TY 2020 Form 990

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W-2/1099-MISC)
(1) BARRY DAVIES...................................................................... LABOR TRUSTEE CO-CHAIR	1.00 .................	X	X
(2) KENT PETERSON...................................................................... MGMT TRUSTEE CO-CHAIR	1.00 .................	X	X
(3) BURT JOHNSON...................................................................... LABOR TRUSTEE	1.00 .................	X
(4) RUSS SCHERBER...................................................................... LABOR TRUSTEE	1.00 .................	X
(5) MATT FAIRBANKS...................................................................... LABOR TRUSTEE	1.00 .................	X
(6) DAVE SCHRUNK...................................................................... LABOR TRUSTEE	1.00 .................	X
(7) SCOTT GALE...................................................................... LABOR TRUSTEE	1.00 .................	X
(8) DOUG SUCHANEK...................................................................... LABOR TRUSTEE	1.00 .................	X
(9) DOUG SCHROEDER...................................................................... LABOR TRUSTEE	1.00 .................	X
(10) MARK ZIEGLER...................................................................... MANAGEMENT TRUSTEE	1.00 .................	X
(11) HEATHER GRAZZINI-SIMS...................................................................... MANAGEMENT TRUSTEE	1.00 .................	X
(12) MICHEL TUBBS...................................................................... MANAGEMENT TRUSTEE	1.00 .................	X
(13) DICK MORRIS...................................................................... MANAGEMENT TRUSTEE	1.00 .................	X
(14) SEAN CONRAD...................................................................... MANAGEMENT TRUSTEE	1.00 .................	X
(15) JOHN NESSE...................................................................... MANAGEMENT TRUSTEE	1.00 .................	X
(16) GARY THADEN...................................................................... MANAGEMENT TRUSTEE	1.00 .................	X
(17) JOHN QUARNSTROM...................................................................... MANAGEMENT TRUSTEE	1.00 .................	X

(A)
Name and title

(B)
Average hours per week (list any hours for related organizations below dotted line)

(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

(1) BARRY DAVIES......................................................................
LABOR TRUSTEE CO-CHAIR

1.00
.................

(2) KENT PETERSON......................................................................
MGMT TRUSTEE CO-CHAIR

1.00
.................

(3) BURT JOHNSON......................................................................
LABOR TRUSTEE

1.00
.................

(4) RUSS SCHERBER......................................................................
LABOR TRUSTEE

1.00
.................

(5) MATT FAIRBANKS......................................................................
LABOR TRUSTEE

1.00
.................

(6) DAVE SCHRUNK......................................................................
LABOR TRUSTEE

1.00
.................

(7) SCOTT GALE......................................................................
LABOR TRUSTEE

1.00
.................

(8) DOUG SUCHANEK......................................................................
LABOR TRUSTEE

1.00
.................

(9) DOUG SCHROEDER......................................................................
LABOR TRUSTEE

1.00
.................

(10) MARK ZIEGLER......................................................................
MANAGEMENT TRUSTEE

1.00
.................

(11) HEATHER GRAZZINI-SIMS......................................................................
MANAGEMENT TRUSTEE

1.00
.................

(12) MICHEL TUBBS......................................................................
MANAGEMENT TRUSTEE

1.00
.................

(13) DICK MORRIS......................................................................
MANAGEMENT TRUSTEE

1.00
.................

(14) SEAN CONRAD......................................................................
MANAGEMENT TRUSTEE

1.00
.................

(15) JOHN NESSE......................................................................
MANAGEMENT TRUSTEE

1.00
.................

(16) GARY THADEN......................................................................
MANAGEMENT TRUSTEE

1.00
.................

(17) JOHN QUARNSTROM......................................................................
MANAGEMENT TRUSTEE

1.00
.................

(A)
Name and title

(B)
Average hours per week (list any hours for related organizations below dotted line)

(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

(18) BONNIE JORGENSON........................................................................
MANAGEMENT TRUSTEE

1.00
.......................

(19) TIM WORKE........................................................................
MANAGEMENT TRUSTEE

1.00
.......................

(20) DAVE SCHUTTA........................................................................
LABOR TRUSTEE

1.00
.......................

(21) NATE SOGGE........................................................................
LABOR TRUSTEE

1.00
.......................

(22) JOEL SMITH........................................................................
LABOR TRUSTEE

1.00
.......................

(23) JEFF STARK........................................................................
LABOR TRUSTEE

1.00
.......................

(24) VIRGIL CHRISTOFFERSEN........................................................................
LABOR TRUSTEE

1.00
.......................

(25) AARON BENIKE........................................................................
MANAGEMENT TRUSTEE

1.00
.......................

(A)
Name and business address

(B)
Description of services

WILSON - MCSHANE CORPORATION

3001 METRO DRIVE
BLOOMINGTON,MN55425

PLAN ADMINISTRATOR

1,248,175

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

	(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 ........


