TY 2022 Form 990

(A) Name and business address	(B) Description of services	(C) Compensation
BLUE CROSSBLUE SHIELD 300 E RANDOLPH STREET CHICAGO,IL60601	CLAIMS PAYER/NETWORK	649,126
ZENITH-AMERICAN 2625 BUTTERFIELD ROAD OAK BROOK,IL60523	THIRD-PARTY ADMIN	587,767
ARNOLD & KADJAN 203 N LASALLE SUITE 1650 CHICAGO,IL60601	LEGAL SERVICES	244,405


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 3

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

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

Attach to Form 990.
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

NECA IBEW 176 HEALTH & WELFARE FUND

Employer identification number

36-1264190

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	1,433,111	242,796	1,190,315
d	Equipment ....
e	Other .....	15,334	15,334	0
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				1,190,315

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) COMMON COLLECTIVE TRUSTS - NIS	11,526,559	F
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)	11,526,559

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
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	25,972,139
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	31,689,403
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a	203,639
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	203,639
3	Subtract line 2e from line 1..................			3	31,485,764
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	104,883
b	Other (Describe in Part XIII.) ...........	4b
c	Add lines 4a and 4b....................			4c	104,883
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......			5	31,590,647

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	30,497,659
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	-1,345,600
e	Add lines 2a through 2d....................			2e	-1,345,600
3	Subtract line 2e from line 1...................			3	31,843,259
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	104,883
b	Other (Describe in Part XIII.) ............	4b
c	Add lines 4a and 4b.....................			4c	104,883
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......			5	31,948,142

Part XIII

Supplemental Information

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

Return Reference	Explanation
PART X, LINE 2:	THE TRUST ESTABLISHED UNDER THE PLAN TO HOLD THE PLAN'S ASSETS IS QUALIFIED PURSUANT TO SECTION 501(C)(9) OF THE INTERNAL REVENUE CODE AS A TAX-EXEMPT ORGANIZATION. THE PLAN HAS OBTAINED A FAVORABLE TAX DETERMINATION LETTER FROM THE INTERNAL REVENUE SERVICE, AND THE PLAN SPONSOR BELIEVES THAT THE PLAN, AS AMENDED, CONTINUES TO QUALIFY AND TO OPERATE IN ACCORDANCE WITH APPLICABLE PROVISIONS 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 (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 ADMINISTRATOR HAS ANALYZED THE TAX POSITIONS TAKEN BY THE PLAN, AND HAS CONCLUDED THAT AS OF MAY 31, 2023, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY (OR ASSET) OR DISCLOSURE IN THE FINANCIAL STATEMENTS. THE PLAN IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. AT MAY 31, 2023, THE PLAN IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR THE YEARS PRIOR TO THE YEAR ENDED MAY 31, 2020.
PART XII, LINE 2D - OTHER ADJUSTMENTS:	CHANGE IN BENEFIT OBLIGATIONS -1,345,600.

Return Reference

Explanation

PART X, LINE 2:

THE TRUST ESTABLISHED UNDER THE PLAN TO HOLD THE PLAN'S ASSETS IS QUALIFIED PURSUANT TO SECTION 501(C)(9) OF THE INTERNAL REVENUE CODE AS A TAX-EXEMPT ORGANIZATION. THE PLAN HAS OBTAINED A FAVORABLE TAX DETERMINATION LETTER FROM THE INTERNAL REVENUE SERVICE, AND THE PLAN SPONSOR BELIEVES THAT THE PLAN, AS AMENDED, CONTINUES TO QUALIFY AND TO OPERATE IN ACCORDANCE WITH APPLICABLE PROVISIONS 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 (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 ADMINISTRATOR HAS ANALYZED THE TAX POSITIONS TAKEN BY THE PLAN, AND HAS CONCLUDED THAT AS OF MAY 31, 2023, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY (OR ASSET) OR DISCLOSURE IN THE FINANCIAL STATEMENTS. THE PLAN IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. AT MAY 31, 2023, THE PLAN IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR THE YEARS PRIOR TO THE YEAR ENDED MAY 31, 2020.

PART XII, LINE 2D - OTHER ADJUSTMENTS:

CHANGE IN BENEFIT OBLIGATIONS -1,345,600.

