F Name and address of principal officer:
MARK ISAACS
1996 BY-PASS SOUTH
LAWRENCEBURG,KY40342
I
Tax-exempt status: ( 9 ) LeftBullet (insert no.) or
J
Website:MediumBullet
N/A
H(a)
Is this a group return for
subordinates?
H(b)
Are all subordinates
included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet  
K Form of organization:  
L Year of formation: 1967
M State of legal domicile: KY
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: EMPLOYEE BENEFIT PLAN PROVIDING ACCIDENT, SICKNESS, VISION, DENTAL, DEATH AND ACCIDENTAL DEATH & DISMEMBERMENT BENEFITS FOR ACTIVE PARTICIPANTS AND ACCIDENT, SICKNESS, VISION, DENTAL AND DEATH BENEFITS FOR RETIRED PARTICIPANTS.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 9
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 9
5 Total number of individuals employed in calendar year 2019 (Part V, line 2a) ...... 5 9
6 Total number of volunteers (estimate if necessary) ............. 6 9
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 39 ......... 7b 0
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 0 0
9 Program service revenue (Part VIII, line 2g) ......... 21,612,700 23,135,360
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 1,156,264 2,939,259
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 54,188 61,349
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12) 22,823,152 26,135,968
Expenses; 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)..... 22,386,944 19,659,836
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 943,680 994,150
16a Professional fundraising fees (Part IX, column (A), line 11e) ..... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet0    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 1,228,476 1,130,986
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 24,559,100 21,784,972
19 Revenue less expenses. Subtract line 18 from line 12....... -1,735,948 4,350,996
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 23,016,317 25,441,958
21 Total liabilities (Part X, line 26)............. 1,029,134 554,884
22 Net assets or fund balances. Subtract line 21 from line 20..... 21,987,183 24,887,074
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
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Type or print name and title
Paid Preparer Use Only
Print/Type preparer's name
Preparer's signature
Date
PTIN
Firm's name MediumBullet

Firm's EIN MediumBullet
Firm's address MediumBullet



Phone no.
May the IRS discuss this return with the preparer shown above? (see instructions) ..........
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y Form 990 (2019)
Form 990 (2019)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response or note to any line in this Part III..............
1
Briefly describe the organization’s mission: EMPLOYEE BENEFIT PLAN PROVIDING ACCIDENT, SICKNESS, VISION, DENTAL, DEATH AND ACCIDENTAL DEATH & DISMEMBERMENT BENEFITS FOR ACTIVE PARTICIPANTS AND ACCIDENT, SICKNESS, VISION, DENTAL AND DEATH BENEFITS FOR RETIRED PARTICIPANTS.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? .....................
If "Yes," describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program
services? ...........................
If "Yes," describe these changes on Schedule O.
4
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
EMPLOYEE BENEFIT PLAN PROVIDING ACCIDENT, SICKNESS, VISION, DENTAL, DEATH AND ACCIDENTAL DEATH & DISMEMBERMENT BENEFITS FOR ACTIVE PARTICIPANTS AND ACCIDENT, SICKNESS, VISION, DENTAL AND DEATH BENEFITS FOR RETIRED 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 expensesMediumBullet  
Form 990 (2019)
Form 990 (2019)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If "Yes," complete Schedule A.....................
1
 
No
2
Is the organization required to complete Schedule B, Schedule of Contributors (see instructions)? ...
2
 
No
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If "Yes," complete Schedule C, Part I.............
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If "Yes," complete Schedule C, Part II.........
4
 
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If "Yes," complete Schedule C, Part III..
5
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If "Yes," complete Schedule D, Part IClick to see attachment.........................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures? If "Yes," complete Schedule D, Part IIClick to see attachment....
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If "Yes,"
complete Schedule D, Part IIIClick to see attachment..............
8
 
No
9
Did the organization report an amount in Part X, line 21 for escrow or custodial account liability; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If "Yes," complete Schedule D, Part IVClick to see attachment..............
9
 
No
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi endowments? If "Yes," complete Schedule D, Part V......
10
 
No
11
If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable.
a
Did the organization report an amount for land, buildings, and equipment in Part X, line 10? If "Yes," complete
Schedule D, Part VI. Click to see attachment...................
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIClick to see attachment.......
11b
 
No
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIIClick to see attachment.......
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part IXClick to see attachment............
11d
 
No
e
Did the organization report an amount for other liabilities in Part X, line 25? If "Yes," complete Schedule D, Part XClick to see attachment
11e
 
No
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If "Yes," complete Schedule D, Part XClick to see attachment
11f
Yes
 
12a
Did the organization obtain separate, independent audited financial statements for the tax year? If "Yes," complete
Schedule D, Parts XI and XIIClick to see attachment......................
12a
Yes
 
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If "Yes," and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional Click to see attachment
12b
 
No
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States? .....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If "Yes," complete Schedule F, Parts I and IV.........
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any foreign organization? If “Yes,” complete Schedule F, Parts II and IV.....
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to or for foreign individuals? If “Yes,” complete Schedule F, Parts III and IV...
16
 
No
17
Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If "Yes," complete Schedule G, Part I(see instructions) ....
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If "Yes," complete Schedule G, Part II............
18
 
No
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If "Yes," complete Schedule G, Part III...................
19
 
No
20a
Did the organization operate one or more hospital facilities? If "Yes," complete Schedule H....
20a
 
No
b
If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return?
20b
 
 
21
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or domestic government on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II.....
21
 
No
Form 990 (2019)
Form 990 (2019)
Page 4
Part IV
Checklist of Required Schedules (continued)
Yes
No
22
Did the organization report more than $5,000 of grants or other assistance to or for domestic individuals on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III........
22
 
No
23
Did the organization answer "Yes" to Part VII, Section A, line 3, 4, or 5 about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If "Yes," complete Schedule J.......................
23
 
No
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer lines 24b through 24d and complete Schedule K. If “No,” go to line 25a...............
24a
 
No
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
 
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds? ...............
24c
 
 
d
Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year?...
24d
 
 
25a
Section 501(c)(3), 501(c)(4), and 501(c)(29) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If "Yes," complete Schedule L, Part I ....
25a
 
 
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If "Yes," complete Schedule L, Part I.......................
25b
 
 
26
Did the organization report any amount on Part X, line 5 or 22 for receivables from or payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons? If "Yes," complete Schedule L, Part II...........
26
 
No
27
Did the organization provide a grant or other assistance to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or employee thereof, a grant selection committee member, or to a 35% controlled entity (including an employee thereof) or family member of any of these persons?
If "Yes," complete
Schedule L, Part III.........................
27
 
No
28
Was the organization a party to a business transaction with one of the following parties (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, key employee, creator or founder, or substantial contributor? If "Yes," complete Schedule L, Part IV......................
28a
 
No
b
A family member of any individual described in line 28a? If "Yes," complete Schedule L, Part IV.....
28b
 
No
c
A 35% controlled entity of one or more individuals and/or organizations described in lines 28a or 28b? If "Yes," complete Schedule L, Part IV.....................
28c
 
No
29
Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M..
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If "Yes," complete Schedule M .................
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If "Yes," complete Schedule N, Part I
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If "Yes," complete Schedule N, Part II........................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If "Yes," complete Schedule R, Part I............Click to see attachment
33
 
No
34
Was the organization related to any tax-exempt or taxable entity? If "Yes," complete Schedule R, Part II, III, or IV, and Part V, line 1.........................Click to see attachment
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
 
No
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If "Yes," complete Schedule R, Part V, line 2 ...
35b
 
 
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If "Yes," complete Schedule R, Part V, line 2.............
36
 
 
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If "Yes," complete Schedule R, Part VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response or note to any line in this Part V...........
Yes
No
1a
Enter the number reported in Box 3 of Form 1096. Enter -0- if not applicable ..
1a
714
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable .
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
Form 990 (2019)
Form 990 (2019)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance (continued)
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and
Tax Statements, filed for the calendar year ending with or within the year covered by this return ..................
2a
9
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?...
3a
 
No
b
If “Yes,” has it filed a Form 990-T for this year? If “No” to line 3b, provide an explanation in Schedule O...
3b
 