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


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

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

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

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total revenue, gains, and other support per audited financial statements .......	1	1,697,740
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d .....................	2e	0
3	Subtract line 2e from line 1..................	3	1,697,740
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a
b	Other (Describe in Part XIII.) ...........	4b
c	Add lines 4a and 4b....................	4c	0
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......	5	1,697,740

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total expenses and losses per audited financial statements ...........	1	1,640,240
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities .........	2a
b	Prior year adjustments ............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d....................	2e	0
3	Subtract line 2e from line 1...................	3	1,640,240
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a
b	Other (Describe in Part XIII.) ............	4b
c	Add lines 4a and 4b.....................	4c	0
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......	5	1,640,240

Return Reference	Explanation
PART X, LINE 2:	THE TRUST ESTABLISHED TO HOLD FUND ASSETS IS QUALIFIED PURSUANT TO SECTION 501(C)(9) OF THE INTERNAL REVENUE CODE (IRC) AND, ACCORDINGLY, THE TRUST'S NET INVESTMENT INCOME IS EXEMPT FROM INCOME TAXES. THE TRUST HAS OBTAINED A FAVORABLE TAX DETERMINATION LETTER FROM THE INTERNAL REVENUE SERVICE (IRS) DATED SEPTEMBER 8, 1997. THE FUND HAS BEEN AMENDED SINCE RECEIVING THE DETERMINATION LETTER. HOWEVER, THE FUND ADMINISTRATOR AND THE FUND'S TAX COUNSEL BELIEVE THAT THE FUND IS DESIGNED AND IS CURRENTLY BEING OPERATED IN COMPLIANCE WITH THE APPLICABLE REQUIREMENTS OF THE IRC. ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE PLAN MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE PLAN AND RECOGNIZE A TAX LIABILITY (OR ASSET) IF THE PLAN HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE IRS. THE PLAN IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS.

- TIN:

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

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

Attach to Form 990 or 990-EZ.
MediumBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2020

