TY 2022 Form 990

(A) Name and business address	(B) Description of services	(C) Compensation
HUMANA INSURANCE CO 1000 EMPLOYERS BLVD GREEN BAY,WI54344	MEDICARE ADVANT	2,986,054
METROPOLITIAN LIFE INSURANCE CO 200 PARK AVE NEW YORK,NY10166	INSURANCE	299,495
ZELIS CLAIMS INTERGRITY LLC 2 CROSSROADS DRIVE BEDMINSTER,NJ07921	CLAIMS EDIT	135,738
BENESYS INC 700 TOWER DRIVE SUITE 300 TROY,MI48098	TPA	116,243

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 4

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SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

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

Attach to Form 990.
SchDMd Bullet

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

OMB No. 1545-0047

2021

Open to Public Inspection

Name of the organization

PIPEFITTERS LOCAL NO 636
RETIREE INSURANCE FUND

Employer identification number

37-6468197

Part I

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

		(a) Donor advised funds	(b) Funds and other accounts
1	Total number at end of year .........
2	Aggregate value of contributions to (during year)
3	Aggregate value of grants from (during year)
4	Aggregate value at end of year ........

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

Yes No

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

Yes No

Part II

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

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

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

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

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


a	Total number of conservation easements ......................	2a
b	Total acreage restricted by conservation easements ....................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after 7/25/06, and not on a historic structure listed in the National Register ...	2d

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

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

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

Yes No

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

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

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

Yes No

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

Part III

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

If the organization elected, as permitted under 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.

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

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:

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

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

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

Cat. No. 52283D

Schedule D (Form 990) 2021

Page 2

Part III

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

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

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

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

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

Yes No

Part IV

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

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

Yes No


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

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

Yes No

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

Part V

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

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

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

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

Board designated or quasi-endowment SchDMd Bullet

Permanent endowment SchDMd Bullet

Term endowment SchDMd Bullet

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

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

Yes

(i) Unrelated organizations .................

3a(i)

(ii) Related organizations .................

3a(ii)

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

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

Part VI

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

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

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

Schedule D (Form 990) 2021

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
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

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

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

Part IX

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

(a) Description				(b) Book value

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

Part X

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

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

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

Schedule D (Form 990) 2021

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	9,959,267
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a	446,415
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	446,415
3	Subtract line 2e from line 1..................			3	9,512,852
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
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......			5	9,512,852

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	9,597,274
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
3	Subtract line 2e from line 1...................		3	9,597,274
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
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......		5	9,597,274

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
SCHEDULE D, PAGE 3, PART X	THE PLAN OBTAINED A FAVORABLE DETERMINATION LETTER ON JANUARY 17, 2013, IN WHICH THE INTERNAL REVENUE SERVICE STATED THAT THE PLAN AND RELATED TRUST, AS THEN DESIGNED, WAS IN COMPLIANCE WITH APPLICABLE REQUIREMENTS OF THE INTERNAL REVENUE CODE. THE PLAN HAS BEEN AMENDED SINCE RECEIVING THE DETERMINATION LETTER. HOWEVER, THE PLAN ADMINISTRATOR AND THE PLAN'S LEGAL COUNSEL BELIEVE THE PLAN IS CURRENTLY DESIGNED AND BEING OPERATED IN COMPLIANCE WITH THE APPLICABLE REQUIREMENTS OF THE INTERNAL REVENUE CODE. 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 IF THE PLAN HAS TAKEN AN UNCERTAIN TAX POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE. THE PLAN IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. THE PLAN ADMINISTRATOR BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO 2019.