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)? ..
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR).
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year? ..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If "Yes," to line 5a or 5b, did the organization file Form 8886-T? ............
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions? ...
6a
 
No
b
If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible? ......................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor? ....................
7a
 
 
b
If "Yes," did the organization notify the donor of the value of the goods or services provided? .....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282? .........................
7c
 
 
d
If "Yes," indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?
7e
 
 
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ..
7f
 
 
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required? ......................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C? ..........................
7h
 
 
8
Sponsoring organizations maintaining donor advised funds. Did a donor advised fund maintained by the sponsoring organization have excess business holdings at any time during the year? ........
8
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
Did the sponsoring organization make any taxable distributions under section 4966?........
9a
 
 
b
Did the sponsoring organization make a distribution to a donor, donor advisor, or related person?...
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ..........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If "Yes," enter the amount of tax-exempt interest received or accrued during the year.
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state? .........
Note. See the instructions for additional information the organization must report on Schedule O.
13a
 
 
b
Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans ....
13b
 
c
Enter the amount of reserves on hand ............
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
No
b
If "Yes," has it filed a Form 720 to report these payments? If "No," provide an explanation in Schedule O..
14b
 
 
15
Is the organization subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or excess parachute payment(s) during the year? ....................
If "Yes," see instructions and file Form 4720, Schedule N.
15
 
No
16
Is the organization an educational institution subject to the section 4968 excise tax on net investment income? ..
If "Yes," complete Form 4720, Schedule O.
16
 
No
Form 990 (2019)
Form 990 (2019)
Page 6
Part VI
Governance, Management, and Disclosure For each "Yes" response to lines 2 through 7b below, and for a "No" response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response or note to any line in this Part VI..............
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year
1a
9
If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
b
Enter the number of voting members included in line 1a, above, who are independent
1b
9
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
 
No
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? .
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
 
No
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................
7a
 
No
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................
7b
 
No
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .......................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If "Yes," provide the names and addresses in Schedule O.......
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If "Yes," did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?
10b
 
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? ............................
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review this Form 990. .....
12a
Did the organization have a written conflict of interest policy? If "No," go to line 13.......
12a
Yes
 
b
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If "Yes," describe in Schedule O how this was done...................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
 
No
b
Other officers or key employees of the organization ................
15b
 
No
If "Yes" to line 15a or 15b, describe the process in Schedule O (see instructions).
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
 
No
b
If "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
 
 
Section C. Disclosure
17
List the states with which a copy of this Form 990 is required to be filedMediumBullet
18
Section 6104 requires an organization to make its Form 1023 (or 1024-A if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how) the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, address, and telephone number of the person who possesses the organization's books and records:
MediumBulletD CROUCH FUND ADMINISTRATORS GRIFFIETH FUND ASSISTANT1996 BY-PASS SOUTH   LAWRENCEBURG,KY40342 (502) 839-8166
Form 990 (2019)
Form 990 (2019)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response or note to any line in this Part VII..............
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See instructions for definition of "key employee."
RoundBullet List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the
organization and any related organizations.

RoundBullet List all of the organization’s former officers, key employees, or highest compensated employees who received more than $100,000
of reportable compensation from the organization and any related organizations.

RoundBullet List all of the organization’s former directors or trustees that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.

See instructions for the order in which to list the persons above.
Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.
(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
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(1) MARK ISAACS......................................................................
CHAIRMAN
 1.00
.................
  		X   X       0 0 0
(2) DOUG HACKER......................................................................
SECRETARY/TREASURER
 1.00
.................
  		X   X       0 0 0
(3) PERRY BLADES......................................................................
TRUSTEE
 1.00
.................
  		X           0 0 0
(4) DONALD TRAVIS......................................................................
TRUSTEE
 1.00
.................
  		X           0 0 0
(5) JEFF STORY......................................................................
TRUSTEE
 1.00
.................
  		X           0 0 0
(6) ANTHONY WICKLINE......................................................................
TRUSTEE
 1.00
.................
  		X           0 0 0
(7) LARRY HENDERSON......................................................................
TRUSTEE
 1.00
.................
  		X           0 0 0
(8) DWAYNE MCCAULEY......................................................................
TRUSTEE
 1.00
.................
  		X           0 0 0
(9) JEREMY JENKINS ALTERNATE......................................................................
TRUSTEE (ALTERNATE)
 1.00
.................
  		X           0 0 0
















Form 990 (2019)
Form 990 (2019)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(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
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;


























1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)...........MediumBullet 0 0 0
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organization MediumBullet0
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If "Yes," complete Schedule J for such individual ..............
3
 
No
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If "Yes," complete Schedule J for such
individual...........................
4
 
No
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If "Yes," complete Schedule J for such person ........
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address 		(B)
Description of services 		(C)
Compensation
CIGNA