Schedule D (Form 990) 2021

Additional Data

Software ID:
Software Version:

- TIN:

Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

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

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

Attach to Form 990.
SchJMediumBullet

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

NECA IBEW 176 HEALTH & WELFARE FUND

Employer identification number

36-1264190

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)
1ANDRES RICO TRUSTEE	(i) (ii)	0 ------------- 138,644	0 ------------- 0	0 ------------- 600	0 ------------- 43,071	0 ------------- 44,031	0 ------------- 226,346	0 ------------- 0

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

NECA IBEW 176 HEALTH & WELFARE FUND

Employer identification number

36-1264190

Return Reference	Explanation
FORM 990, PART VI, SECTION A, LINE 3	LINE 3 EXPLANATION - ZENITH-AMERICAN IS THE THIRD PARTY ADMINISTRATOR HIRED TO ADMINISTER THE FUND'S DAY-TO-DAY OPERATIONS.
FORM 990, PART VI, SECTION B, LINE 11B	THE TRUSTEES AUTHORIZE THE FUND'S THIRD-PARTY ADMINISTRATOR AND A DESIGNATED TRUSTEE TO REVIEW THE FORM 990 BEFORE IT IS FILED.
FORM 990, PART VI, SECTION B, LINE 12C	THE TRUSTEES ARE GOVERNED BY THE TRUST DOCUMENT AND A WRITTEN POLICY AND HAVE A FIDUCIARY RESPONSIBILITY UNDER ERISA TO ADMINISTER THE PLAN IN THE BEST INTEREST OF THE MEMBERSHIP. THE U.S. DEPARTMENT OF LABOR REQUIRES ALL LABOR TRUSTEES TO REPORT ON FORM LM-30 POTENTIAL SITUATIONS WHERE THERE MAY BE CONFLICTS OF INTEREST. THIS INFORMATION IS OPEN TO THE PUBLIC.
FORM 990, PART VI, SECTION C, LINE 19	A SUMMARY ANNUAL REPORT IS DISTRIBUTED TO ALL PARTICIPANTS. PARTICIPANTS ARE ABLE TO REQUEST THE AUDITOR'S REPORT AND OTHER FINANCIAL INFORMATION FROM THE PLAN ADMINISTRATOR AND/OR THE U.S. DEPARTMENT OF LABOR. ALSO, FORM 5500 IS OPEN TO PUBLIC INSPECTION THROUGH THE U.S. DEPARTMENT OF LABOR.
FORM 990, PART XII, LINE 2C:	THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.

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:

- 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

2021

Open to Public Inspection

Name of the organization

NECA IBEW 176 HEALTH & WELFARE FUND

Employer identification number

36-1264190

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)IBEW LOCAL 176 SUPP UNEMPLOYMENT BEN FND 1100 NE FRONTAGE ROAD JOLIET,IL60431 36-3936888	PROVIDE UNEMPLOYMENT BENEFITS TO PARTICIPANTS	IL	501(C)(9)				No
(2)IBEW LOCAL 176 UNION 1100 NE FRONTAGE ROAD JOLIET,IL60431 36-1264196	LABOR UNION		501(C)(5)				No
(3)LOCAL 176 JATC 1110 NE FRONTAGE ROAD JOLIET,IL60431 36-6408014							No
(4)NECA - EASTERN ILLINOIS CHAPTE 1308 HOUBOLT ROAD JOLIET,IL60431 36-2753258	CONTRACTORS ASSOCIATION		501(C)(6)				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