Open to Public
Inspection

Name of the organization

UNION CONSTRUCTION CRAFTS WORKERS'
COMPENSATION FUND

Employer identification number

41-1835606

Return Reference	Explanation
FORM 990, PART VI, SECTION A, LINE 1	THE TRUSTEES, AT THEIR DISCRETION, MAY APPOINT AN EXECUTIVE COMMITTEE CONSISTING OF AN EQUAL NUMBER OF UNION TRUSTEES AND EMPLOYER TRUSTEES. THE EXECUTIVE COMMITTEE SHALL ASSIST THE FUND IN CARRYING OUT THE POLICIES AND PROGRAMS ESTABLISHED BY THE BOARD OF TRUSTEES. IN ADDITION, THE EXECUTIVE COMMITTEE MAY ACT IN PLACE AND INSTEAD OF THE BOARD OF TRUSTEES BETWEEN TRUSTEE MEETINGS ON ALL MATTERS EXCEPT THOSE SPECIFICALLY RESERVED TO THE BOARD OF TRUSTEES BY THE TRUST AGREEMENT OR BY ACTION OF THE BOARD OF TRUSTEES. AN EXECUTIVE COMMITTEE MEETING MAY BE CONDUCTED, OR AN INDIVIDUAL MEMBER MAY PARTICIPATE IN SUCH A MEETING, BY TELEPHONE OR BY ANY SIMILAR COMMUNICATIONS SYSTEM WHICH ALLOWS ALL PERSONS PARTICIPATING IN THE MEETING TO HEAR EACH OTHER AT THE SAME TIME.
FORM 990, PART VI, SECTION A, LINE 3	WILSON-MCSHANE IS THE MANAGEMENT COMPANY RESPONSIBLE FOR THE FINANCIAL OPERATIONS OF THE FUND. WILSON-MCSHANE PREPARES THE GENERAL LEDGER, MAKES JOURNAL ENTRIES, MANAGES CLAIMS AND OPERATIONAL EXPENSES.
FORM 990, PART VI, SECTION A, LINE 7A	THIS TRUST WILL BE ADMINISTERED BY A BOARD OF TWELVE (12) UNION TRUSTEES AND TWELVE (12) EMPLOYER TRUSTEES APPOINTED BY THE ENTITIES ENUMERATED IN SECTIONS 3.2 AND 3.3 OF THIS ARTICLE. THE APPOINTMENT OF THE TRUSTEES IS TO BE EVIDENCED BY A WRITTEN DOCUMENT OF APPOINTMENT FROM THE APPOINTING ENTITY. THE NUMBER OF TRUSTEES OF THIS FUND MAY BE MODIFIED BY AMENDMENT OF THIS TRUST AGREEMENT, PROVIDED THAT THERE WILL ALWAYS BE AN EQUAL NUMBER OF EMPLOYER TRUSTEES AND UNION TRUSTEES. THE TWELVE (12) EMPLOYER TRUSTEES WILL BE DESIGNATED AS FOLLOWS: SIX BY THE AGC OF MINNESOTA; ONE (1) BY THE MINNESOTA MECHANICAL CONTRACTORS ASSOCIATION (MMCA); ONE (1) BY THE NATIONAL ELECTRICAL CONTRACTORS ASSOCIATION (NECA) CHAPTERS IN MINNESOTA; ONE (1) BY THE CARPENTRY CONTRACTORS ASSOCIATION (CCA); ONE (1) BY THE MINNESOTA DRYWALL AND PLASTERERS ASSOCIATION (MDPA); ONE (1) BY THE SHEET METAL, AIR CONDITIONING & ROOFING CONTRACTORS ASSOCIATION (SMARCA); AND ONE (1) BY THE MINNESOTA CONCRETE & MASONRY CONTRACTORS ASSOCIATION (MCMCA). IF AN ENTITY ENTITLED TO APPOINT A TRUSTEE FAILS TO DO SO WITHIN 60 DAYS AFTER THE TRUST NOTIFIES IT OF THE NEED TO MAKE AN APPOINTMENT, THE BOARD OF TRUSTEES MAY APPOINT A RESPONSIBLE INDIVIDUAL WHO IS EMPLOYED BY A PARTICIPATING EMPLOYER THAT IS A MEMBER IN GOOD STANDING OF THE ENTITY THAT FAILED TO APPOINT A TRUSTEE. THE TWELVE (12) UNION TRUSTEES WILL BE DRAWN FROM EITHER A LOCAL UNION OR AN INTERMEDIATE LABOR ORGANIZATION THAT IS PARTICIPATING IN THIS TRUST AS EVIDENCED BY A PARTICIPATION AGREEMENT THAT HAS BEEN SIGNED AND FILED WITH THE ADMINISTRATOR OF THIS TRUST. THE APPOINTMENT OF A UNION TRUSTEE WILL BE EVIDENCED BY WRITTEN APPOINTMENT FROM THE MOST-SENIOR LEADER OF THE LOCAL UNION OR INTERMEDIATE LABOR ORGANIZATION. THE TWELVE (12) UNION TRUSTEES WILL BE DESIGNATED AS FOLLOWS: A. THE SIX (6) LOCAL UNIONS OR INTERMEDIATE LABOR ORGANIZATIONS THAT HAVE THE HIGHEST NUMBER OF MEMBERS PARTICIPATING IN THE TRUST WILL BE GIVEN THE FIRST OPPORTUNITY TO APPOINT A TRUSTEE. B. THE REMAINING (6) UNION TRUSTEES WILL BE APPOINTED FROM ANY OF THE OTHER PARTICIPATING LOCAL UNIONS OR INTERMEDIATE LABOR ORGANIZATION. IF AN ENTITY ENTITLED TO APPOINT A TRUSTEE FAILS TO DO SO WITHIN 60 DAYS AFTER NOTICE FROM THE TRUST OF THE VACANCY, THE BOARD OF TRUSTEES MAY FILL THE VACANCY BY APPOINTING A RESPONSIBLE INDIVIDUAL WHO IS EITHER SERVING IN A LEADERSHIP POSITION FOR, OR IS EMPLOYED BY, A PARTICIPATING LOCAL UNION OR INTERMEDIATE LABOR ORGANIZATION.
FORM 990, PART VI, SECTION B, LINE 11B	WHEN THE AUDITOR HAS PREPARED THE FORM 990, IT IS GIVEN TO THE AUDIT COMMITTEE AND THE BOARD OF TRUSTEES FOR REVIEW. THE TRUSTEES ARE ALLOWED TIME IN WHICH TO EXAMINE THE FORM 990 AND COMMUNICATE WITH THE ADMINISTRATOR IN THE EVENT THE TRUSTEE HAS ANY QUESTIONS OR COMMENTS. AT THE REQUEST OF ANY TRUSTEE, OR IF THERE ARE QUESTIONS OR COMMENTS THAT CANNOT BE ADEQUATELY AND FULLY ADDRESSED, THE ADMINISTRATOR WILL ARRANGE A CONFERENCE CALL FOR ALL TRUSTEES TO DISCUSS THE FORM 990 AND WHETHER OR NOT REVISIONS ARE NEEDED BEFORE IT IS FINALIZED.
FORM 990, PART VI, SECTION B, LINE 12C	1. AT THE FIRST MEETING OF THE BOARD OF TRUSTEES OF THE UCCWCF HELD EACH YEAR, A COPY OF THE CONFLICTS OF INTEREST POLICY IS DISTRIBUTED TO THE TRUSTEES. IN ADDITION, A DISCLOSURE STATEMENT IS DISTRIBUTED TO EACH TRUSTEE. THE DISCLOSURE STATEMENT HAS BEEN PREPARED IN COMPLIANCE WITH THE CONFLICTS OF INTEREST POLICY. FUND COUNSEL EXPLAINS TO THE BOARD THE OPERATION OF THE CONFLICTS OF INTEREST POLICY, WHAT TYPES OF INTERESTS HAVE TO BE DISCLOSED AND THE ADMINISTRATIVE PROCEDURES FOR ADVISING THE ORGANIZATION REGARDING INTERESTS TO BE DISCLOSED. TRUSTEES ARE ASKED AT THAT MEETING TO COMPLETE THE DISCLOSURE FORM AND RETURN IT TO THE ADMINISTRATOR. THE FORM IS COMPLETED BY EACH OF THE BOARD OF TRUSTEES AND ANY SENIOR STAFF OF WILSON-MCSHANE CORPORATION WORKING ON THE UCCWCF. 2. THE FUND ADMINISTRATOR REVIEWS THE CONFLICT DISCLOSURES WHEN RETURNED, AND REFERS ANY WITH CONFLICTS FOR FURTHER REVIEW. 3. ANY CONFLICTS THAT ARE DISCLOSED ARE REVIEWED BY THE FUND CO-CHAIRS IN CONJUNCTION WITH FUND COUNSEL. ANY TRUSTEE THAT HAS DISCLOSED A CONFLICT OF INTEREST WOULD BE PROHIBITED FROM PARTICIPATING IN ANY DISCUSSION OR VOTING ON ANY MOTION REGARDING THE MATTER THAT GAVE RISE TO THE CONFLICT OF INTEREST.
FORM 990, PART VI, SECTION C, LINE 19	THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY OR FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC.