Return Reference

Explanation

SCHEDULE D, PAGE 3, PART X

THE PLAN OBTAINED A FAVORABLE DETERMINATION LETTER ON JANUARY 17, 2013, IN WHICH THE INTERNAL REVENUE SERVICE STATED THAT THE PLAN AND RELATED TRUST, AS THEN DESIGNED, WAS IN COMPLIANCE WITH APPLICABLE REQUIREMENTS OF THE INTERNAL REVENUE CODE. THE PLAN HAS BEEN AMENDED SINCE RECEIVING THE DETERMINATION LETTER. HOWEVER, THE PLAN ADMINISTRATOR AND THE PLAN'S LEGAL COUNSEL BELIEVE THE PLAN IS CURRENTLY DESIGNED AND BEING OPERATED IN COMPLIANCE WITH THE APPLICABLE REQUIREMENTS OF THE INTERNAL REVENUE CODE. 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 IF THE PLAN HAS TAKEN AN UNCERTAIN TAX POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE. THE PLAN IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. THE PLAN ADMINISTRATOR BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO 2019.

Schedule D (Form 990) 2021

Additional Data

Software ID:
Software Version:

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Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

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

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

Attach to Form 990.
SchJMediumBullet

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

OMB No. 1545-0047

2022

Open to Public Inspection

Name of the organization

PIPEFITTERS LOCAL NO 636
RETIREE INSURANCE FUND

Employer identification number

37-6468197

Part I

Questions Regarding Compensation

Yes

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

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

Travel for companions Payments for business use of personal residence

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

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

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

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

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

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Cat. No. 50053T

Schedule J (Form 990) 2022

Page 2

Part II

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

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

(A) Name and Title		(B) Breakdown of W-2, 1099-MISC compensation, and/or 1099-NEC			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation in column (B) reported as deferred on prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1SAMUEL CADENA CHAIRMAN	(i) (ii)	------------- 117,396	-------------	------------- 8,601	-------------	-------------	------------- 125,997	-------------
2BILL HOLSOMBACK TRUSTEE	(i) (ii)	------------- 107,281	-------------	------------- 8,601	-------------	-------------	------------- 115,882	-------------
3THERESA DANKO TRUSTEE	(i) (ii)	------------- 106,701	-------------	------------- 8,601	-------------	-------------	------------- 115,302	-------------

Schedule J (Form 990) 2022

Page 3

Part III

Supplemental Information

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

Return Reference	Explanation

Schedule J (Form 990) 2022

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990)

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

2021

Open to Public
Inspection

Name of the organization

PIPEFITTERS LOCAL NO 636
RETIREE INSURANCE FUND

Employer identification number

37-6468197

Return Reference	Explanation
FORM 990, PAGE 1, PART I, LINE 6	ALL BOARD MEMEBERS ARE NOT COMPENSATED
FORM 990, PAGE 6, PART VI, LINE 3	MANAGEMENT OF DAY TO DAY OPERATION IS HANDLED BY A THIRD PARTY ADMINISTRATOR, BENESYS, INC.
FORM 990, PAGE 6, PART VI, LINE 11B	FORM 990 IS PREPARED BY THE CPA AND SUBMITTED TO THE TPA AND TRUSTEES FOR REVIEW, BOARD THEN AUTORIZES THE SIGNATURE OF THE FORM 8879-TE.
FORM 990, PAGE 6, PART VI, LINE 19	GOVERNING DOCUMENTS 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) 2021

Additional Data

Software ID:
Software Version:

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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

2021

Open to Public Inspection

Name of the organization

PIPEFITTERS LOCAL NO 636
RETIREE INSURANCE FUND

Employer identification number

37-6468197

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)PIPEFITTERS LOCAL 636 30100 NORTHWESTERN HIGHWAY FARMINGTON HILLS,MI48334 38-1068240	UNION	MI			N/A		No