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) 9 VOLT 2 LIGHTNING ELECTRIC INC
(2) A & F ELECTRICAL SERVICES
(3) AMC TELEPHONE SERVICE INC
(4) AARDEMA ELECTRIC LLC
(5) ABCO
(6) ABR COMMUNICATIONS INC
(7) ABS ELECTRICAL DIVISION
(8) ACAMARD TECHNOLOGIES INC
(9) ADVANCED COMMUNICATIONS INC
(10) ADVANCED DATA TECHNOLOGIES
(11) ADVANCED ELECTRICAL SYSTEMS INC
(12) ADVANCED WIRING SOLUTIONS INC
(13) ADVANTAGE TECHNOLOGIES LLC
(14) ADVENT SYSTEMS LLC DBA ALLIED UNIVERSAL TECHNOLOGY
(15) AIRPORT ELECTRIC CO
(16) ALL ELECTRIC SERVICES INC
(17) ALLIED POWER SERVICES LLC
(18) ALPHA CONTROLS & SERVICES LLC
(19) AMBER MECHANICAL DBA TOTAL AUTOMATION CONCEPTS INC
(20) AMERICAN ELECTRIC CONST CO LLC
(21) AMERICAN ELECTRICAL INC
(22) AMP ELECTRICAL SERVICES INC
(23) AMS MECHANICAL SYSTEMS INC
(24) ANCHOR ELECTRIC CORP
(25) ANDERSON PUMP SERVICE INC
(26) ANJ ELECTRIC INC
(27) APPLIED COMMUNICATIONS GROUP
(28) ARC 1 ELECTRIC
(29) ASSOCIATED ELEC CONTR OF IL LLC
(30) ATLANTIC PLANT MAINTENANCE
(31) ATOMATIC MECHANICAL SERVICES INC
(32) AUSTGEN'S ELECTRIC INC
(33) AUSTIN ELECTRIC INC
(34) AWF INC DBA AURORA WIRE & FIXTURE
(35) AYERS ELECTRIC INC
(36) B & B ELECTRIC INC
(37) B ARMSTRONG ELECTRICAL SERVICES INC
(38) BARCOM ELECTRONIC INC DBA BARCOM SECURITY INC
(39) BATT & GRAHAM LLC DBA B & G ELECTRIC
(40) BEACON SALES SERVICE INC
(41) BELCORE ELECTRIC CONST
(42) BELMONT LEAVITT DBA AVONDALE ELECTRIC
(43) BENNETT ELECTRONIC SERVICES
(44) BENSON ELECTRICAL CONTRACTING
(45) BERNARDONI ELECTRIC INC
(46) BERRY ELECTRIC CONTR CO INC
(47) BHI ENERGY SPECIALTY SERVICES LLC
(48) BLACKHAWK ELECTRICAL CONSTRUCTION LLC
(49) BLADE ELECTRIC & TECHNOLOGIES LLC
(50) BLOCK ELEC CO INC
(51) BODINE ELECTRIC OF DECATUR
(52) BRANDENBURG ELECTRONIC SYSTEMS LLC
(53) BRITTON AUTOMATION
(54) BROWN ELECTRIC SERVICE INC
(55) CARILEY ELECTRIC CONSTRUCTION CORP
(56) CABLE COMMUNICATIONS INC
(57) CABLE ELECTRIC
(58) CACHE VALLEY ELECTRIC
(59) CANINO ELECTRIC
(60) CAPITOL CONSTRUCTION GROUP LLC DBA EGIZII ELECTRIC
(61) CAREY ELECTRIC CONTRACTING LLC
(62) CENTRAL ILLINOIS ELECTRICAL SR
(63) CHICAGO HTS CARRIER ELEC CO
(64) CHICAGO POWER & COMMUNICATIONS
(65) CHICAGOLAND CABLING SOLUTIONS
(66) CIPHER TECHNOLOGY SOLUTIONS INC
(67) CIRCLE R ELECTRIC INC
(68) CITY SERVICE ELECTRIC
(69) CJ POWER INC
(70) CLEGG-PERKINS ELECTRIC INC
(71) CLENNON ELECTRIC CO INC
(72) CLIMATE PROS LLC
(73) COMM-TEST ELECTRIC INC
(74) COMMERCIAL ELECTRONIC SYS INC
(75) COMMUNICATION SOLUTIONS INC IL
(76) COMMUNICATION SPECIALTIES INC
(77) COMMUNICATION ZONE INC
(78) COMPLETE ELECTRICAL SERVICE
(79) CONCUR
(80) CONNELLY ELECTRIC
(81) CONNOR ELECTRIC SERVICES
(82) CONTI LLC
(83) CONTINENTAL ELECTRIC
(84) COPPERFIELD COMMUNICATIONS & ELECTRIC CO
(85) CORRECT ELECTRIC
(86) CRAWFORD CO DBA ART-O-LITE ELECTRIC
(87) CROSSTOWN ELEC INC
(88) CSN ELECTRIC LLC
(89) CURRENT COMMUNICATIONS & ELECT
(90) CURRENT ELECTRICAL MECHANICAL INC
(91) D CONSTRUCTION
(92) DAV-COM ELECTRIC INC
(93) DAVENPORT ELECTRICAL CONTRACT
(94) DELANEY TELECOM INC DBA BLACK BOX NETWORK
(95) DUAL TEMP OF ILLINOIS
(96) DURKIN ELECTRIC
(97) DYNAMIC ELECTRIC INC
(98) E STONE INC
(99) ECO LIGHTING SERVICES & TECHNOLOGY LLC
(100) EGAN COMPANY
(101) ELECTRIC CONDUIT CONSTRUCTION COMPANY
(102) ELECTRIC ONE INC
(103) ELECTRICAL BUILDERS INC
(104) ELECTRICAL CONTRACTORS INC
(105) ELECTRICAL DESIGN SYSTEMS CORP
(106) ELLIOTT ELECTRIC INC
(107) ELMUND & NELSON CO INC
(108) EMCOR HYRE ELECT CO OF INDIANA
(109) EMMRICK ELECTRIC INC
(110) ENGEL ELECTRIC CO
(111) EXCEL ELECTRIC INC
(112) EXPRESS SIGNS & LIGHTING PAYROLL CORPORATION