PO BOX 644546
PITTSBURGH,PA152644546 		REPRICING OF CLAIMS, PRE-CERTIFICATION 391,040
BENESYS

700 TOWER DR SUITE 300
TROY,MI48098 		CONSULTING AND ELIGIBILITY AND CLAIMS PR 156,799
CIGN HEALTH & LIFE INS CO

2 CROSSROADS DRIVE
BEDMINSTER,NJ07921 		REPRICING OF NON-PPO CLAIMS 141,474
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet3
Form 990 (2019)
Form 990 (2019)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII.............
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512 - 514
Contributions, Gifts, GrantAmt and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues..1b  
c Fundraising events..1c  
d Related organizations1d  
e Government grants (contributions)1e  
f All other contributions, gifts, grants, and similar amounts not included above1f  
g Noncash contributions included in lines 1a - 1f:$ 1g  
h Total. Add lines 1a-1f.......MediumBullet  
Program Service RevenueAmt Business Code
2a EMPLOYER CONTRIBUTIONS 900099 21,754,528 21,754,528    
b EMPLOYEE CONTRIBUTIONS 900099 1,380,832 1,380,832    
c
d
e
f All other program service revenue.        
g Total. Add lines 2a–2f .....MediumBullet 23,135,360
OtherAmtRevenueAmt 3 Investment income (including dividends, interest, and othersimilar amounts) ......MediumBullet 720,128     720,128
4 Income from investment of tax-exempt bond proceedsMediumBullet        
5 Royalties...........MediumBullet        
(ii) Personal (i) Real
6a Gross rents     6a
b Less: rental expenses     6b
c Rental income or (loss)     6c
d Net rental income or (loss).......MediumBullet        
(ii) Other (i) Securities
7a Gross amount from sales of assets other than inventory   35,207,900 7a
b Less: cost or other basis and sales expenses   32,988,769 7b
c Gain or (loss)   2,219,131 7c
d Net gain or (loss).........MediumBullet 2,219,131     2,219,131
8a Gross income from fundraising events (not including $   of contributions reported on line 1c). See Part IV, line 18 ....
8a  
b Less: direct expenses ... 8b  
c Net income or (loss) from fundraising events..MediumBullet      
9a Gross income from gaming activities.
See Part IV, line 19 ...
9a  
b Less: direct expenses ... 9b  
c Net income or (loss) from gaming activities..MediumBullet        
10a Gross sales of inventory, less
returns and allowances ..
10a  
b Less: cost of goods sold .. 10b  
c Net income or (loss) from sales of inventory..MediumBullet        
Business Code Miscellaneous Revenue
11a CONTRIBUTION RECORDS F 900099 61,349 61,349    
b            
c            
d All other revenue ....        
e Total. Add lines 11a–11d ...... MediumBullet 61,349
12 Total revenue. See instructions.....MediumBullet 26,135,968 23,196,709 0 2,939,259
Form 990 (2019)
Form 990 (2019)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).Check if Schedule O contains a response or note to any line in this Part IX..............
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII. 		(A)
Total expenses 		(B)
Program service expenses 		(C)
Management and general expenses 		(D)
Fundraising
expenses
1 Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....    
2 Grants and other assistance to domestic individuals. See Part IV, line 22 ...........    
3 Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............    
4 Benefits paid to or for members ....... 19,659,836  
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........ 590,384      
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 212,285      
9 Other employee benefits ....... 145,045      
10 Payroll taxes ........... 46,436      
11 Fees for services (non-employees):        
a Management ...... 72,959      
b Legal ......... 66,130      
c Accounting ........... 37,923      
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) 579,593      
12 Advertising and promotion ....        
13 Office expenses ....... 110,467      
14 Information technology ...... 135,255      
15 Royalties ..        
16 Occupancy ........... 40,889      
17 Travel ............ 305      
18 Payments of travel or entertainment expenses for any federal, state, or local public officials .        
19 Conferences, conventions, and meetings .... 10,879      
20 Interest ...........        
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization .. 7,978      
23 Insurance ... 13,938      
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 INTERNATIONAL FOUNDATIO 29,429      
b EMPLOYEE ASSISTANCE PLA 14,236      
c PCORI TAX 7,306      
d MAINTENANCE & SERVICE C 2,803      
e All other expenses 896      
25 Total functional expenses. Add lines 1 through 24e 21,784,972      
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 MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2019)
Form 990 (2019)
Page 11
Part X
Balance Sheet
Check if Schedule O contains a response or note to any line in this Part IX..............
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash–non-interest-bearing ........ 192,455 1 298,955
2 Savings and temporary cash investments .........   2  
3 Pledges and grants receivable, net ......   3  
4 Accounts receivable, net ............. 2,296,287 4 2,285,544
5 Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
  5  
6 Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
  6  
7 Notes and loans receivable, net ...........   7  
8 Inventories for sale or use ............   8  
9 Prepaid expenses and deferred charges ...... 37,538 9 35,642
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 129,171
b Less: accumulated depreciation 10b 102,679 9,936 10c 26,492
11 Investments—publicly traded securities . 20,480,101 11 22,795,325
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 33)... 23,016,317 16 25,441,958
Liabilities 17 Accounts payable and accrued expenses ..... 1,029,134 17 554,884
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 any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
  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.. 1,029,134 26 554,884
Net Assets or Fund Balance Organizations that follow FASB ASC 958, check here MediumBullet and complete lines 27, 28, 32, and 33.
27 Net assets without donor restrictions ..........   27  
28 Net assets with donor restrictions ...........   28  
Organizations that do not follow FASB ASC 958, check here MediumBullet and complete lines 29 through 33.
29 Capital stock or trust principal, or current funds ..... 21,987,183 29 24,887,074
30 Paid-in or capital surplus, or land, building or equipment fund ... 0 30 0
31 Retained earnings, endowment, accumulated income, or other funds 0 31 0
32 Total net assets or fund balances ........... 21,987,183 32 24,887,074
33 Total liabilities and net assets/fund balances ........ 23,016,317 33 25,441,958
Form 990 (2019)
Form 990 (2019)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response or note to any line in this Part XI..............
1
Total revenue (must equal Part VIII, column (A), line 12) ............
1
26,135,968
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
21,784,972
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
4,350,996
4
Net assets or fund balances at beginning of year (must equal Part X, line 32, column (A)) ..
4
21,987,183
5
Net unrealized gains (losses) on investments ...............
5
-1,451,105
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
 
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
0
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 32, column (B))
10
24,887,074
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response or note to any line in this Part XII.............
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?
2a
 
No
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:
b
Were the organization’s financial statements audited by an independent accountant?
2b
Yes
 
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:
c
If "Yes," to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
2c
Yes
 
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133?
3a
 
No
b
If "Yes," did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits.
3b
 
 
Form 990 (2019)
Form 990 (2019)
Additional Data


Software ID:  
Software Version:  
Form 990, Special Condition Description:
Special Condition Description
SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet 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.
SchDMd Bullet Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2019
Open to Public Inspection
Name of the organization
KENTUCKY LABORERS DISTRICT COUNCIL
HEALTH & WELFARE FUND
Employer identification number

23-7017526
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 ........    
5
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? ............
6
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? ...................................
Part II
Conservation Easements.
Complete if the organization answered "Yes" on Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
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.
Held at the End of the 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 7/25/06, and not on a historic structure listed in the National Register ... 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............
6
Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet $  
8
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)? .............................
9
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.
1a
If the organization elected, as permitted under FASB 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.
b
If the organization elected, as permitted under FASB 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 $  
2
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 FASB ASC 958 relating to these items:
a
Revenue included on Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
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) 2019

Schedule D (Form 990) 2019
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
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):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.
5
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?...
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.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
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  
2a
Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...
b
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 ......          
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet  
b
Permanent endowment SchDMd Bullet  
c
Term endowment SchDMd Bullet  
The percentages on lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) Unrelated organizations .................
3a(i)
 
 
(ii) Related organizations .................
3a(ii)
 
 
b
If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
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   28,610 28,610 0
d Equipment ....   100,561 74,069 26,492
e Other .....        
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..SchDMdBullet 26,492
Schedule D (Form 990) 2019

Schedule D (Form 990) 2019
Page 3
Part VII
Investments—Other 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
(B)
(C)
(D)
(E)
(F)
(G)
(H)
(I)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet  
Part VIII
Investments—Program 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
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)Small Bullet  
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
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet  
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.)Small Bullet  
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) 2019

Schedule D (Form 990) 2019
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 24,684,863
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains (losses) on investments .... 2a -1,451,105
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 -1,451,105
3 Subtract line 2e from line 1.................. 3 26,135,968
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 26,135,968
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 21,784,972
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 21,784,972
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  
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 21,784,972
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 UNDER THE PLAN TO HOLD THE PLAN'S ASSETS IS INTENDED TO QUALIFY PURSUANT TO SECTION 501(C)(9) OF THE INTERNAL REVENUE CODE ("IRC"), AND, ACCORDINGLY, THE TRUST'S NET INVESTMENT INCOME IS EXEMPT FROM INCOME TAXES. THE TRUST HAS OBTAINED A FAVORABLE TAX DETERMINATION LETTER DATED MAY 14, 1969 FROM THE INTERNAL REVENUE SERVICE ("IRS"), AND THE PLAN ADMINISTRATOR AND THE PLAN'S TAX COUNSEL BELIEVE THAT THE TRUST, AS AMENDED, CONTINUES TO QUALIFY AND TO OPERATE IN ACCORDANCE WITH APPLICABLE PROVISIONS OF THE IRC. U.S. GAAP REQUIRES PLAN MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE PLAN AND RECOGNIZE A TAX LIABILITY (OR ASSET) IF THE ORGANIZATION HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE. THE PLAN ADMINISTRATOR HAS ANALYZED THE TAX POSITIONS TAKEN BY THE PLAN, AND HAS CONCLUDED THAT AS OF DECEMBER 31, 2018 AND 2017, THERE ARE NO UNCERTAIN TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY (OR ASSET) OR DISCLOSURE IN THE FINANCIAL STATEMENTS. THE PLAN IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS.
Schedule D (Form 990) 2019


Additional Data


Software ID:  
Software Version:  




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 Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2019
Open to Public
Inspection
Name of the organization
KENTUCKY LABORERS DISTRICT COUNCIL
HEALTH & WELFARE FUND
Employer identification number