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

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2020

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

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

Attach to Form 990.
MediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2020

Open to Public Inspection

Name of the organization

UNION CONSTRUCTION CRAFTS WORKERS'
COMPENSATION FUND

Employer identification number

41-1835606

Part I

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

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

Part II

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1)ASSOCIATED GENERAL CONTRACTORS OF MINNESOTA INC
(2)LOCAL NO 512 OF THE INTERNATIONAL ASSOCIATION OF BRIDGE AND STRUCTURAL IRON
(3)LOCAL NO 49 OF THE INTERNATIONAL UNION OF OPERATING ENGINEERS
(4)NORTH CENTRAL STATES REGIONAL COUNCIL OF CARPENTERS (FKA LAKES AND PLAINS)
(5)MINNESOTA CONSTRUCTION CONFERENCE OF TEAMSTERS

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

Cat. No. 50135Y

Schedule R (Form 990) 2020

Page 2

Part III

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?		(k) Percentage ownership
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No	(k) Percentage ownership

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?
(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	Yes	No
(1) 360 WALL SYSTEMS INC
(2) 3D MECHANICAL INC
(3) AE CONRAD COMPANY
(4) AG O'BRIEN PLUMBING & HEATING CO
(5) AW KUETTEL & SONS INC
(6) ABLE FENCE INC
(7) ACE ELECTRICAL CONTRACTORS INC
(8) ACME TUCKPOINTING & RESTORATION COMPANY
(9) ADOLFSON & PETERSON CONSTRUCTION
(10) ADVANCED MASONRY RESTORATION INC
(11) AID ELECTRIC CORPORATION
(12) AIR CONDITIONING ASSOCIATES INC
(13) ALBERS MECHANICAL CONTRACTORS INC
(14) ALDO INC
(15) ALLAN MECHANICAL INC
(16) ALLIANCE MECHANICAL SERVICES INC
(17) ALLIED BLACKTOP COMPANY
(18) ALLTECH ENGINEERING CORP
(19) AMERECT INC
(20) AMERICAN MASONRY RESTORATION CORP
(21) ANDERSON DRYWALL INC
(22) ANDERSON GLASS CO INC
(23) ARCHITECTURAL SALES OF MN
(24) ARMSTRONG CRANE AND RIGGING CORP
(25) ARNT CONSTRUCTION COMPANY INC
(26) ARROWHEAD CONCRETE WORKS INC
(27) ASSOCIATED MECHANICAL CONTRACTORS INC
(28) AXEL H OHMAN INC
(29) BALD EAGLE ERECTORS INC
(30) BCM CONSTRUCTION INC
(31) BECKERS INC
(32) BELAIR SITEWORK SERVICES
(33) BENIKE CONSTRUCTION
(34) BERG DRYWALL LLC
(35) BERG PAINTING LLC
(36) BILLMAN CONSTRUCTION INC
(37) BINDER HEATING & AIR CONDITIONING INC
(38) BITUMINOUS ROADWAYS INC
(39) BLOOMINGTON ELECTRIC COMPANY
(40) BOILER SERVICES INC
(41) BOLLIG & SONS INC
(42) BRAXTON & SONS INC
(43) BRAXTON HANCOCK & SONS INC
(44) BREDAHL PLUMBING INC
(45) BRITE LITE ELECTRIC COMPANY
(46) BUDGET PLUMBING CORP
(47) BURSCHVILLE CONSTRUCTION
(48) CR FISCHER & SONS INC
(49) CW HOULE INC
(50) CAMCO CONSTRUCTION INC
(51) CAPITAL CITY GLASS INC
(52) CARCIOFINI COMPANY
(53) CARPENTRY BUILDERS INC
(54) CD TILE & STONE INC
(55) CENTURY CONSTRUCTION CO INC
(56) CHAPPELL CENTRAL INC
(57) CLIMATE MAKERS INC
(58) CM CONSTRUCTION COMPANY INC
(59) COMMERCIAL DRYWALL INC
(60) COMMERCIAL FLOORING SERVICES LLC
(61) COMMERCIAL PLUMBING & HEATING
(62) COMMERCIAL REFRIGERATION SYSTEMS INC
(63) COMMERCIAL ROOFING INC