(113) FE MORAN INC FIRE PROTECTION OF NORTHERN IL
(114) FE MORAN INC SPECIAL HAZARD SYSTEMS
(115) FARRELL ELECTRIC CO
(116) FENNELL ELECTRIC INC
(117) FICEK ELEC & COMM SYSTEMS
(118) FIRETEK LLC
(119) FIRST SECURITY SYSTEMS INC
(120) FLEMING ELECTRIC
(121) FOREFRONT ELECTRICAL TESTING
(122) FOUR STAR ELECTRIC
(123) FRANK MARSHALL ELECTRIC LLC
(124) FRIENDLY SIGNS
(125) G & M ELECTRICAL CONTRACTORS
(126) GATZA ELECTRICAL CONTRACTING INC
(127) GD BARRI & ASSOCIATES INC
(128) GEARY ELECTRIC INC
(129) GIBSON ELECTRIC CO INC
(130) GOORSKY ELECTRIC INC
(131) GRAND KAHN ELECTRIC INC
(132) GREATLINE COMMUNICATIONS
(133) GREEN ELECTRICAL CONTRACTING INC
(134) GS ELECTRIC CO INC
(135) GUARANTEE ELECTRICAL CONSTRUCT
(136) GURTZ ELECTRIC
(137) H & G SERVICES
(138) H & H ELECTRIC
(139) H & S MECHANICAL INC
(140) HMM SYSTEMS INC
(141) HALM ELECTRICAL CONTRACTING
(142) HARD ROCK CONCRETE CUTTERS
(143) HARDT ELECTRIC
(144) HART ELECTRIC INC
(145) HARTMANN ELECTRIC
(146) HAWK ENTERPRISES
(147) HEARTLAND ELECTRIC LLC
(148) HECKER AND CO
(149) HELM ELECTRIC FACILITY SOLUTIONS INC
(150) HEPA DBA LAUREL ELECTRIC INC
(151) HESS ELECTRICAL CONSTRUCTION C
(152) HIGH VOLTAGE MAINTENANCE CORP
(153) HINSDALE ELECTRIC
(154) HLP SYSTEMS INC
(155) HOLMGREN ELECTRIC INC
(156) HOME TOWNE ELECTRIC INC
(157) HOMESTEAD ELECTRICAL CONTRACTING LLC
(158) HUEN ELECTRIC INC
(159) HUSSMANN CORPORATION
(160) HY-POWER ELECTRIC CO
(161) IO ELECTRIC LLC
(162) ICOM INC
(163) IDEAL ELECTRIC INC
(164) ILLINOIS BUSINESS COMMUNICATIO
(165) IMPERIAL LIGHTING MAINTENANCE
(166) INDICOMMIV INC
(167) INTEGRATED CONTROL TECHNOLOGIES LLC
(168) INTEGRATED ELECTRICAL SERVICES LLC
(169) INTEGRITY SIGN COMPANY
(170) INTERSTATE ELECTRONICS CO
(171) INTREN
(172) J HORN ELECTRIC LLC
(173) JB CONTRACTING CORP
(174) JC POWER & CONTROL
(175) JF EDWARDS CONSTRUCTION CO
(176) JF ELECTRIC INC
(177) JAMERSON AND BAUWENS ELECTRICAL CONT INC
(178) JAN ELECTRIC LLC
(179) JASCO ELECTRIC INC
(180) JDR ELECTRIC
(181) JJ JONES & COMPANY LTD
(182) JM ELECTRIC SERVICE INC
(183) JMS ELECTRICAL CONSTRUCTION
(184) JOHN BURNS ELECTRIC CO
(185) JOLEN ELECTRIC & COMMUNICATION
(186) JONES ELECTRICAL CONTRACTORS INC
(187) K L ELECTRIC
(188) KAISER ELECTRICAL CONTRACTOR'S
(189) KALISH ELECTRIC CO
(190) KAVANAUGH ELECTRIC
(191) KEAST ELECTRIC
(192) KELLY ELECTRIC INC
(193) KELSO-BURNETT ELEC CO
(194) KIEWIT POWER CONSTRUCTORS
(195) KLASS ELECTRIC INC
(196) KOEHLER ELECTRIC INC JW
(197) KOENER ELECTRIC INC
(198) KPI ELECTRIC
(199) KREYKES ELECTRIC
(200) KROESCHELL ENGINEERING CO
(201) KTK ELECTRICAL CONTRACTORS IC
(202) KWASIGROCH ELECTRIC INC
(203) L & F ELECTRIC INC
(204) LACROSSE ELECTRIC CO
(205) LAMARCHE ELECTRIC
(206) LASER ELECTRIC
(207) LAUDERDALE ELECTRIC
(208) LEYDEN ELECTRIC INC
(209) LIGHTING MAINTENANCE INC
(210) LIGHTNING PROTECTION SYSTEMS LLC DBA VFC
(211) LINEAR ELECTRIC INC
(212) LIVEWIRE ELECTRIC
(213) LOESCHER HEATING & AIR CONDITIONING INC
(214) LOHBAUER ELECTRIC LLC
(215) LOW VOLTAGE SOLUTIONS
(216) LYONS ELECTRIC CO
(217) MJ ELECTRIC LLC
(218) MT KELLEY ELECTRIC LLC
(219) M3 ELECTRIC INC
(220) M3 ELECTRICAL CONTRACTING INC
(221) MAC COMMUNICATIONS
(222) MALKO COMMUNICATION SERVICES LLC
(223) MARCHIONE ELECTRIC INC
(224) MARON ELECTRIC COMPANY
(225) MASTERS INCWILLIAM
(226) MATCO FIRE PROTECTION INC
(227) MCWILLIAMS ELECTRIC CO INC
(228) MDI ELECTRIC CONSTRUCTION INC
(229) MEADE ELECTRIC
(230) MEANY ELECTRIC
(231) MECHANICAL SERVICES OF GALESBURG
(232) MECHANICAL SYS INC DBA CONTECH
(233) MEDLIN COMMUNICATIONS INC
(234) MERIT ELECTRIC LLC
(235) MICHELS POWER INC
(236) MID ILLINOIS ELECTRIC INC (NEW)