23-7017526
Return Reference Explanation
FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED BY THE FUND AUDITOR. IT IS REVIEWED BY THE FUND ATTORNEY, FUND CONSULTANT AND FUND ADMINISTRATOR PRIOR TO PRESENTATION TO THE BOARD OF TRUSTEES. THE BOARD OF TRUSTEES THEN REVIEW THE FORM 990 BEFORE APPROVAL AND SIGNING. AFTER APPROVAL AND EXECUTION BY BOARD OF TRUSTEES, THE FORM 990 IS FILED. (IN THIS CASE, IT IS E-FILED BY THE FUND AUDITOR)
FORM 990, PART VI, SECTION B, LINE 12C EACH TRUSTEE OR EMPLOYEE OF THE FUND HAS THE DUTY TO DISCLOSE ANY ACTUAL OR POSSIBLE CONFLICT OF INTEREST. EACH TRUSTEE OR EMPLOYEE MUST DISCLOSE THE EXISTENCE OF THE FINANCIAL INTEREST AND BE GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS TO THE TRUSTEES DELEGATED POWERS CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT. AFTER DISCLOSURE OF THE FINANCIAL INTEREST AND ALL MATERIAL FACTS, AND AFTER ANY DISCUSSION WITH THE INTERESTED PERSON, THE BOARD OF TRUSTEES WILL DISCUSS AND VOTE TO DETERMINE IF A CONFLICT OF INTEREST EXISTS. IF A CONFLICT OF INTEREST IS DETERMINED TO EXIST, THE CHAIRPERSON OF THE BOARD OF TRUSTEES SHALL, IF APPROPRIATE, APPOINT A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT. THE BOARD OF TRUSTEES SHALL THEN DETERMINE WHETHER THE FUND CAN OBTAIN WITH REASONABLE EFFORTS A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT FROM A PERSON OR ENTITY THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST. IF A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT IS NOT REASONABLY POSSIBLE UNDER CIRCUMSTANCES NOT PRODUCING A CONFLICT OF INTEREST, THE BOARD OF TRUSTEES SHALL DETERMINE BY A MAJORITY VOTE OF THE DISINTERESTED TRUSTEES WHETHER THE TRANSACTION OR ARRANGEMENT IS IN THE FUND'S BEST INTEREST, FOR ITS OWN BENEFIT, AND WHETHER IT IS FAIR AND REASONABLE.
FORM 990, PART VI, SECTION B, LINE 15 IN DETERMINING WAGE INCREASES FOR FUND EMPLOYEES, THE TRUSTEES REVIEW THE CURRENT AND PROJECTED FINANCIAL STATUS OF THE FUND, INCLUDING CURRENT AND PROJECTED ADMINISTRATIVE COSTS, AND TAKE INTO CONSIDERATION THE WAGES FOR SIMILAR POSITIONS IN OTHER TAFT-HARTLEY TRUST FUNDS, PROJECTED COST OF LIVING TRENDS, AND EMPLOYEES' WORK HISTORIES AND JOB PERFORMANCES. THE TRUSTEES HAVE ALSO IMPLEMENTED A POLICY WHEREIN THE ADMINISTRATOR WILL PERFORM ANNUAL JOB PERFORMANCE REVIEWS FOR EACH FUND EMPLOYEE. THE FUND TRUSTEES DO NOT RECEIVE COMPENSATION OF ANY KIND. THERE IS NO CEO, EXECUTIVE DIRECTOR OR TOP MANAGEMENT OFFICIAL OF THIS FUND.
FORM 990, PART VI, SECTION C, LINE 19 THEY ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2019


Additional Data


Software ID:  
Software Version:  
SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBulletAttach to Form 990.
MediumBullet Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047
2019
Open to Public Inspection
Name of the organization
KENTUCKY LABORERS DISTRICT COUNCIL
HEALTH & WELFARE FUND
Employer identification number

23-7017526
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?
Yes No












For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2019
Schedule R (Form 990) 2019
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



 		(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(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?



 		(k)
Percentage
ownership
Yes No 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
 		(h)
Percentage
ownership
 		(i)
Section 512(b)(13) controlled entity?
Yes No
(1) A1 INDUSTRIAL INC