(64) CONSTRUCTION RESULTS CORPORATION
(65) CONTRACT TILE & CARPET LLC
(66) COOL AIR MECHANICAL INC
(67) CORPORATE MECHANICAL INC
(68) CRAWFORD MERZ LLC
(69) CROSSTOWN MASONRY INC
(70) CURB MASTERS INC
(71) CUSTOM DRYWALL INC
(72) DJ KRANZ CO INC
(73) DANNER INC
(74) DANNY'S CONSTRUCTION CO LLC
(75) DAVIDS HYDRO VAC INC
(76) DAYCO CONCRETE COMPANY INC
(77) DEL'S CONSTRUCTION INC
(78) DESIGNING EARTH CONTRACTING INC
(79) DIRTWORX LLC
(80) DIVISION V SHEET METAL INC
(81) DOBOSZENSKI & SONS INC
(82) DONALD R FRANTZ CONCRETE CONSTRUCTION
(83) DONLAR CONSTRUCTION COMPANY
(84) DRESEL CONTRACTING INC
(85) DULUTH READY MIX CONCRETE INC
(86) DZIEDZIC CAULKING INC
(87) E&J REBAR INC
(88) ELANDER MECHANICAL INC
(89) EMERALD BUILDERS INC
(90) EMPIREHOUSE INC
(91) ENEBAK CONSTRUCTION COMPANY
(92) ENGELSMA CONSTRUCTION INC
(93) ENGINEERED CONCRETE PLACER OF MN INC
(94) ENVIROBATE INC
(95) EVEREST STEEL INC
(96) FEHN COMPANIES INC
(97) FLANNERY CONSTRUCTION
(98) FORCED AIR INC DBA WENZEL HEAT & AC
(99) FOREST LAKE CONTRACTING INC
(100) FOWLER & HAMMER INC
(101) FPI PAVING CONTRACTORS INC
(102) FRASER-MORRIS ELECTRIC COMPANY
(103) FRATTALONE COMPANIES INC
(104) FRERICHS CONSTRUCTION COMPANY
(105) GF JEDLICKI INC
(106) GL CONTRACTING INC
(107) GAGE BROTHERS CAULKING INC
(108) GAGNON INC
(109) GEISLINGER & SONS INC
(110) GENERAL OFFICE PRODUCTS CO
(111) GENERAL SHEET METAL COMPANY LLC
(112) GEORGE SIEGFRIED CONSTRUCTION CO
(113) GEPHART ELECTRIC CO INC
(114) GILBERT MECHANICAL CONTRACTORS INC
(115) GLOBAL SPECIALTY CONTRACTORS INC
(116) GR MECHANICAL PLUMBING & HEATING INC
(117) GRAHAM CONSTRUCTION SERVICES INC
(118) GRAZZINI BROTHERS AND COMPANY
(119) GREINER CONSTRUCTION INC
(120) GRESSER COMPANIES INC
(121) GUNNAR ELECTRIC INC
(122) HARBOR CITY MASONRY INC
(123) HARDSCAPE CONSTRUCTION INC
(124) HARRISON TILE COMPANY
(125) HEARTLAND GLASS COMPANY
(126) HIGH FIVE ERECTORS II
(127) HOLLENBACK & NELSON INC
(128) HOMECO INSULATION INC
(129) HOOVER CONSTRUCTION COMPANY
(130) HORWITZ INC
(131) HOVLAND INC
(132) ICON LLC
(133) IMPERIAL WALL INC
(134) INCOR INSTALLATION LLC
(135) INFINITY ACCESS INC
(136) INSULATION MIDWEST INC
(137) INTEX CORPORATION
(138) J BECHER & ASSOCIATES INC
(139) J&K BUILDERS INC
(140) J&K MASONRY INC
(141) JAMES STEELE CONSTRUCTION CO
(142) JOHNSON-NELSON MASONRY INC
(143) JOHNSON-WILSON CONSTRUCTORS INC
(144) JORGENSON CONSTRUCTION INC
(145) JULIAN M JOHNSON CONSTRUCTION CORP
(146) JULIUS B NELSON & SON INC
(147) K PEARSON MECHANICAL LLC
(148) KB SERVICE COMPANY
(149) KELLEHER CONSTRUCTION INC
(150) KERN & TABERY INC
(151) KGM CONTRACTORS INC
(152) KIFFMEYER INC
(153) KILLMER ELECTRIC CO INC
(154) KIRTLAND INC
(155) KLAMM MECHANICAL CONTRACTORS INC
(156) KMH ERECTORS INC
(157) KNUTSON CONSTRUCTION SERVICES INC
(158) KRAUS ANDERSON COMPANIES INC
(159) KUECHLE UNDERGROUND INC
(160) KUNZ CONSTRUCTION CO
(161) KUSSKE CONSTRUCTION COMPANY INC
(162) LAKE AREA ROOFING AND CONSTRUCTION INC
(163) LAKEHEAD CONSTRUCTORS INC
(164) LAMETTI & SONS INC
(165) LANDMARK CONCRETE INC
(166) LATOUR CONSTRUCTION INC
(167) LBP MECHANICAL INC
(168) LEGACY COMPANIES
(169) LEGEND MECHANICAL INC
(170) LEGENDS CONCRETE INC
(171) LENCI ENTERPRISES INC
(172) LINCO FAB INC
(173) LLOYD'S CONSTRUCTION SERVICES INC