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

Cat. No. 50135Y

Schedule R (Form 990) 2021

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
(1) ALLIED GENERAL MECHANICAL LLC 7600 IOWA DETROIT,MI48212 20-0086475			N/A				No			No
(2) HERITAGE MECHANICAL LLC 100 INDUSTRIAL ST JAMESTOWN,NY14701 99-9999999			N/A				No			No
(3) JOHNSON & WOOD LLC 3419 PIERSON PLACE FLUSHING,MI48433 38-3386488			N/A				No			No
(4) JG MECHANICAL LLC 181 LATHERS STREET GARDEN CITY,MI48135 27-5300583			N/A				No			No
(5) K & S MECHANICAL SERVICES LLC 18766 GREY AVE ALLEN PARK,MI48101 27-2117806			N/A				No			No
(6) KGB MECHANICAL LLC 5745 N 32 ST RICHLAND,MI49083 80-1814859			N/A				No			No
(7) ABM BUILDING SOLUTIONS LLC 1775 CROOKS RD STE B ATTN MARILYN SMUCKER TROY,MI48084 20-0357058			N/A				No			No
(8) MECHANICAL SYSTEMS SERV LLC 1731 E 11 MILE ROAD MADISON HTS,MI48071 04-6299466			N/A				No			No
(9) REAGAN MECHANICAL LLC 422 W CONGRESS SUITE 350 DETROIT,MI48226 47-3781231			N/A				No			No
(10) SUPERIOR FLUID SYSTEMS LLC PO BOX 81 GROSSE ILE,MI48138 20-5248621			N/A				No			No
(11) VRF TECHNOLOGIES HVAC LLC 2215 KRONNER RD COLUMBUS,MI48063 47-5519753			N/A				No			No
(12) CANAM INDUSTRIAL LLC 12749 RICHFIELD CT LIVONIA,MI48150 47-4815008			N/A				No			No
(13) THERMAL-NETICS LLC 3955 PINNACLE CT SUITE 200 AUBURN HILLS,MI48326 20-0567738			N/A				No			No
(14) UNIVERSAL PIPING INDUSTRIESLLC 769 CHICAGO ROAD TROY,MI480834223 38-3630755			N/A				No			No