(237) MIDWEST INTERSTATE ELECTRICAL
(238) MIDWEST MECHANICAL GROUP INC
(239) MIDWESTERN ELECTRIC INC
(240) MILLER ENGINEERING CO
(241) MOHAWK ELEC CONST CO
(242) MORAN ELECTRICAL CONTRACTING
(243) MORSE ELECTRIC INC
(244) MTS TITAN ELECTRIC LLC
(245) MUZAK LLC
(246) MZI ELECTRIC INC
(247) NAPERVILLE ELECTRICAL CONTRACT
(248) NATIONAL CONDUCTOR CONSTRUCTOR
(249) NESKO ELECTRIC CO INC
(250) NEW RIVER ELECTRICAL CORP
(251) NEWKIRK ELECTRIC ASSOCIATES INC
(252) NORTHWEST TECHNICAL
(253) NUCORE ELECTRIC INC
(254) O'CARROLL ELECTRIC
(255) OBERLANDER ELECTRIC
(256) OMEGA ELECTRIC CO INC
(257) OUTSEN ELECTRIC INC
(258) P & D SIGN
(259) P & H ELECTRIC CORP
(260) PAGODA ELECTRIC INC
(261) PALOS ELECTRIC CO INC
(262) PARKVIEW ELECTRIC
(263) PEAK ELECTRIC INC
(264) PIEPER ELECTRIC INC
(265) PIERRO QUALITY ELECTRICAL CONS
(266) PINNACLE SERVICE INC
(267) PINNER ELECTRIC CO
(268) PIPCO
(269) PIPECO ELECTRIC INC
(270) PLATT ELECTRIC INC
(271) PORTER ELECTRIC LLC
(272) PRECISION CONTROL SYSTEMS INC
(273) PREFERRED ELECTRIC CONSTRUCTION
(274) PREMIER POWER PROFESSIONALS
(275) PREMIER TECHNOLOGY GROUP INC
(276) PREMIUM ELECTRIC SERV INC
(277) PRIME ELECTRIC CO INC
(278) PRO-ARC ELECTRICAL CONSTRUCTION
(279) PROCESS ELECTRIC & COMMUNICATI
(280) PROSPECT ELECTRIC CO
(281) PROTEX INSTALLATIONS
(282) QIS INC
(283) QUALITY ELECTRIC HEATING & AIR
(284) QUANTUM CROSSINGS LLC
(285) R & R SOLUTIONS
(286) RAG'S ELECTRIC INC
(287) RAPTOR INDUSTRIES INC
(288) RENEW ENERGY ELECTRICAL LLC
(289) REX ELECTRIC & TECHNOLOGIES LLC
(290) RICHMOND ELECTRIC CO INC
(291) RLG POWER & CONTROL
(292) ROCK RIVER ELECTRIC INC
(293) ROY KEITH ELECTRIC
(294) RUDER ELECTRIC INC
(295) RUYLE MECHANICAL SERVICES INC
(296) RYAN ELECTRICAL SERVICES INC
(297) S & S SYSTEMS OF AMERCIA INC
(298) SARGENT ELECTRIC CO
(299) SCHAEFER ELECTRIC INCTEGC0
(300) SCHERI ELEC COGL
(301) SCHMIDT ELECTRIC INC
(302) SCHNEIDER ELECTRIC
(303) SECURITAS ELEC DBA FEMORAN SECUIRTY SOLUTIONS
(304) SEICO INC
(305) SENERGY ELECTRIC INC
(306) SHARLEN ELECTRIC
(307) SHILLELAGH ELECTRIC INC
(308) SHOULDICE INDUSTRIAL MANUFACTURES AND CONTRACTORS
(309) SIEVERT ELECTRIC SERVICE & SALES CO
(310) SKITCH ELECTRIC
(311) SLOAN ELECTRIC
(312) SMG SECURITY HOLDINGS LLC
(313) SONOMA ELECTRICAL SERVICES INC
(314) SOUND INC
(315) SPIRAL SERVICES LLC DBA BURNETT & SONS ELECTRIC
(316) SPL INTERGRATED SOLUTIONS
(317) STANCY ELECTRIC INC
(318) SUSTAINABLE ELECTRIC LLC
(319) SUTTERFIELD ELECTRIC CONTRACTING CORP
(320) SWENEY ELECTRIC CO INC
(321) T & R ELECTRIC INC
(322) TAL SYSTEMS LTD
(323) TALON ELECTRIC CO
(324) TAYLOR ELECTRIC CO
(325) TECH ELECTRONICS OF IL LLC
(326) TERRANCE ELECTRIC CO
(327) TESCO
(328) TEUFEL HUNDEN ELECTRONICS INC
(329) THE STATE GROUP IND (USA) LTD
(330) THOMPSON ELECTRONICS CO
(331) THORNE ELECTRIC
(332) TIMM ELECTRIC
(333) TOMAHAWK COMMUNICATION LTD
(334) TOPP NOTCH ELECTRIC LLC
(335) TORRES ELECTRICAL CONTRACTORS LLC
(336) TOTAL ELECTRIC INC
(337) TRI CITY ELECTRIC (IOWA)
(338) TRI POWER ELECTRICAL CONTRACTORS LLC
(339) TRI TECH ELECTRIC INC
(340) TRI-CITY ELECTRIC SERVICES LLC
(341) TRI-M ELECTRIC INC
(342) TRI-R SYSTEMS INC
(343) TWIN ELECTRIC CO OF CHICAGO L
(344) VALLEY ELECTRICAL CONTRACTORS INC
(345) VAN MACK ELECTRIC CO (NEW)
(346) VERTICAL CONTRACTING SERVICES OF ILLINOIS LLC
(347) VIDEOTEC CORP II
(348) VISIONS SIGNS INC
(349) VOLT ELECTRIC INC
(350) WESTBROOK ELECTRIC
(351) WHITE ELECTRICAL CONSTRUCTION CO
(352) WILCOX ELECTRIC & SERVICE
(353) WILLIAM CHARLES CONST DBA WM CHARLES ELECTRIC
(354) WILSON ELECTRIC
(355) WOOD DALE ELECTRIC
(356) ZELLER ELECTRIC