2861 BARDSTOWN RD
LAWRENCEBURG,KY40342
14-1952494 		     
          No
(2) ABATEMENT & ENVIR0NMENTAL SER

DBA AES LLC SPECIALTY 1441 HUGH AVE
LOUISVILLE,KY40213
61-1384615 		     
          No
(3) ABEL CONSTRUCTION CO INC

3401 BASHFORD AVE CT
LOUISVILLE,KY40218
61-0674234 		     
          No
(4) ACE PIPELINE

189 CARRIER WAY SUITE 2
SCOTT DEPOT,WV25560
45-4834309 		     
          No
(5) ACMS GROUP INC

10769 BROADWAY 333
CROWN POINT,IN46307
35-1959011 		     
          No
(6) AMERICAN CONTRACTING & SERVICE

6200 E HWY 62 BLDG 2503
JEFFERSONVILLE,IN47130
35-1618530 		     
          No
(7) AMERICAN DEMOLITION

305 RAMONA AVE
ELGIN,IL60120
39-1658166 		     
          No
(8) APACHE INDUSTRIAL UNITED

11171 VIRGINIA STREET
CROWN POINT,IN46307
36-4814424 		     
          No
(9) APCOMPOWER INC

175 ADDISON RD A1N2
WINDSOR,CT06095
06-1310571 		     
          No
(10) APEX PIPELINE SERVICES INC

P O BOX 580
NITRO,WV25143
20-4082705 		     
          No
(11) API CONTRACTORS

2950 LITTLE CYPRESS ROAD
CALVERT CITY,KY42029
61-0716199 		     
          No
(12) ARC CONSTRUCTION CO INC

PO BOX 2660
EVANSVILLE,IN47728
35-1164830 		     
          No
(13) ARISTEO CONSTRUCTION CO

12811 FARMINGTON ROAD
LIVONIA,MI48150
38-2168471 		     
          No
(14) ASSOC PIPE LINE CONT INC

3535 BRIAR3535 BRIARPARK STE 135 PO
HOUSTON,TX77042
74-1250343 		     
          No
(15) B&N CLEARING AND ENVIRONMENTAL

438 E MILLSAP RD STE 102
FAYETTEVILLE,AR72703
26-1131284 		     
          No
(16) BADGETT CONSTRUCTION LLC

217 EAST BURNETT AVE
LOUISVILLE,KY40208
61-1276211 		     
          No
(17) BAKER CONCRETE CONSTRUCTION IN

900 NORTH GARVER RD
MONROE,OH45050
31-0817881 		     
          No
(18) BASS MAINTENANCE CORP

PO BOX 98
WICKLIFFE,KY42087
61-1085308 		     
          No
(19) BERGER INC

P O BOX 16250
LOUISVILLE,KY402560250
61-0657134 		     
          No
(20) BERKEL & COMPANY CONTR INC

PO BOX 335
BONNER SPRING,KS66012
48-0650969 		     
          No
(21) BLUE FLAME PIPELINE

464 STRAIGHT UP RD
WEST UNION,WV26456
46-2140252 		     
          No
(22) BOBBY LUTTRELL & SONS LLC

190 BANK CIRCLE DR
DUNDEE,KY42338
61-1383224 		     
          No
(23) BORAL RESOURCES

7900 METROPOLIS LAKE RD
WEST PADUCAH,KY42086
81-2150627 		     
          No
(24) BOWEN ENGINEERING CORP

8802 N MERIDIAN ST SUITE 100
INDIANAPOLIS,IN46260
35-1136995 		     
          No
(25) BRAND ENERGY SERVICES LLC

17315 ASHLAND AVE
EAST HAZEL CREST,IL60429
13-3909680 		     
          No
(26) BRANDENBURG INDUSTRIAL SERVICE

501 W LAKE ST STE 104
ELMHURST,IL601261419
36-3353196 		     
          No
(27) BRANDSAFWAY SERVICES LLC

9536 GLADES DR
HAMILTON,OH45011
34-1761339 		     
          No
(28) BRAY CONCRETE LLC

941 BRIER FIELDS LN
CLOVERPORT,KY40111
82-5528481 		     
          No
(29) BUILDING LABORERS LOCAL 310

BENEFITS FUNDS 3250 EUCLID AVE ROOM
CLEVELAND,OH441152520
34-1217340 		     
          No
(30) BUNN ENTERPRISES INC

13589 STATE ROUTE 550
FLEMING,OH45729
31-1456458 		     
          No
(31) C J MAHAN CONSTRUCTION

250 NORTH HARTFORD AVE
COLUMBUS,OH43222
72-1576467 		     
          No
(32) CARDINAL INDUSTRIAL INSULATION

1300 WEST MAIN ST
LOUISVILLE,KY40203
61-0154975 		     
          No
(33) CESA CONTRACTORS INC

PO BOX 525
CALVERT CITY,KY420290525
61-0673737 		     
          No
(34) CHRISTY INDUSTRIAL SERVICES

4641 MCREE AVENUE
ST LOUIS,MO63110
59-3774717 		     
          No
(35) CLARK NICKLES INC

1501 TUNNEL MILL RD
CHARLESTOWN,IN47111
35-1366374 		     
          No
(36) CLAYS PERFORMANCE CONSTR LLC

2022 BEAR CREEK
WEST HAMLIN,WV25571
47-2331636 		     
          No
(37) CONCRETE PLUS LLC

P O BOX 330
MT STERLING,KY40353
05-0568199 		     
          No
(38) CONGLETON HACKER COMPANY

PO BOX 22640
LEXINGTON,KY405222640
61-0592669 		     
          No
(39) CONTINENTAL PIPELINE SERVICES

301 N MASON STREET
CARROLLTON,MO64633
37-1272978 		     
          No
(40) CONTRACTORS RENTAL CORP

PO BOX 7305
HUNTINGTON,WV25776
55-0624135 		     
          No
(41) DANCO CONSTRUCTION INC

3201 INTERSTATE DR
EVANSVILLE,IN47715
35-1552239 		     
          No
(42) DEBRA-KUEMPEL INC

3976 SOUTHERN AVE
CINCINNATI,OH45227
31-1615931 		     
          No
(43) DECORATIVE PAVING OF INDIANA

3859 CARSON AVE
INDIANAPOLIS,IN46227
11-3825952 		     
          No
(44) DIXIE PAVERS INC

P O BOX 25250
NASHVILLE,TN372025250
61-0563555 		     
          No
(45) DK CONSTRUCTION CO INC

P O BOX 388 5165 GILBERTSVILLE HWY
CALVERT CITY,KY42029
46-1625389 		     
          No
(46) DURR SYSTEMS

26801 NORTHWESTERN HWY
SOUTHFIELD,MI48170
38-1961423 		     
          No
(47) E&B PAVING INC

8032 N STATE ROAD 9
GREENFIELD,IN46140
35-1139301 		     
          No
(48) EARLY CONSTRUCTION COMPANY

P O BOX 7966
HUNTINGTON,WV25779
55-0620961 		     
          No
(49) EARTH IMAGES INC

5868 STILLER ROAD PO BOX 216
FLOYD KNOBS,IN47119
35-1990156 		     
          No
(50) EAST COAST METAL SYS INC

625 DISTRIBUTION RD
TRIADELPHIA,WV26059
55-0702472 		     
          No
(51) EATON CONSTRUCTION CO

PO BOX 684
CIRCLEVILLE,OH43113
31-0882530 		     
          No
(52) ELITE ENVIRONMENTAL SERVICES

1200 N WILLOW RD 105
EVANSVILE,IN47711
35-2019819 		     
          No
(53) EMPIRE SOLUTIONS NA INC

2979 REMICO ST SW
GRANDVILLE,MI49418
20-3972233 		     
          No
(54) ENERFAB POWER & INDUSTRIAL INC

4430 CHICKERING AVE
CINCINNATI,OH45232
46-5227318 		     
          No
(55) F A WILHELM CONSTRUCTION CO

P O BOX 516 3914 PROSPECT STREET
INDIANAPOLIS,IN46206
35-2124363 		     
          No
(56) FISHER CONTRACTING COMPANY

3401 CONTRACTOR DR
MIDLAND,MI48642
38-1547520 		     
          No
(57) FORCE DRILLING LLC

PO BOX 174
MOUNT MORRIS,PA15349
20-2269621 		     
          No
(58) FRONTIER ENTERPRISES INC

4101 RALPH AVE
LOUISVILLE,KY40211
61-1175067 		     
          No
(59) G&A ENVIROMENTAL CONT LLC

76 SWIFT STREET EAST
