2023-11-14T19:34:30-06:00 2022-12-31 410746749 CLIFTONLARSONALLEN LLP 301 SW ADAMS STREET SUITE 1000 PEORIA IL 61602 990 2022-01-01 261382332 OPERATING ENGINEERS LOCAL 112 HEALTH & WELFARE TRUST OPER 7656435112 2716 S RANGELINE RD ANDERSON IN 46017 RANDALL HUGHES CHAIRMAN 7656435112 2023-11-09 1 RANDALL HUGHES 999009999 1 ANDREW SMITH CPA P01518894 3096714500 2023-11-09 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z RANDALL HUGHES 2716 S RANGELINE RD ANDERSON IN 46017 36373983 0 X N/A X 2007 IN PROVIDE HEALTH AND WELFARE BENEFITS FOR ELIGIBLE MEMBERS AND THEIR DEPENDENTS 5 5 8 0 0 0 0 0 9251936 7508691 1592272 517174 167 3742 10844375 8029607 0 0 11081549 9100406 0 0 0 0 0 1473433 1611086 12554982 10711492 -1710607 -2681885 62193235 54388899 25000 25000 62168235 54363899 PROVIDE HEALTH AND WELFARE BENEFITS FOR ELIGIBLE MEMBERS AND THEIR DEPENDENTS 0 0 THE PLAN PROVIDES MEDICAL, DENTAL, PHARMACY, VISION, LIFE AND SHORT-TERM DISABILITY BENEFITS TO ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS. ALL BENEFITS ARE PROVIDED ON A SELF-FUNDED BASIS EXCEPT FOR LIFE, WHICH IS FULLY INSURED. 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 1 8 1 0 0 0 0 0 0 0 0 0 0 X 5 5 0 0 0 0 0 1 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X RANDALL HUGHES 7656435112 2716 S RANGELINE RD ANDERSON IN 46017 X RANDALL HUGHES UNION TRUSTEE 5.00 X 0 0 0 TONY TIDWELL UNION TRUSTEE 5.00 X 0 0 0 ERIN BUCK UNION TRUSTEE 5.00 X 0 0 0 JIM BARRETT EMPLOYER TRUSTEE 1.00 X 0 0 0 JEREMY GURETZKI EMPLOYER TRUSTEE 1.00 X 0 0 0 0 0 0 0 0 0 0 0 EMPLOYER CONTRIBUTIONS 525100 7508691 7508691 7508691 1151528 1151528 27710022 28344376 -634354 -634354 -634354 MISCELLANEOUS INCOME 525100 3742 3742 3742 8029607 7512433 0 517174 X 9100406 10697 23120 101501 69904 18212 486276 CLAIMS ADMINISTRATION 621833 ADMINISTRATIVE EXPENSES 266350 BANK SERVICE CHARGES 7551 POSTAGE AND DELIVERY 4497 1145 10711492 357855 382370 2157583 1095429 1080320 9679 60778 8640 8640 0 0 59495527 51562291 172591 207711 62193235 54388899 25000 25000 25000 25000 X 0 0 0 0 62168235 54363899 62168235 54363899 62193235 54388899 -2681885 -6396709 1274258 0 X X 0 1 X 1 0 8640 8640 0 0 PREPAID CONTRIBUTIONS 25000 25000 X 1531397 -6396709 -6396709 7928106 101501 101501 8029607 10609991 0 10609991 101501 101501 10711492 PART X, LINE 2: THE VEBA TRUST FUNDING BENEFITS OF THE PLAN HAS BEEN ORGANIZED UNDER THE PROVISIONS OF SECTION 501(C)(9) OF THE INTERNAL REVENUE CODE (IRC). THE PLAN AND TRUST ARE REQUIRED TO OPERATE IN CONFORMITY WITH THE IRC TO MAINTAIN THE TAX-EXEMPT STATUS OF THE TRUST. THE BOARD OF TRUSTEES BELIEVES THAT THE PLAN IS BEING OPERATED IN COMPLIANCE WITH THE APPLICABLE REQUIREMENTS OF THE IRC AND, THEREFORE, BELIEVES THAT THE RELATED TRUST IS TAX-EXEMPT. U.S. GAAP 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 INTERNAL REVENUE SERVICE (IRS). THE PLAN IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. FORM 990, PART VI, SECTION A, LINE 7A THE TRUST IS GOVERNED BY A JOINT BOARD OF TRUSTEES CONSISTING OF FIVE TRUSTEES. TWO TRUSTEES ARE APPOINTED BY INTERNATIONAL UNION OF OPERATING ENGINEERS LOCAL 112 REPRESENTING THE PARTICIPANTS AND TWO ARE APPOINTED BY THE CONTRIBUTIONG EMPLOYERS. ONE ADDITIONAL TRUSTEE IS APPOINTED AS A MANAGING TRUSTEE. FORM 990, PART VI, SECTION B, LINE 11B FORM 990 IS PREPARED BY THE INDEPENDENT ACCOUNTANTS AND PRESENTED TO THE TRUSTEES FOR REVIEW. IF ANY OF THE TRUSTEES HAVE COMMENTS OR QUESTIONS, THEY ARE RESOLVED PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C THE TRUSTEES ARE REQUIRED TO DISCLOSE ACTUAL OR PERCEIVED CONFLICTS OF INTEREST BY DECEMBER 31ST OF EACH YEAR. ANY INTERESTED PERSON WITH OBJECTIVE EVIDENCE THAT A TRUSTEE MAY HAVE VIOLATED ANY OF THE PROVISIONS OF THE POLICY MAY REPORT SUCH POSSIBLE VIOLATION TO THE BOARD OF TRUSTEES IN WRITING. THE BOARD OF TRUSTEES WILL INVESTIGATE AND DETERMINE THE APPROPIRATE COURSE OF ACTION. FORM 990, PART VI, SECTION C, LINE 19 ALL GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE AVAILABLE FOR PUBLIC INSPECTION UPON REQUEST. FORM 990, PART IX, LINE 11G ACTUARY FEES 9,000. CONSULTING 60,904. FORM 990, PART IX, LINE 24E CONTINUING EDUCATION 1,145. FORM 990, PART XII, LINE 2C: THE BOARD OF TRUSTEES ASSUMES RESPONSIBILITY FOR THE SELECTION, OVERSIGHT, AND RETENTION OF THE INDEPENDENT AUDITORS. THIS PROCESS HAS NOT CHANGED FROM PRIOR YEAR. INTERNATIONAL UNION OF OPERATING ENGINEERS LOCAL 112 2716 S RANGELINE ROAD ANDERSON IN 46017 450546196 CONTRIBUTING EMPLOYER IN 501(C)(5) 0 LOCAL 112 NDE TRAINING FUND 2716 S RANGELINE ROAD ANDERSON IN 46017 431412060 CONTRIBUTING EMPLOYER IN 501(C)(5) 0 JANX CONTRIBUTING EMPLOYER MI 0 MID AMERICAN INSPECTION CONTRIBUTING EMPLOYER MI 0 PRIME NDT CONTRIBUTING EMPLOYER PA 0 SHAW PIPELINE CONTRIBUTING EMPLOYER OK 0 STANLEY INSPECTION CONTRIBUTING EMPLOYER TX 0 TEI ANALYTICAL SERVICES CONTRIBUTING EMPLOYER PA 0 UT QUALITY CONTRIBUTING EMPLOYER TX 0 WAGGONER & ASSOCIATES CONTRIBUTING EMPLOYER LA 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0