Part IV

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(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) A & B REFRIGERATION 24435 W WARREN DEARBORN HGTS,MI48127 38-2001850			N/A						No
(2) ADVANTAGE MECHANICAL REFRIDGERATION 4870 W RIVER DR NE COMSTOCK PARK,MI49321 01-0554304			N/A						No
(3) ALLIANCE AC & HEATING INC 20800 HUBBELL OAK PARK,MI48237 38-1891905			N/A						No
(4) ALLOY MECHANICAL 17865 CHAPPEL AVENUE LANSING,IL60438 20-8630536			N/A						No
(5) ANDY J EGAN 2001 WALDORF NW SUITE 200 GRAND RAPIDS,MI49544 38-0512360			N/A						No
(6) ARCTIC AIR INC 4918 FERNLEE ROYAL OAK,MI480731017 38-1801848			N/A						No
(7) ATLANTIC PLANT MAINTENANCE INC 3225 PASADENA BLVD PASADENA,TX77503 14-1587578			N/A						No
(8) AUGUST WINTER & SONS INC PO BOX 1896 APPLETON,WI54912 39-0855115			N/A						No
(9) B & C TEN AIR HVAC SYSTEMS 3861 CHILDS LAKE ROAD MILFORD,MI48381 20-1325155			N/A						No
(10) MASTER MECHANICAL INSULATION 1206 E MAPLE RD TROY,MI48083 38-2939877			N/A						No
(11) BLUEWATER BOILER & MECH 7557 MARKEL RD FAIRHAVEN,MI48023 38-3582478			N/A						No
(12) BRINE'S REFRIGERATION 26400 SOUTHFIELD ROAD LATHRUP VILLAGE,MI48076 38-3019914			N/A						No
(13) BUMLER MECHANICAL 6260 18 1/2 MILE ROAD STERLING HEIGHTS,MI48314 20-1252207			N/A						No
(14) BULLET INDUSTRIAL SERVICES PO BOX 3201 SULPHUR,LA70664 46-3141346			N/A						No
(15) CAMPBELL INC 2875 CRANE WAY NORTHWOOD,OH43619 34-1080113			N/A						No
(16) CARRIER CORPORATION 5900 NORTHWOODS BUS PRKY STB ATTN ACCOUNTING DPT CHARLOTTE,NC28269 99-9999999			N/A						No
(17) CBRE INC 2375 N GLENVILLE DR RICHARDSON,TX750824470 47-1807842			N/A						No
(18) CLIMATE PROS INC 2190 GLADSTONE DRIVE SUITE E GLENDALE HEIGHTS,IL60139 55-0914273			N/A						No
(19) COASTLINE MECHANICAL 8861 STONE ROAD CLAY TOWNSHIP,MI48001 80-2524157			N/A						No
(20) COMPLETE MECHANICAL CONTRACT 681 MANUFACTOR DRIVE WESTLAND,MI48186 01-0583872			N/A						No
(21) CONTI MECHANICAL INC 6417 CENTER DRIVE STERLING HTS,MI48312 38-1884765			N/A						No
(22) DAIKIN APPLIED 13600 INDUSTRIAL PARK BLV MINNEAPOLIS,MN55441 41-0404230			N/A						No
(23) CONTROL SOLUTIONS INC 5805 WOLLER COURT STE A WYOMING,MI49509 80-0206784			N/A						No
(24) CR MEYER & SONS COMPANY PO BOX 2157 OSHKOSH,WI54903 39-0467980			N/A						No
(25) DANBOISE MECHANICAL INC 31625 GRAND RIVER AVENUE FARMINGTON,MI48336 41-2105440			N/A						No
(26) DE-CAL INC 24659 SCHOENHERR RD WARREN,MI48089 38-3023202			N/A						No
(27) DEE CRAMER INC 4221 E BALDWIN HOLLY,MI48442 38-1434878			N/A						No
(28) DELTA TEMP INC 44285 NORTH GROESBECK CLINTON TWP,MI48036 38-1950675			N/A						No
(29) DETROIT BOILER COMPANY 2931 BEAUFAIT ST DETROIT,MI48207 38-2147918			N/A						No
(30) DUAL TEMP REFRIGERATION INC 33798 CAPITOL LIVONIA,MI48150 38-2470904			N/A						No
(31) DUNBAR MECH INC 2806 N REYNOLDS ROAD TOLEDO,OH43615 34-4467756			N/A						No
(32) MACOMB MECHANICAL 6250 19 MILE ROAD STERLING HTS,MI48314 38-3119199			N/A						No
(33) ECKER MECH CONTR INC PO 190099 BURTON,MI48519 38-1806282			N/A						No
(34) ENERFAB INC 4955 SPRING GROVE AVENUE CINCINNATI,OH45232 31-0217488			N/A						No
(35) ERIE WELDING & MECH CONSTR INC PO BOX 254 9776 S DIXIE HWY ERIE,MI48133 80-0034852			N/A						No
(36) FM SYLVAN INC 3800 MAPLE STREET DEARBORN,MI48126 22-3841378			N/A						No
(37) GEM INDUSTRIAL INC 6842 COMMODORE DRIVE WALBRIDGE,OH43565 31-1036493			N/A						No
(38) GRAYCOR INDUSTRIAL CONSTRUCTOR 2 MID AMERICA PL SUITE 400 OAKBROOK TERRACE,IL60181 36-0898220			N/A						No
(39) GOLDEN REFRIGERANT 31800 INDUSTRIAL RD LIVONIA,MI481501820 38-3245149			N/A						No