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: TO PROVIDE MEDICAL, DISABILITY, LIFE, AND AD&D BENEFITS TO ELIGIBLE MEMBERS AND THEIR DEPENDENTS.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	6
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	95
6	Total number of volunteers (estimate if necessary) .............	6	0
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	0
b	Net unrelated business taxable income from Form 990-T, Part I, line 11 .........	7b	0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	0	0
9	Program service revenue (Part VIII, line 2g) .........	31,415,345	31,248,320
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	822,208	342,327
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	0	0
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	32,237,553	31,590,647
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).....	30,260,865	30,089,534
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	60,098	63,769
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)....	2,003,537	1,794,839
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	32,324,500	31,948,142
19	Revenue less expenses. Subtract line 18 from line 12.......	-86,947	-357,495
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	60,369,090	61,398,406
21	Total liabilities (Part X, line 26).............	28,477,943	29,661,115
22	Net assets or fund balances. Subtract line 21 from line 20.....	31,891,147	31,737,291

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )
	PAYMENTS OF MEDICAL, DENTAL, VISION, DISABILITY, LIFE, AND ACCIDENTAL DEATH & DISMEMBERMENT BENEFITS TO ELIGIBLE MEMBERS AND THEIR DEPENDENTS.

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) DAVID RUDER...................................................................... TRUSTEE	3.00 .................	X	0	0	0
(2) NICK OLSEN...................................................................... TRUSTEE	3.00 ................. 6.00	X	0	15,502	12,669
(3) PAUL ROLIH...................................................................... TRUSTEE	3.00 .................	X	0	0	0
(4) ANDRES RICO...................................................................... TRUSTEE	3.00 ................. 40.00	X	0	139,244	87,102
(5) JEFF KEAST...................................................................... TRUSTEE	3.00 .................	X	0	0	0
(6) RYAN ALDRICH...................................................................... TRUSTEE	3.00 ................. 40.00	X	0	73,548	44,633