MCEWEN,TN37101
81-2518934 		     
          No
(60) GALLAGHER-KAISER CORP

777 CHICAGO ROAD
TROY,MI48083
38-1396724 		     
          No
(61) GATEWAY CONCRETE FORMING

P O BOX 130
MIAMITOWN,OH45041
31-0958608 		     
          No
(62) GEIGER BROTHERS

P O BOX 469 317 RALPH STREET
JACKSON,OH45640
31-0733949 		     
          No
(63) GILLESPIE & POWERS

9550 TRUE DRIVE
ST LOUIS,MO631321580
43-0648117 		     
          No
(64) GLOBAL CONTAINMENT SOLUTIONS

405 EAST FOREST ST
OCONOMOWOC,WI53066
46-0728365 		     
          No
(65) GLOBAL SCAFFOLD CNSTR SVCS INC

720 WASHINGTON ST UNIT 5
HANOVER,MA02339
27-1258935 		     
          No
(66) GREER EXCAVATING

897 HOWARDS GROVE RD
CALVERT CITY,KY42029
46-4288608 		     
          No
(67) GROUT SYSTEMS

P O BOX 557
WADSWORTH,OH44282
34-1481761 		     
          No
(68) G-UB-MK

PO BOX 340
LOUISVILLE,TN37777
62-1623583 		     
          No
(69) HAGERMAN CONSTRUCTION CORP

P O BOX 10690
FORT WAYNE,IN46853
35-0813400 		     
          No
(70) HARMON CONSTRUCTION INC

621 S STATE ST PO BOX 386
NORTH VERNON,IN47265
35-1610556 		     
          No
(71) HAYES DRILLING INC

15525 S MAHAFFIE STREET
OLATHE,KS66062
43-1875850 		     
          No
(72) HAZEX CONSTRUCTION CO

P O BOX 357
HENDERSON,KY42420
61-0623578 		     
          No
(73) HEIMBROCK INC

4632 ILLINOIS AVE
LOUISVILLE,KY40213
61-0663114 		     
          No
(74) HELMKAMP CONSTRUCTION CO

707 BERKSHIRE BLVD
EAST ALTON,IL62024
37-1353840 		     
          No
(75) HENKELS & MCCOY

985 JOLLY RD
BLUE BELL,PA19422
23-1535602 		     
          No
(76) HUELSMAN - SWEENEY CONSTRUCTIO

PO BOX 188
SELLERSBURG,IN47172
35-1548740 		     
          No
(77) HUFF SEALING CORPORATION

P O BOX 127
ALBION,IL62806
37-1215990 		     
          No
(78) INDEPENDENCE EXCAVATING INC

5720 E SCHAAF RD
INDEPENDENCE,OH44131
34-0938274 		     
          No
(79) INDIANA LABORERS WELFARE FUND

P O BOX 1587
TERRE HAUTE,IN478081587
35-0923209 		     
          No
(80) INDUSTRIAL CONTRACTORS SKANSKA

401 NW FIRST ST
EVANSVILLE,IN477020208
35-1103660 		     
          No
(81) INLAND INDUSTRIAL SRVS GRP LLC

987 WEST HURD RD
MONROE,MI48612
20-8630545 		     
          No
(82) INTERNATIONAL CHIMNEY CORP

PO BOX 260
BUFFALO,NY142310260
16-0850893 		     
          No
(83) INTERNATIONAL INDUSTRIAL CONTR

35900 MOUND RD
STERLING HEIGHTS,MI483104793
38-1658550 		     
          No
(84) INTREN INC

18202 W UNION RD
UNION,IL60180
36-3772971 		     
          No
(85) J H RUDOLPH CO & INC

PO BOX 5226 1251 N STOCKWELL RD
EVANSVILLE,IN47716
35-0626844 		     
          No
(86) J T THORPE & SON INC

1060 HENSLEY STREET
RICHMOND,CA94801
94-0925270 		     
          No
(87) J&J GENERAL MAINTENANCE INC

2430 S 3RD ST
IRONTON,OH456380633
26-2399696 		     
          No
(88) JAMES H DREW CORPORATION

8701 ZIONSVILLE RD
INDIANAPOLIS,IN462680935
35-0821499 		     
          No
(89) JBI CONSTRUCTION INC

10335 HEDDEN ROAD
EVANSVILLE,IN47725
35-2131982 		     
          No
(90) JIM SMITH CONTRACTING CO

1108 DOVER ROAD
GRAND RIVERS,KY42045
61-1380786 		     
          No
(91) JOHN A PAPALAS & CO

1187 EMPIRE AVE
LINCOLN PARK,MI48146
38-1684381 		     
          No
(92) JOHNSON CONTRACTORS INC

PO BOX 3779
MUSCLE SHOALS,AL35662
63-0646944 		     
          No
(93) KENTUCKY LABORERS DIST COUNCIL

1994 BY PASS SO
LAWRENCEBURG,KY40342
61-0655782 		     
          No
(94) KLENCK COMPANY

5800 RUSTON LANE
EVANSVILLE,IN47725
26-3575075 		     
          No
(95) KS ENERGY SERVICES

19705 W LINCOLN AVE
NEW BERLIN,WI53146
68-0587337 		     
          No
(96) KY COOP TRUST-LECET

1998 BYPASS SOUTH
LAWRENCEBURG,KY40342
62-1520871 		     
          No
(97) KY LABORERS HEALTH & WELFARE F

1996 BY-PASS SOUTH
LAWRENCEBURG,KY40342
23-7017526 		     
          No
(98) KY LABORERS TRAINING FUND

2000 US BY PASS SOUTH
LAWRENCEBURG,KY40342
61-1145645 		     
          No
(99) L E MYERS GROUP INCMYR GROUP

401 CHESTNUT STREET STE 120
CHANTANOOGO,TN37402
36-1517230 		     
          No
(100) LABORERS COMBINED FUNDS W PA

P O BOX 360137
PITTSBURGH,PA152516137
25-6035806 		     
          No
(101) LABORERS LOCAL #189

2631 WILHITE DRIVE
LEXINGTON,KY40503
61-2098401 		     
          No
(102) LABORERS LOCAL 1214

1415 SOUTH 3RD ST
PADUCAH,KY42002
61-0366884 		     
          No
(103) LABORERS LOCAL 1392

827 OLD HARTFORD RD
OWENSBORO,KY42303
61-0430426 		     
          No
(104) LABORERS LOCAL 1445

P O BOX 438
CATLETTSBURG,KY41129
61-0391690 		     
          No
(105) LABORERS LOCAL 231

2503 BROADWAY PO BOX 374
PEKIN,IL61554
37-6031467 		     
          No
(106) LABORERS LOCAL 576

646 PHILLIPS LANE
LOUISVILLE,KY40209
61-0235277 		     
          No
(107) LABORERS LOCAL #1174

HEALTH WELFARE FUNDS PO BOX 6250
HARRISBURG,PA171120480
24-0856734 		     
          No
(108) LACY CONSTR GROUP DBA THE NE GROUP

1339 SUNDAY DR
INDIANAPOLIS,IN46217
81-3131218 		     
          No
(109) LANEY DIRECTIONAL DRILLING CO

831 CROSSBRIDGE DR
SPRING,TX773733501
76-0283584 		     
          No
(110) LESCO DESIGN & MFG CO

1120 FT PICKINS RD
LAGRANGE,KY40031
61-0600006 		     
          No
(111) LETOURNEAU ENTERPRISES LLC

11325 N COMMUNITY HOUSE R
CHARLOTTE,NC28277
37-1788415 		     
          No
(112) LIGHT'S ENTERPRISES LLC

PO BOX 710
ASHLAND,KY41105
61-1198456 		     
          No
(113) LUNDA CONSTRUCTION CO

P O BOX 669
BLACK RIVER FALLS,WI54615
39-0648769 		     
          No
(114) MARIETTA SILOS LLC

2417 WATERFORD ROAD
MARIETTA,OH45750
52-2455990 		     
          No
(115) MAY CONTRACTING INC

12354 VIRGINIA BLVD
ASHLAND,KY41102
61-1452423 		     
          No
(116) MCKINNEY DRILLING LLC

7550 TEAGUE RD STE 300
HANOVER,MD21076
75-1236157 		     
          No
(117) MICHELS PIPELINE CONSTRUCTION

817 W MAIN ST PO BOX 128
BROWNSVILLE,WI530060128
39-0970311 		     
          No
(118) MICHIGAN LABORERS HEALTH CARE FUND