(40) GOYETTE MECHANICAL PO BOX 33 FLINT,MI48501 38-1332690			N/A						No
(41) GREAT LAKES MECHANICAL 3800 MAPLE DEARBORN,MI48126 38-1745758			N/A						No
(42) HENKELS & MCCOY INC 985 JOLLY ROAD BLUE BELL,PA19422 23-1535602			N/A						No
(43) HOLLY CONSTRUCTION 19000 MEGINNITY AVE MELVINDALE,MI48122 38-2361545			N/A						No
(44) HOYT BRUMM & LINK 1400 E 9 MILE ROAD FERNDALE,MI48220 38-1948484			N/A						No
(45) HUSSMANN SERVICES CORPORATION 3123 WILSON DRIVE NW GRAND RAPIDS,MI49534 43-0156220			N/A						No
(46) INDUSTRIAL PIPING SYSTEMS PO BOX 1733 TROY,MI480991733 38-3556141			N/A						No
(47) INDUSTRIAL POWER SYSTEMS INC 146 DIXIE HWY ROSSFORD,OH43460 34-1473329			N/A						No
(48) JANSSEN REFRIGERATION COMPANY 26725 BUNERT WARREN,MI48089 38-3392937			N/A						No
(49) JOHN DARR MECHANICAL INC 293 DINO DRIVE ANN ARBOR,MI48103 38-3375244			N/A						No
(50) JOHN E GREEN P&H CO 220 VICTOR HIGHLAND PARK,MI48203 38-0607500			N/A						No
(51) JOHNSON CONTROLS INC 507 E MICHIGAN STREET MAIL STATION LD-54 MILWAUKEE,WI53202 39-0380010			N/A						No
(52) KIEWIT POWER CONSTRUCTORS 12720 I ST OMAHA,NE68137 47-0647804			N/A						No
(53) KROPF SERVICE CO 33792 CAPITOL LIVONIA,MI481501554 38-2167403			N/A						No
(54) WHISLER PLUMBING & HEATING INC 2521 LINCOLN WAY E MASSILLON,OH44646 34-0862669			N/A						No
(55) LAMSAR INC PO BOX 611020 PORT HURON,MI48061 38-3550559			N/A						No
(56) LIMBACH COMPANY 926 FEATHERSTONE PONTIAC,MI48342 16-1622725			N/A						No
(57) LONG MECHANICAL 190 E MAIN NORTHVILLE,MI48167 38-1897840			N/A						No
(58) BHI ENERGY SERVICES 2005 NEWPOINT PKWY LAWRENCEVILLE,GA30043 61-1717549			N/A						No
(59) M-TECH KROGER 40399 GRAND RIVER AVE NOVI,MI48375 31-0345740			N/A						No
(60) MAP GENERAL MECHANICAL CONTRAC 2600 NORTHWEST RIVER ROAD SANFORD,MI48657 80-0064015			N/A						No
(61) AINSWORTH INC 1515 E KIRBY DETROIT,MI48211 83-1674559			N/A						No
(62) MECHANICAL SERVICES INC 9897 WEBER ST BRIGHTON,MI48116 38-3479779			N/A						No
(63) METRO CONTROLS INC 22660 15 MILE RD CLINTON TWP,MI48035 38-2659587			N/A						No
(64) METRO PIPING INC 1500 TROMBLY DETROIT,MI48211 38-3575640			N/A						No
(65) MID-AMERICAN GUNITE INC 8475 PORT SUNLIGHT ROAD NEWPORT,MI48166 38-2482769			N/A						No
(66) MILLER - BOLDT INC 21481 CARLO DRIVE CLINTON TOWNSHIP,MI48038 22-3877519			N/A						No
(67) MONROE PLBG & HTG 506 COOPER STREET MONROE,MI481610307 38-1296178			N/A						No
(68) MSL MECHANICAL 333 W FORT ST SUITE 1960 DETROIT,MI48226 20-3866199			N/A						No
(69) N B PROCESSING INC 2025 LATIMER DRIVE MUSKEGON,MI49442 38-2964796			N/A						No
(70) CLIMATE TECHNOLOGY MECH SYSTEM 38209 ABRUZZI DRIVE WESTLAND,MI48185 20-8681490			N/A						No
(71) OSCAR W LARSON NMA COMPANY 10080 DIXIE HWY CLARKSTON,MI48348 36-4587871			N/A						No
(72) PCS PO BOX 510 RIPLEY,WV25271 04-3815019			N/A						No
(73) PHOENIX ENVIRONMENTAL 12815 PREMIER CENTER CRT PLYMOUTH,MI48170 38-3397670			N/A						No
(74) PHOENIX REFRIGERATION 29333 LORIE LN WIXOM,MI48393 30-0058938			N/A						No
(75) PIPEFITTERS EDUC SCHOOL 636 EXECUTIVE DRIVE TROY,MI48083 38-6221933			N/A						No
(76) PJ STEEL SUPPLY INC 305 E PARK DR PO BOX 1057 KALKASKA,MI49646 45-4345153			N/A						No
(77) POWER PROCESS PIPING INC 45780 PORT STREET PLYMOUTH,MI48170 38-2041808			N/A						No
(78) PREMIER REFRIGERATION CO 6650 HIGHLAND RD STE 311 WATERFORD,MI48327 38-2390938			N/A						No
(79) PROGRESSIVE MECHANICAL 1080 N CROOKS ROAD CLAWSON,MI48017 38-2552170			N/A						No
(80) PURVIS & FOSTER INC 9640 GRINNELL ST DETROIT,MI48213 38-1310985			N/A						No
(81) R & D MECHANICAL SYSTEMS 39111 W SIX MILE ROAD SUITE 111 LIVONIA,MI48152 38-3402166			N/A						No