(174) LS BLACK CONSTRUCTORS INC
(175) MP JOHNSON CONSTRUCTION
(176) MAG MECHANICAL LLC
(177) MAGNEY CONSTRUCTION INC
(178) MAJESTIC FLOORING INC
(179) MAJOR MECHANICAL INC
(180) MARCY CONSTRUCTION CO LLC
(181) MASTER ELECTRIC COMPANY INC
(182) MASTER MECHANICAL INC
(183) MAX GRAY CONSTRUCTION INC
(184) MAX STEININGER INC
(185) MCNAMARA CONTRACTING INC
(186) MCQUILLAN BROS PLUMBING HEATING & AC LLC
(187) MEDINA ELECTRIC INC
(188) MERIT ELECTRIC COMPANY
(189) METRO SHEET METAL INC
(190) MEYER CONTRACTING INC
(191) MG MCGRATH ARCHITECTURAL SURFACES INC
(192) MICS CONSTRUCTION SERVICES
(193) MID-CITY MECHANICAL CORP
(194) MIDWEST ASPHALT SERVICES LLC
(195) MIDWEST CONCRETE SPECIALTIES INC
(196) MINERAL SERVICE PLUS LLC
(197) MINGER CONSTRUCTION COMPANIES INC
(198) MINNEAPOLIS GLASS COMPANY
(199) MINNESOTA UTILITIES & EXCAVATIONS
(200) MODERN ELECTRICAL SOLUTIONS INC
(201) MORCON CONSTRUCTION INC
(202) MULCAHY NICKOLAUS LLC
(203) MURPHY RIGGING & ERECTING INC
(204) MUSKA ELECTRIC COMPANY
(205) NAC MECHANICAL & ELECTRICAL SERVICES
(206) NASSEFF MECHANICAL CONTRACTORS
(207) NEATON BROTHERS EROSION CONTROL LLC
(208) NEW LOOK CONTRACTING INC
(209) NORDSTROM ARCHITECTURAL SHEET METAL INC
(210) NORTH COUNTRY CONCRETE INC
(211) NORTH PINE AGGREGATE INC
(212) NORTH VALLEY INC
(213) NORTHERN DEWATERING INC
(214) NORTHERN GLASS & GLAZING INC
(215) NORTHERN INDUSTRIAL ERECTORS
(216) NORTHLAND CONCRETE & MASONRY COMPANY LLC
(217) NORTHLAND CONSTRUCTORS OF DULUTH LLC
(218) NORTHLAND MECHANICAL CONTRACTORS
(219) NORTHLAND PAVING LLC
(220) NORTHWEST ASPHALT INC
(221) OLYMPIATECH ELECTRICAL CONTRACTORS INC
(222) OLYMPIC COMPANIES INC
(223) OWENS COMPANIES INC
(224) PAAPE COMPANIES INC
(225) PAINTING BY NAKASONE
(226) PARK CONSTRUCTION COMPANY
(227) PARKOS CONSTRUCTION COMPANY INC
(228) PATRIOT ERECTORS INC
(229) PCI ROADS LLC
(230) PENN CONTRACTING INC
(231) PETERSON COMPANIES INC
(232) PETERSON SHEET METAL
(233) PHASOR ELECTRIC
(234) PINE BEND PAVING INC
(235) PINNACLE WALL SYSTEMS
(236) PLATINUM FLOORCOVERING
(237) PRAIRIE ELECTRIC COMPANY
(238) PREFERRED ELECTRIC INC
(239) PREMIER ELECTRICAL CORPORATION
(240) PREMIUM CARPET INSTALLATION INC
(241) PRESTIGE DRYWALL
(242) PROGRESSIVE BUILDING SYSTEMS
(243) PULSE ELECTRIC INC
(244) Q3 CONTRACTING INC
(245) QUALITY DRYWALL MIDWEST INC
(246) QUALITY MANUFACTURING INC
(247) RW CARLSTROM CONSTRUCTION CO
(248) RACHEL CONTRACTING INC
(249) RADOTICH INC
(250) RAINBOW INC
(251) RAINVILLE-CARLSON INC
(252) RAMSEY EXCAVATING COMPANY INC
(253) RAY RIIHILUOMA INC
(254) RED CEDAR STEEL ERECTORS INC
(255) REGER COMPANIES INC
(256) REINER CONTRACTING INC
(257) RESHETAR SYSTEMS INC
(258) RESTORATION SYSTEMS INC
(259) RICE LAKE CONSTRUCTION GROUP
(260) RIESGRAF'S INSTALLATION CO INC
(261) RIVER CITY ERECTORS INC
(262) RJ MECHANICAL INC
(263) RJ RYAN CONSTRUCTION INC
(264) RJM CONSTRUCTION LLC
(265) ROBERT R SCHROEDER CONSTRUCTION INC
(266) ROCKET CRANE SERVICE INC
(267) RON KASSA CONSTRUCTION INC
(268) ROYL MASONRY
(269) RTL CONSTRUCTION INC
(270) RYAN COMPANIES US INC
(271) RYAN CONTRACTING CO
(272) S A JORDAN CONSTRUCTION INC
(273) S R MECHANICAL INC
(274) SGO ROOFING & CONSTRUCTION LLC
(275) SM HENTGES & SONS INC
(276) SR WEIDEMA INC