CARE FUND 6525 CENTURION DRIVE
LANSING,MI489179275
38-6058384 		     
          No
(119) MI-DE-CON INC

3331 SOUTH 3RD
IRONTON,OH45638
31-1653157 		     
          No
(120) MILLER PIPELINE CORP

PO BOX 34141
INDIANAPOLIS,IN46234
35-1959522 		     
          No
(121) MINNESOTA LIMITED INC

P O BOX 410
BIG LAKE,MN55309
41-0881999 		     
          No
(122) MORSEY CONSTRUCTORS LLC

P O BOX 558
CALVERT CITY,KY42029
20-5544676 		     
          No
(123) MURTCO MECHANICAL

815 ABELL ST
PADUCAH,KY42003
61-1127838 		     
          No
(124) NATIONAL MACHINERY & CONVEYOR

P O BOX 3128
MARION,IN46953
61-1453584 		     
          No
(125) NEW TOWNE CONSULTANTS DBA NTC

105 DAVENTRY LANE SUITE 201
LOUISVILLE,KY40223
26-3232255 		     
          No
(126) NORTH AMERICAN DISMANTLING CO

P O BOX 307
LAPEER,MI484460307
38-2551338 		     
          No
(127) NORTHEAST KY EXCAVATING

P O BOX 486
GRAYSON,KY41143
27-0509502 		     
          No
(128) OHIO LABORERS DIST COUN OH CON

800 HILLSDOWNE RD
WESTERVILLE,OH43081
31-6052984 		     
          No
(129) OHIO LABORERS DISTRICT COUNCIL

800 HILLSDOWNE RD
WESTERVILLE,OH43081
31-6052984 		     
          No
(130) OTIS EASTERN SERVICE INC

PO BOX 330
WELLSVILLE,NY14895
16-0725868 		     
          No
(131) OVERCASH PIPELINE LLC

121 N COMMERCIAL DR
MOORESVILLE,NC28115
47-1970825 		     
          No
(132) PARCO CONSTRUCTORS GROUP LLC

2521 RIGEMAR CT PO BOX 99339
LOUISVILLE,KY40299
26-1751402 		     
          No
(133) PERFORMANCE CONTRACTING INC

P O BOX 2198
SHAWNEE MISSION,KS66201
34-1467168 		     
          No
(134) PHILLIPS & JORDAN INC

10201 PARKSIDE DRIVE STE 300
KNOXVILLE,TN37922
56-0694573 		     
          No
(135) PIQUA STEEL CO-DBA PSC CRANE &

4243 W US RT 36
PIQUA,OH45356
31-0621738 		     
          No
(136) PLATT CONSTRUCTION INC

PO BOX 320160 7407 S 27TH ST
FRANKLIN,WI53132
39-1368357 		     
          No
(137) PRECISION COOLING TOWERS INC

1365 COMMONWEALTH DRIVE
HENDERSON,KY42420
61-1133637 		     
          No
(138) PRECISION PIPELINE LLC

3314 56TH STREET
EAU CLAIRE,WI54703
20-0667117 		     
          No
(139) PRETEC DIRECTIONAL DRILLING L

3314 56TH ST
EAU CLAIRE,WI54703
81-2154750 		     
          No
(140) PRICE GREGORY INTERNATIONAL

920 MEMORIAL CITY WAY SUITE 600
HOUSTON,TX77024
73-1103884 		     
          No
(141) PROFESSIONAL CONST SERVICES

RT 1 BOX 123 D PO BOX 510
RIPLEY,WV25271
04-3815019 		     
          No
(142) R C REFRACTORY INC

P O BOX 488
CARNEGIE,PA15106
20-2691958 		     
          No
(143) RAM CONSTRUCTION SERVICES

13800 ECKLES ROAD
LIVONIA,MI48150
38-1164400 		     
          No
(144) RAM CONSTRUCTION SERVICES OF CINCINNATI LLC

4710 ASHLEY DRIVE
WESTCHESTER,OH45011
04-3837131 		     
          No
(145) RAY BLACK & SON INC

348 S 31ST ST
PADUCAH,KY42001
61-0707318 		     
          No
(146) RENASCENT INC

935 W TROY AVE
INDIANAPOLIS,IN46225
20-2107424 		     
          No
(147) RICK EPLION PAVING INC

7159 ST RT 7 PO BOX 712
PROCTORVILLE,OH45669
55-0761380 		     
          No
(148) RICKARD FARM LLC

311 BRANCH SCHOOLHOUSE RD
SACRAMENTO,KY42372
32-0093961 		     
          No
(149) RIGHT OF WAY CLEARING & MAIN

PO BOX 638 33 E PITTSBURGH AVE
GREENSBURG,PA15601
25-1202256 		     
          No
(150) RIVER CITY CONSTRUCTION LLC

101 HOFFER LANE
E PEORIA,IL61611
37-1366545 		     
          No
(151) RIVER TOWN CONSTRUCTION LLC

P O BOX 444
NEWBURGH,IN47629
35-2267846 		     
          No
(152) RLA INVESTMENTS INC

389 S WAYNE AVE
CINCINNATI,OH45215
31-1456664 		     
          No
(153) ROAD BUILDERS LLC DBA PARKWAY CONSTRUCTION

P O BOX 388
GREENVILLE,KY42345
36-4516278 		     
          No
(154) ROCKFORD CORPORATION

22845 NW BENNETT ST SUITE 150
HILLSBORO,OR97124
93-1021510 		     
          No
(155) ROCKY MOUNTAIN SPECIALTY SVC

1824 SUMNER ST
HAMMOND,IN46320
45-3064985 		     
          No
(156) ROY ZENENE TRUCKING & EXC

317 E MARGARET ST
THORNTON,IL60476
36-2419836 		     
          No
(157) RTW REFRACTORY INC

3141 BROADWAY AVENUE
EVANSVILLE,IN47712
35-2136416 		     
          No
(158) S & D SMITH INC

8615 STATE ROUTE 120 E
SLAUGHTERS,KY42456
83-1228070 		     
          No
(159) SAK CONSTRUCTION LLC

864 HOFF ROAD
OFALLON,MO63366
20-4193988 		     
          No
(160) SCHAD BOILER SETTING COMPANY

15240 CASTLETON
DETROIT,MI48227
38-1844208 		     
          No
(161) SCHNELL CONTRACTORS INC

1343 TILE FACTORY LANE
LOUISVILLE,KY40213
61-1044453 		     
          No
(162) SHEATRAYLOR JV

667 BREA CANYON RD STE 30
WALNUT,CA91789
26-1604292 		     
          No
(163) SOUTHEAST LABORERS H & W

P O BOX 1449
GOODLETTSVILLE,TN37070
23-7100845 		     
          No
(164) SOUTHERN ILLINOIS HEALTH AND W

5100 LABORERS WAY SUITE A
MARION,IL62959
37-1037101 		     
          No
(165) SOUTHERN ILLINOIS LABORERS

5100 LABORERS WAY SUITE A
MARION,IL62959
77-7777714 		     
          No
(166) SOUTHERN OHIO TRENCHING & EXCAVATING INC

3228 COUNTY ROAD 103
IRONTON,OH45638
31-1041046 		     
          No
(167) ST LOUIS CONSTRUCTION LABORERS WELFARE FUND

2357 59TH ST
ST LOUIS,MO63110
43-0688695 		     
          No
(168) STEPPO SUPPLY & CONSTRUCTION

3450 RIDGE ROAD
LANSING,IL60438
36-3650472 		     
          No
(169) STERLING BOILER MECHANICAL

PO BOX 8004 1420 KIMBER LANE
EVANSVILLE,IN47715
35-1537007 		     
          No
(170) STRUCTSURE SCAFFOLD LLC

1054 CENTRAL INDUSTRIAL
ST LOUIS,MO63110
26-4128886 		     
          No
(171) SULLIVAN COZART INC

PO BOX 953
LOUISVILLE,KY40201
61-0416180 		     
          No
(172) T & T PIPE RENOVATIONS

1367 S STATE RD 60
SALMEN,IN47167
35-2141150 		     
          No
(173) TAYLOR BROS CONSTRUCTION CO

4555 MIDDLE ROAD PO BOX 248
COLUMBUS,IN47203
35-1161310 		     
          No
(174) TENNESSEE VALLEY INDUSTRIAL

269 TRIPORT RD
GEORGETOWN,KY40324
30-0315882 		     
          No
(175) THALLE CONSTRUCTION CO INC

900 NC 86 NORTH
HILLSBOROUGH,NC27278
13-1734206 		     
          No
(176) THE BOLDT COMPANY

P O BOX 419
APPLETON,WI549120419
39-0174190 		     
          No
(177) THE HARPER COMPANY

P O BOX 420 1648 PETERSBURG RD
HEBRON,KY41048
31-0533105 		     
          No
(178) THE HILLIS GROUP LLC

132 PALOMINO CIRCLE
BANGOR,PA18013
20-1756428 		     
          No
(179) THE SELINSKY FORCE LLC

5355 EAST CENTER DRIVE NE
CANTON,OH44721
20-8865828 		     
          No
(180) THE STATE GROUP INDUSTRIAL (USA) LIMITED

13800 N HWY 57
EVANSVILLE,IN47725
98-0361702 		     
          No
(181) THERMAL SOLUTIONS INC

9329 COUNTY RD 107
PROCTORVILLE,OH45669
55-0772752 		     
          No
(182) THIENEMAN CONSTRUCTION

521 W 84TH DRIVE STE A
MERRILLVILLE,IN46410
35-2073270 		     
          No
(183) THOMAS & SONS CONCRETE CONST

438 CARSON WAY
PADUCAH,KY42003
82-1941154 		     
          No
(184) THREE PHASE LINE CONSTRUCTION

35 E INDUSTRIAL WAY STE 202
ROCHESTER,NH03867
02-0486688 		     
          No
(185) TRANS ASH INC

617 SHEPHERD DRIVE
CINCINNATI,OH45215
31-0643128 		     
          No
(186) TRAVIS CONSTRUCTION CO INC

PO BOX 248
CALVERT CITY,KY42029
61-0999813 		     
          No
(187) TRI AMERICA CONTRACTORS INC

1664 STATE RT 522
WHEELERSBURG,OH45694
31-1556463 		     
          No
(188) TURN KEY TUNNELING INC

1247 STIMMEL RD
COLUMBUS,OH43223
05-0620667 		     
          No
(189) TURNER INDUSTRIAL MAINTENANCE

P O BOX 2750
BATON ROUGE,LA70827
55-0869273 		     
          No
(190) US PIPELINE INC

950 ECHO LANE 100
HOUSTON,TX77024
52-2129576 		     
          No
(191) UNITED CONSTRUCTION COMPANY I

3120 NORTHWESTERN PIKE
PARKERSBURG,WV261044859
55-0676159 		     
          No
(192) UNITED MECHANICAL MARINE

3233 CLARKS RIVER RD SUITE 1
PADUCAH,KY42003
45-3233834 		     
          No
(193) UNIVERSAL PIPING INDUSTRIES

769 CHICAGO ROAD
TROY,MI48083
27-2451663 		     