(82) RW MEAD & SONS INC 33795 RIVIERA FRASER,MI48026 38-3388367			N/A						No
(83) RENE VANASSCHE & SONS 21530 GROESBECK WARREN,MI48089 38-1887156			N/A						No
(84) MICHIGAN PIPE TRADES ASSOC 7920 JACKSON RD ANN ARBOR,MI48103 23-7352117			N/A						No
(85) S & D MECHANICAL SERVICES INC 7503 FENTON ROAD GRAND BLANC,MI48439 45-5269520			N/A						No
(86) S & M SHEET METAL 23262 TELEGRAPH SOUTHFIELD,MI480334156 38-2581135			N/A						No
(87) SAMA MECHANICAL PIPING 6659 SCHAEFER STE 1063 DEARBORN,MI48126 80-2621781			N/A						No
(88) SCHECK MECHANICAL CORP 545 PLAINFIELD ROAD UNIT F WILLOWBROOK,IL60527 36-3294759			N/A						No
(89) SEAWAY MECH CONTR 650 W JEFFERSON PO BOX 476 TRENTON,MI48183 38-1557953			N/A						No
(90) SHAMBAUGH & SON INC PO BOX 1287 FORT WAYNE,IN46801 35-0965412			N/A						No
(91) SIEMENS BUILDING TECHNOLOGIES 45470 COMMERCE CENTER DR ATTENTION TERRI MARTIN PLYMOUTH TOWNSHIP,MI48170 13-2762488			N/A						No
(92) SONGER STEEL SVCS (SSSI INC) 100 HOUSTON SQUARE SUITE 200 CANONSBURG,PA15317 25-1480393			N/A						No
(93) SUMMIT CONTRACTORS INC PO BOX 219 HASLETT,MI48840 38-3441559			N/A						No
(94) SYSTEMP CORPORATION 3355 BALD MOUNTAIN ROAD SUITE 10 AUBURN HILLS,MI48326 38-3090285			N/A						No
(95) SYENERGY ENGINEERING 2129 AUSTIN AVE ROCHESTER HILLS,MI48309 45-4704340			N/A						No
(96) TH EIFERT MECH CONTRACTORS 3302 WEST STJOSEPH LANSING,MI48917 38-2658387			N/A						No
(97) TEMPCO MECHANICAL CONTRACTORS 24383 INDOPLEX CIRCLE FARMINGTON HILLS,MI48335 38-2447830			N/A						No
(98) TEMPERATURE SERVICES 37679 SCHOOLCRAFT LIVONIA,MI48150 38-2447830			N/A						No
(99) TRANE US INC 800 - D BEATY STREET DAVIDSON,NC28036 25-0900465			N/A						No
(100) UNITED PIPING INC 4510 AIRPORT ROAD DULUTH,MN55811 41-1863656			N/A						No
(101) UNITED TECHNICAL SERVICES 2505 HUTCHINSON MCDONALD CHARLOTTE,NC28269 46-3705133			N/A						No
(102) W J O'NEIL MECHANICAL SVS 35457 INDUSTRIAL RD LIVONIA,MI48150 38-2489126			N/A						No
(103) W SOULE & CO 7125 S SPRINKLE RD KALAMAZOO,MI49002 38-1811731			N/A						No
(104) W J O'NEIL COMPANY 35457 INDUSTRIAL RD LIVONIA,MI48150 38-2489126			N/A						No
(105) WAGNER-MEINERT INC 7617 FREEDOM WAY FORT WAYNE,IN46818 35-1831650			N/A						No
(106) WATSON BROS SERVICE COMPANY 3433 ELECTRIC AVE PORT HURON,MI48060 38-3568239			N/A						No
(107) WAYNE STATE UNIVERSITY 5700 CASS AVENUE SUITE 3800 DETROIT,MI48202 38-6028429			N/A						No
(108) WEBB MECH & ELEC CONTRACTORS 12550 UNIVERSAL DRIVE TAYLOR,MI48180 38-3272253			N/A						No
(109) WESTERN MECH CONTR IN 22630 15 MILE ROAD CLINTON TOWNSHIP,MI480353100 38-2492950			N/A						No
(110) WHITE REFRIGERATION INC 7920 W ORLANDO ROAD ANGOLA,IN46703 35-2045457			N/A						No
(111) WILLIAM E WALTER INC 1917 HOWARD AVENUE FLINT,MI48503 38-1227478			N/A						No
(112) WITT MECHANICAL INC P O BOX 930379 WIXOM,MI48393 38-3334606			N/A						No
(113) WOOD REFRIGERATION 11336 EAGLE WAY BRIGHTON,MI48114 61-1527372			N/A						No
(114) DUAL TEMP COMPANIES 9550 W 55TH STREET MCCOOK,IL60525 36-3261109			N/A						No
(115) LINCOLN MANUFACTURING INC 198 MEADOWLANDS BLVD WASHINGTON,PA15301 51-0480851			N/A						No
(116) RW LAPINE INC PO BOX 2045 KALAMAZOO,MI490032045 80-0179216			N/A						No
(117) PIPELINE INDUSTRY BENEFIT FUND PO BOX 470950 TULSA,OK74147 73-6146433			N/A						No
(118) LOCAL 17 PO BOX 1449 GOODLETTSVILLE,TN37070 99-9999999			N/A						No
(119) LU 178 PLUMBERS & PIPEFITTERS BENEF 2501 W GRAND SPRINGFIELD,MO65802 23-7001199			N/A						No
(120) US LOCAL UNION 85 PO BOX 6547 3535 BAY RD SAGINAW,MI48608 38-1119237			N/A						No
(121) APCOM POWER 3225 PASADENA BLVD PASADENA,TX77503 60-1292279			N/A						No