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	0	228,294	144,404

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	30,791,585	30,791,585
b	PARTICIPANT CONTRIBUTIONS	900099	456,735	456,735
c
d
e
f	All other program service revenue.
g	Total. Add lines 2a–2f .....		31,248,320

3 Investment income (including dividends, interest, and othersimilar amounts) ......			859,226			859,226
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		33,509,746	7a
b	Less: cost or other basis and sales expenses		34,026,645	7b
c	Gain or (loss)		-516,899	7c
d	Net gain or (loss).........			-516,899			-516,899
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.....			31,590,647	31,248,320	0	342,327

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 .......	30,089,534
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 ...........	63,769
11	Fees for services (non-employees):
a	Management ......	521,996
b	Legal .........	219,162
c	Accounting ...........	73,677
d	Lobbying ...........
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......	104,883
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	814,089
12	Advertising and promotion ....
13	Office expenses .......	41,722
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 ....	15,897
20	Interest ...........
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..
23	Insurance ...	3,413
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
b
c
d
e	All other expenses
25	Total functional expenses. Add lines 1 through 24e	31,948,142
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 ........			6,435,535	1	6,450,841
2	Savings and temporary cash investments .........				2
3	Pledges and grants receivable, net ......				3
4	Accounts receivable, net .............			3,926,650	4	4,197,998
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 ......			301,838	9	242,312
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	1,448,445
b	Less: accumulated depreciation	10b	258,130	1,270,209	10c	1,190,315
11	Investments—publicly traded securities .			36,866,923	11	37,323,174
12	Investments—other securities. See Part IV, line 11 .....			11,501,139	12	11,526,559
13	Investments—program-related. See Part IV, line 11 ..				13
14	Intangible assets ...............				14
15	Other assets. See Part IV, line 11 ...........			66,796	15	467,207
16	Total assets. Add lines 1 through 15 (must equal line 33)...			60,369,090	16	61,398,406

17	Accounts payable and accrued expenses .....	4,195,843	17	3,688,976
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	24,282,100	25	25,972,139
26	Total liabilities. Add lines 17 through 25..	28,477,943	26	29,661,115

	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 .....	0	29	0
30	Paid-in or capital surplus, or land, building or equipment fund ...	0	30	0
31	Retained earnings, endowment, accumulated income, or other funds	31,891,147	31	31,737,291
32	Total net assets or fund balances ...........	31,891,147	32	31,737,291
33	Total liabilities and net assets/fund balances ........	60,369,090	33	61,398,406