          No
(194) US TRINITY ENERGY LABOR SERVIC

200 HIGHLAND CIRCLE
ARGYE,TX76226
30-0855613 		     
          No
(195) W B FOSSON & SONS

P O BOX 1859
ASHLAND,KY411051859
61-0985720 		     
          No
(196) WALBRIDGE EQUIPMENT

777 WOODWARD AVE STE 300
DETROIT,MI48226
36-3973394 		     
          No
(197) WALSH CONSTRUCTION COMPANY

929 WEST ADAMS ST
CHICAGO,IL60607
36-2231526 		     
          No
(198) WASHINGTON GROUPALBERICI JV

675 NEW DAM ROAD
OLMSTED,IL62970
20-0796997 		     
          No
(199) WEHR CONSTRUCTORS INC

2517 PLANTSIDE DRIVE
LOUISVILLE,KY40299
61-0668134 		     
          No
(200) WELDED CONSTRUCTION COMPANY

26933 ECKEL ROAD PO BOX 470
PERRYSBURG,OH43552
77-0594803 		     
          No
(201) WEST VIRGINIA LABORERS TRUST F

ONE UNION SQUARE STE 200
CHARLESTON,WV25302
55-0451207 		     
          No
(202) WEST VIRGINIA LABORERS TRUST F

ONE UNION SQUARE
CHARLESTON,WV25302
55-0451207 		     
          No
(203) WESTERN SPECIALTY CONTRACORS

2915 TOBEY DRIVE
INDIANAPOLIS,IN46219
43-0634668 		     
          No
(204) WEDDLE BROS BUILDING GROUP LLC

4424 VOGEL RD SUITE 302
EVANSVILLE,IN47715
35-0906416 		     
          No
(205) WHITTENBERG CONSTRUCTION

4774 ALLMOND AVE
LOUISVILLE,KY40209
61-1201183 		     
          No
(206) WHM CONSTRUCTION INC

3033 CR 2723
ALTO,TX75925
26-4516799 		     
          No
(207) WISCONSIN LABORERS HEALTH FUND

4633 LIUNA WAY
DE FOREST,WI53532
23-7009055 		     
          No
(208) WISHBONE POULTRY INC

PO BOX 510
CALHOUN,KY42372
26-2247888 		     
          No
(209) ALLARD EXCAVATION LLC

8336 BENNETT SCH HOUSE RD
SOUTH WEBSTER,OH45682
45-4040618 		     
          No
(210) API INC

1100 OLD HWY 8 NW
NEW BRIGHTON,MN55112
41-0670985 		     
          No
(211) ARMORMAX CONSTRUCTION

PO BOX 1542
NEW CASTLE,PA16103
27-1994681 		     
          No
(212) AECOM ENERGY & CONSTRUCTION IN

6200 S QUEBEC ST
GREENWOOD VILLAGE,CO80111
34-0217470 		     
          No
(213) BROWN SERVICES CO LLC

4805 PRIME PARKWAY
MCHENRY,IL60050
31-1716616 		     
          No
(214) CARL WALKER CONSTRUCTION

935 VISTA PARK DRIVE
PITTSBURGH,PA15205
27-1071378 		     
          No
(215) C R MEYER & SONS COMPANY

895 W 20TH AVE
OSHKOSH,WI54902
39-0467980 		     
          No
(216) CHESAPEAKE CONTAINMENT SYSTEMS

2690 D SALISBURY HWY
STATESVILLE,NC28677
20-8372336 		     
          No
(217) FRED CHRISTEN AND SONS

P O BOX 547 714 GEORGE STREET
TOLEDO,OH43697
34-4204250 		     
          No
(218) ENTACT LLC

1 E OAK HILL DR STE 102
WESTMONT,IL60559
77-0594061 		     
          No
(219) ENVIROCON INC

101 INTERNATIONAL DR
MISSOULA,MT59808
81-0448332 		     
          No
(220) FORCE CONSTRUCTION CO INC

990 N NATIONAL RD
COLUMBUS,IN47201
35-1385672 		     
          No
(221) CONNETICUT LABORERS BENEFIT

435 CAPITIAN THOMAS BLVD
WEST HAVEN,CT06516
06-0960814 		     
          No
(222) HALL INDUSTRIAL SVC

60 JERRY RICE LANE
SALYERSVILLE,KY41465
45-4518014 		     
          No
(223) HAMON-CUSTODIS INC

PO BOX 1500
SOMERVILLE,NJ08876
22-3595109 		     
          No
(224) HANGING H COMPANIES LLC

1912 S BURLINGTON BLVD
BURLINGTON,WA98233
26-4674139 		     
          No
(225) HEETER GEOTECHNICAL CONST

130 MEADOW RIDGE RD
MT MORRIS,PA15349
47-2016663 		     
          No
(226) JUSTICE BUSINESS SERVICES LLC

PO BOX 33
MARIETTA,OH45750
45-0592874 		     
          No
(227) LABORERS COMBINED FUNDS W PA

12 8TH ST
PITTSBURGH,PA15222
25-6035806 		     
          No
(228) L G FOX INC

PO BOX 11841
LEXINGTON,KY40578
61-1163618 		     
          No
(229) MDS BORING AND DRILLING INC

PO BOX 11557
HOUSTON,TX77293
74-2035651 		     
          No
(230) MIDWAY STORAGE & DISTRIBUTION

P O BOX 410
MONROE,OH45050
01-0651298 		     
          No
(231) MOMENTUM PIPELINE LLC

8075 S CALHOUN HWY
MILLSTONE,WV25261
82-4761564 		     
          No
(232) NKC CONVEYOR INSTALLATION

1572 BROOKS ROAD EAST
MEMPHIS,TN38116
62-1269337 		     
          No
(233) OMI REFRACTORIES LLC

DBA BISCO REFRACTORIES 500 SUPERIOR
CARNEGIE,PA15106
20-0386326 		     
          No
(234) RAGLE INC

P O BOX 444
NEWBURGH,IN47629
35-1878024 		     
          No
(235) ROBERTS PIPE LINE

P O BOX 169
SULPHUR SPRINGS,IN47388
35-1380031 		     
          No
(236) SCHMID PIPELINE SERVICES

850 MALLARD DRIVE
MAYVILLE,WI53050
39-1820821 		     
          No
(237) SCRUGGS CONSTRUCTION INC

6550 WEST US HWY 50
NORTH VERNON,IN47265
82-4549462 		     
          No
(238) SILMAN CONSTRUCTION

1600 FACTOR AVE
SAN LEANDRO,CA94577
13-4363138 		     
          No
(239) TRAN MECHANICAL INC

331 W SECOND ST PO BOX 691
MOUNT VERNON,IN47620
35-1469812 		     
          No
(240) THE NEW GROUP INC

1339 SUNDAY DRIVE
INDIANAPOLIS,IN46217
35-1483686 		     
          No
(241) WB-KOESTER CONSTRUCTION LLC

PO BOX 1330
BLOOMINGTON,IN474021330
06-1738116 		     
          No
(242) KIEWIT POWER CONST

12720 I ST ATTN 1037-KYLA0001-10
OMAHA,NE68137
47-0647804 		     
          No
(243) KOLB GRADING LLC

5731 WESTWOOD
ST CHARLES,MO63304
32-0289822 		     
          No
(244) SOIL INSTALLERS DBA HELITECH

8251 BUNKHUM RD
CASEYVILLE,IL62232
20-2274806 		     
          No
(245) SUPERIOR CONTRACTING CORPORATI

475 N WILLIAMSON BLVD
DAYTONA BEACH,FL32114
38-3539315 		     
          No
Schedule R (Form 990) 2019
Schedule R (Form 990) 2019
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
No
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 .....................
1a
 
No
b Gift, grant, or capital contribution to related organization(s) ............................
1b
 
No
c Gift, grant, or capital contribution from related organization(s) ............................
1c
 
No
d Loans or loan guarantees to or for related organization(s) ............................
1d
 
No
e Loans or loan guarantees by related organization(s) ............................
1e
 
No
f Dividends from related organization(s) ............................
1f
 
No
g Sale of assets to related organization(s) ............................
1g
 
No
h Purchase of assets from related organization(s) ............................
1h
 
No
i Exchange of assets with related organization(s) ............................
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) .......................
1j
 
No
k Lease of facilities, equipment, or other assets from related organization(s) ......................
1k
 
No
l Performance of services or membership or fundraising solicitations for related organization(s) .....................
1l
 
No
m Performance of services or membership or fundraising solicitations by related organization(s) .................
1m
 
No
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................
1n
 
No
o Sharing of paid employees with related organization(s) ............................
1o
 
No
p Reimbursement paid to related organization(s) for expenses ............................
1p
 
No
q Reimbursement paid by related organization(s) for expenses ............................
1q
 
No
r Other transfer of cash or property to related organization(s) ............................
1r
 
No
s Other transfer of cash or property from related organization(s) ............................
1s
 
No
2
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) 2019
Schedule R (Form 990) 2019
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) 		(d)
Predominant income (related, unrelated, excluded from tax under sections 512-514)

(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? 		(k)
Percentage
ownership
Yes No Yes No Yes No






























Schedule R (Form 990) 2019
Schedule R (Form 990) 2019
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) 2019

Additional Data


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