(277) SCHADEGG MECHANICAL INC
(278) SCHAEFER HARDWOOD FLOORS INC
(279) SCHAMMEL ELECTRIC INC
(280) SCHNEIDER COMPANY INC
(281) SEE BEE GLASS INC
(282) SENTRA-SOTA SHEET METAL INC
(283) SEPPI BROTHERS CONCRETE PRODUCTS CORP
(284) SHANK CONSTRUCTORS INC
(285) SHANNON'S INC
(286) SHAW-LUNDQUIST ASSOCIATES INC
(287) SHEEHY CONSTRUCTION COMPANY
(288) SHEET METAL CONNECTORS INC
(289) SILVER TREE PLUMBING & HEATING LLC
(290) SOLBERG AGGREGATE INC
(291) SPECIALTY SYSTEMS INC
(292) SPRIGGS PLUMBING & HEATING INC
(293) ST PAUL LINOLEUM & CARPET
(294) STANDARD CONTRACTING INC
(295) STAPF CONCRETE CONSTRUCTION INC
(296) STEINHAGEN ENTERPRISES INC
(297) STEINKRAUS PLUMBING INC
(298) STERN DRYWALL INC
(299) STONE CONSTRUCTION INC
(300) STRETAR MASONRY & CONCRETE INC
(301) SUMMIT CONCRETE & MASONRY CONSTRUCTION
(302) SUN MECHANICAL INC
(303) SUNRAM CONSTRUCTION INC
(304) SUPERIOR PAINTING & DECORATING INC
(305) TA SCHIFSKY & SONS INC
(306) THE CAULKERS COMPANY INC
(307) THELEN HEATING & ROOFING INC
(308) THOMAS AND SONS CONSTRUCTION INC
(309) THOMAS FINN COMPANY
(310) TIMCO CONSTRUCTION INC
(311) TORRINI COMPANIES
(312) TOTAL MECHANICAL SERVICES INC
(313) TRADE ACCESS LLC
(314) TRI-CONSTRUCTION INC
(315) TWIN CITY GLASS CONTRACTORS INC
(316) TWIN CITY TILE AND MARBLE COMPANY
(317) UHL COMPANY INC
(318) UNITED GLASS INC
(319) UNITED REFRACTORIES INC
(320) UNITED STATES MECHANICAL INC
(321) URBANSKI BUILDERS INC
(322) US SITEWORK INC
(323) VALLEY-RICH CO INC
(324) VALLEY PAVING INC
(325) VCI ENVIRONMENTAL INC
(326) VEIT DISPOSAL SYSTEMS
(327) VIC'S CRANE & HEAVY HAUL INC
(328) VOGEL MECHANICAL INC
(329) VOSON PLUMBING INC
(330) WAGNER CONSTRUCTION INC
(331) WASCHE COMMERCIAL FINISHES INC
(332) WATSON-FORSBERG CO
(333) WEISE MASONRY INC
(334) WENZEL PLYMOUTH PLUMBING LLC
(335) WOODY'S REBAR CO INC
(336) WTG TERRAZZO & TILE INC
(337) WYSAN PRECAST SERVICES LLC
(338) ZINTL INC
(339) ACI ASPHALT & CONCRETE INC
(340) ALBERT LEA ELECTRIC CO
(341) ALLSTATES PAVEMENT RECYCLING & STABILIZATION INC
(342) AUSTINS PAINTING & DECORATING LLC
(343) BENSON-CLAUGHERTY CONTRACTING INC
(344) BRIN NORTHWESTERN GLASS COMPANY
(345) CASTREJON INC
(346) CENTRAL ROOFING COMPANY
(347) CROSSTOWN MECHANICAL INC
(348) DAKOTA GLASS AND GLAZING LLC
(349) DCOR TEC INC
(350) ENERVATION INC
(351) GARTNER REFRIGERATION AND MANUFACTURING INC
(352) GENZ-RYAN PLUMBING & HEATING CO INC
(353) GEORGE F COOK CONSTRUCTION CO
(354) HANSON CUSTOM CRUSHING INC
(355) HARRIS
(356) HOFFMAN CONCRETE INC
(357) K&H EXTERIORS INC
(358) MAVEN CONSTRUCTION LLC
(359) MG MCGRATH ARCHITECTURAL GLASS AND GLAZING
(360) MUSKA PLUMBING LLC
(361) NATUS CORPORATION DBA HAMERNICK DECORATING CENTER
(362) NEO ELECTRICAL SOLUTIONS LLC
(363) NORTHDALE CONSTRUCTION CO INC
(364) NORTHERN LINES CONTRACTING INC
(365) P&R CONTRACTING INC
(366) PETES WATER & SEWER
(367) PHLAG MECHANICAL INC DBA FEDER MECHANICAL
(368) ROSENQUIST CONSTRUCTION INC
(369) SELLIN BROTHERS INC
(370) STACK BROS MECHANICAL CONSTRUCTION INC
(371) STEVENS DRILLING & ENVIRONMENTAL SERVICES INC
(372) TEKTON CONSTRUCTION CO
(373) TR CONCRETE INC
(374) VEIT COMPANIES
(375) VIKING DEMOLITION & SPECIALTY SERVICES LLC
(376) VIKING ELECTRIC INC
(377) VOSS UTILITY & PLUMBING
(378) ZENITH TECH INC