Schedule R (Form 990) 2021

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) 2021

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) 2021

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) 2021

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: PROVIDING HEALTH AND WELFARE BENEFITS FOR RETIREES.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	8
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	3
5	Total number of individuals employed in calendar year 2021 (Part V, line 2a) ......	5	0
6	Total number of volunteers (estimate if necessary) .............	6	3
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	0
b	Net unrelated business taxable income from Form 990-T, Part I, line 11 .........	7b

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........		0
9	Program service revenue (Part VIII, line 2g) .........	9,810,851	9,714,359
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	29,430	-201,507
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)		0
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	9,840,281	9,512,852
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...		0
14	Benefits paid to or for members (Part IX, column (A), line 4).....	7,590,593	9,193,467
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)		0
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....		0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	259,318	403,807
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	7,849,911	9,597,274
19	Revenue less expenses. Subtract line 18 from line 12.......	1,990,370	-84,422
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	13,627,990	13,575,269
21	Total liabilities (Part X, line 26).............	515,485	100,771
22	Net assets or fund balances. Subtract line 21 from line 20.....	13,112,505	13,474,498

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )
	HOSPITAL, MEDICAL, DENTAL, LIFE, VISION, HEARING, RX, AND OTHER SUPPLEMENTAL BENEFITS PAID TO OR ON THE BEHALF OF RETIRED MEMBERS OF PIPEFITTERS LOCAL NO. 636 AND THEIR DEPENDENTS AND BENEFICIARIES.