Schedule R (Form 990) 2020

Page 3

Part V

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

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

Yes

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Schedule R (Form 990) 2020

Page 4

Part VI

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

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

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

Schedule R (Form 990) 2020

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) 2020

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: TO PROVIDE A WORKER'S COMP. COLLECTIVELY-BARGAINED PROGRAM AUTHORIZED UNDER MINNESOTA STATUTES.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	24
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	19
5	Total number of individuals employed in calendar year 2020 (Part V, line 2a) ......	5	0
6	Total number of volunteers (estimate if necessary) .............	6	25
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

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	0	0
9	Program service revenue (Part VIII, line 2g) .........	1,556,452	1,694,957
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	2,584	1,569
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	144	1,214
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	1,559,180	1,697,740
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	0	0
14	Benefits paid to or for members (Part IX, column (A), line 4).....	0	0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	0	0
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	1,530,330	1,640,240
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	1,530,330	1,640,240
19	Revenue less expenses. Subtract line 18 from line 12.......	28,850	57,500
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	438,652	473,510
21	Total liabilities (Part X, line 26).............	73,836	51,194
22	Net assets or fund balances. Subtract line 21 from line 20.....	364,816	422,316

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )
	TO PROVIDE A WORKER'S COMPENSATION COLLECTIVELY-BARGAINED PROGRAM AUTHORIZED UNDER MINNESOTA STATUTES: TO PROVIDE ALTERNATIVE DISPUTE RESOLUTION RULES AND REGULATIONS WHICH WILL PROVIDE A METHOD OF RESOLVING CONTESTED WORKERS' COMPENSATION CASES WITHIN THE STATE OF MINNESOTA TO IMPROVE THE SAFETY AND WELFARE OF WORKERS WHO ARE COVERED UNDER THE PROGRAM. AT THE END OF 2020, THE FUND HAD 364 PARTICIPATING CONTRACTORS EMPLOYING 24,516 TRADES-PEOPLE. DURING 2020, THE FUND HELD 50 INTERVENTIONS, 56 FACILITATIONS, 52 MEDIATIONS, 3 ARBITRATION, AND 69 NEUTRAL PHYSICIANS EXAMS.

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












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












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

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

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

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

g	Noncash contributions included in lines 1a - 1f:$	1g

h Total. Add lines 1a-1f.......

		Business Code
2a	EMPLOYER CONTRIBUTIONS	900099	1,343,522	1,343,522
b	PHYSICIAN OPINIONS	900099	243,702	243,702
c	MEDIATION/ARBITRATION	900099	107,733	107,733
d
e
f	All other program service revenue.
g	Total. Add lines 2a–2f .....		1,694,957

3 Investment income (including dividends, interest, and othersimilar amounts) ......			1,569			1,569
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
		(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).......
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory			7a
b	Less: cost or other basis and sales expenses			7b
c	Gain or (loss)			7c
d	Net gain or (loss).........
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..
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..
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..
Business Code			Miscellaneous Revenue
11a	LIQUIDATED DAMAGES		900099	1,214	1,214
b
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......			1,214
12	Total revenue. See instructions.....			1,697,740	1,696,171	0	1,569

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 .......
5	Compensation of current officers, directors, trustees, and key employees ...........
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........
7	Other salaries and wages........
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....
9	Other employee benefits .......
10	Payroll taxes ...........
11	Fees for services (non-employees):
a	Management ......	1,248,175
b	Legal .........	2,462
c	Accounting ...........	10,300
d	Lobbying ...........
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)
12	Advertising and promotion ....	3,681
13	Office expenses .......	3,346
14	Information technology ......
15	Royalties ..
16	Occupancy ...........
17	Travel ............
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	307
20	Interest ...........
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..
23	Insurance ...	7,114
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	DISPUTE RESOLUTION EXAM	247,640
b	MEDIATION & ARBITRATION	108,609
c	OTHER EXPENSE	4,568
d	EXCLUSIVE PROVIDER FEE	4,038
e	All other expenses
25	Total functional expenses. Add lines 1 through 24e	1,640,240
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........				1
2	Savings and temporary cash investments .........			386,218	2	425,767
3	Pledges and grants receivable, net ......				3
4	Accounts receivable, net .............			51,377	4	46,644
5	Loans and other receivables from 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 ......			1,057	9	1,099
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	22,918
b	Less: accumulated depreciation	10b	22,918	0	10c	0
11	Investments—publicly traded securities .				11
12	Investments—other securities. See Part IV, line 11 .....				12
13	Investments—program-related. See Part IV, line 11 ..				13
14	Intangible assets ...............				14
15	Other assets. See Part IV, line 11 ...........				15
16	Total assets. Add lines 1 through 15 (must equal line 33)...			438,652	16	473,510

17	Accounts payable and accrued expenses .....	29,483	17	12,512
18	Grants payable ...		18
19	Deferred revenue .........	44,353	19	38,682
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..	73,836	26	51,194

	Organizations that follow FASB ASC 958, check here 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 and complete lines 29 through 33.
29	Capital stock or trust principal, or current funds .....	335,966	29	364,816
30	Paid-in or capital surplus, or land, building or equipment fund ...	0	30	0
31	Retained earnings, endowment, accumulated income, or other funds	28,850	31	57,500
32	Total net assets or fund balances ...........	364,816	32	422,316
33	Total liabilities and net assets/fund balances ........	438,652	33	473,510

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 ......

1a	Land .....
b	Buildings ....
c	Leasehold improvements
d	Equipment ....
e	Other .....	22,918	22,918	0
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				0

(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.)