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












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












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

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)			(D) Reportable compensation from the organization (W-2/1099-MISC/1099-NEC)	(E) Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and title
(1) SAMUEL CADENA...................................................................... CHAIRMAN	0.00 ................. 40.00			X	0	125,997	0
(2) ANTONI SIEVERT...................................................................... TRUSTEE	0.00 ................. 40.00	X			0	115,882	0
(3) BILL HOLSOMBACK...................................................................... TRUSTEE	0.00 ................. 40.00			X	0	115,882	0
(4) THERESA DANKO...................................................................... TRUSTEE	0.00 ................. 40.00			X	0	115,302	0
(5) JAKE REGITS...................................................................... TRUSTEE	0.00 ................. 40.00	X			0	107,562	0
(6) LARRY KRISNISKI...................................................................... CHAIRMAN	0.00 ................. 40.00	X	X		0	106,882	0
(7) MICHAEL FLESHER...................................................................... TRUSTEE	0.00 ................. 0.00	X			0	0	0
(8) CHRISTOPHER FREEMAN...................................................................... TRUSTEE	0.00 ................. 0.00	X			0	0	0
(9) JOHN GREEN...................................................................... SECRETARY	0.00 ................. 0.00	X	X		0	0	0

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	687,507

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		6,969,080	6,969,080
b	EMPLOYEE CONTRIBUTIONS		2,745,279	2,745,279
c
d
e
f	All other program service revenue.
g	Total. Add lines 2a–2f .....		9,714,359

3 Investment income (including dividends, interest, and othersimilar amounts) ......			366,205			366,205
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		5,123,766	7a
b	Less: cost or other basis and sales expenses		5,691,478	7b
c	Gain or (loss)		-567,712	7c
d	Net gain or (loss).........			-567,712			-567,712
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
b
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......
12	Total revenue. See instructions.....			9,512,852	9,714,359		-201,507

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 .......	9,193,467	9,193,467
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 ......	305,019	305,019
b	Legal .........	33,184	33,184
c	Accounting ...........	10,450	10,450
d	Lobbying ...........
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......	1,455	1,455
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	10,214	10,214
12	Advertising and promotion ....
13	Office expenses .......	20,623	20,623
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 ....	3,927	3,927
20	Interest ...........
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..
23	Insurance ...	13,898	13,898
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	FUNDING OF JAC	5,037	5,037
b
c
d
e	All other expenses
25	Total functional expenses. Add lines 1 through 24e	9,597,274	9,597,274	0	0
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 ........		2,769,915	1	1,112,130
2	Savings and temporary cash investments .........		92,028	2	1,729,320
3	Pledges and grants receivable, net ......			3
4	Accounts receivable, net .............		586,216	4	779,844
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 ......		5,127	9	719,018
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a
b	Less: accumulated depreciation	10b		10c
11	Investments—publicly traded securities .		10,174,704	11	9,234,957
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)...		13,627,990	16	13,575,269

17	Accounts payable and accrued expenses .....	262,448	17	100,771
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	253,037	25
26	Total liabilities. Add lines 17 through 25..	515,485	26	100,771

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	13,112,505	27	13,474,498
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 .....		29
30	Paid-in or capital surplus, or land, building or equipment fund ...		30
31	Retained earnings, endowment, accumulated income, or other funds		31
32	Total net assets or fund balances ...........	13,112,505	32	13,474,498
33	Total liabilities and net assets/fund balances ........	13,627,990	33	13,575,269