2024-05-16T12:04:14-05:00 2023-07-31 562552172 INEICH & COMPANY LLP 950 TOWER LANE SUITE 780 FOSTER CITY CA 94404 990 2022-08-01 946074642 ROOFERS HEALTH & WELFARE TRUST FUND OF NORTHERN CALIFORNIA ROOF 4082884400 6800 SANTA TERESA BLVD 100 SAN JOSE CA 95119 MANUEL DE SANTIAGO III TRUSTEE 4082884400 2024-05-16 1 MANUEL DE SANTIAGO III 999009999 0 MICHAEL T SAVASTA P01259186 6505738007 X 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z MANUEL DE SANTIAGO III 6800 SANTA TERESA BLVD SUITE 100 SAN JOSE CA 95119 40535521 0 X N/A X 1959 CA PROVIDING HEALTH BENEFITS TO ELIGIBLE PARTICIPANTS. 12 12 0 0 0 0 0 0 33118330 35204783 447359 426679 1870024 2029327 35435713 37660789 0 0 35900586 34856368 0 0 0 0 0 1279819 1350312 37180405 36206680 -1744692 1454109 35589741 35664358 16505392 15664768 19084349 19999590 THE PURPOSE OF THIS TRUST IS TO COLLECT EMPLOYER AND PARTICIPANT CONTRIBUTIONS FOR THE PURPOSE OF PROVIDING HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS. 0 0 34856368 35204783 PROVIDING HEALTH BENEFITS TO ELIGIBLE PARTICIPANTS. 34856368 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 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 8 0 1 0 0 0 0 0 0 0 0 0 0 0 X 12 12 0 0 0 0 0 0 0 1 1 0 0 1 1 1 0 1 1 0 0 0 CA X UNITED ADMINISTRATIVE SERVICES 4082884420 6800 SANTA TERESA BLVD SUITE 100 SAN JOSE CA 95119 X DANIEL GARCIA TRUSTEE 5.00 X 0 0 0 SALVADOR RICO TRUSTEE 5.00 X 0 0 0 CARLOS OPFERMANN TRUSTEE 5.00 X 0 0 0 STEVE HENRIS TRUSTEE 5.00 X 0 0 0 RICHARD J LAWSON TRUSTEE 5.00 X 0 0 0 LEO IBARRA TRUSTEE 5.00 X 0 0 0 ROBERT RIOS TRUSTEE 5.00 X 0 0 0 MANUEL DE SANTIAGO TRUSTEE 5.00 X 0 0 0 MICHAEL LI TRUSTEE 5.00 X 0 0 0 STEVE REARDON TRUSTEE 5.00 X 0 0 0 PETER LANG TRUSTEE 5.00 X 0 0 0 MORGAN MOLDE TRUSTEE 5.00 X 0 0 0 0 0 0 0 0 0 0 0 EMPLOYER CONTRIB. 230000 34201512 34201512 PARTICIPANT CONTRIB. 230000 1003271 1003271 35204783 600132 600132 2701279 2874732 -173453 -173453 -173453 EXCESS LOSS REIMBURSE 230000 1988489 1988489 LIQUIDATED DAMAGES 230000 40838 40838 2029327 37660789 35204783 0 2456006 34856368 34856368 98009 98009 56065 56065 55197 55197 5213 5213 PRE-CERTIFICATION & BEN 355162 355162 ADMINISTRATION 338111 338111 CLAIMS FEES 202838 202838 PRINTING & STATIONERY 85060 85060 154657 154657 36206680 34856368 1350312 0 2314641 4815846 10501474 10677387 7539023 5086776 67210 61170 15167393 15023179 35589741 35664358 122433 127197 16382959 15537571 16505392 15664768 X 0 0 0 0 19084349 19999590 19084349 19999590 35589741 35664358 1454109 -538868 0 X X 0 1 X 1 0 0 HEALTH CLAIMS & PREMIUMS PAYABLE 2511392 CLAIMS INCURRED BUT NOT REPORTED 4300000 ACCUMULATED ELIGIBILITY CREDITS 8726179 15537571 37066724 -538868 -538868 37605592 55197 55197 37660789 36996871 0 36996871 55197 -845388 -790191 36206680 PART XII, LINE 4B - OTHER ADJUSTMENTS: CHANGE IN BENEFIT OBLIGATION FORM 990, PART VI, SECTION B, LINE 11B PROCESS TO REVIEW FROM 990: THE FORM 990 IS PREPARED BY THE PLAN'S AUDITOR (CPA FIRM) BASED ON THE PLAN'S FINANCIAL STATEMENT AUDIT. THE COMPLETED FORM 990 IS FORWARDED TO TRUSTEES FOR REVIEW. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XII, LINE 2C FINANCIAL STATEMENTS AND REPORTING AS IN PRIOR YEARS, THE AUDIT FINANCIAL STATEMENTS ARE REVIEWED WITH THE BOARD OF TRUSTEES. THE BOARD OF TRUSTEES SELECT THE INDEPENDENT ACCOUNTANT. PACIFIC COAST ROOFERS PENSION PLAN 6800 SANTA TERESA BLVD SUITE 100 SAN JOSE CA 95119 946051377 MULTI EMPLOYER PENSION PLAN TO PROVIDE BENEFITS TO PARTICIPANTS 401(B) 0 ASSOC ROOFING CONTRACTORS PO BOX 5067 CONCORD CA 94524 946107585 ROOFING ASSOCIATION 501 (C) 0 SC BLDG & CONST TRADES 2102 ALMADEN RD STE 101 SAN JOSE CA 95125 940348196 LABOR ORGANIZATION 501 (C) 0 STATE BUILDING TRADES 1231 I ST STE 302 SACRAMENTO CA 95814 940896460 LABOR ORGANIZATION 501 (C) 0 SANTA CLARA VALLEY & VICINITY LMC TRUST 2330-A WALSH AVE SANTA CLARA CA 95051 776047865 LABOR MANAGEMENT ORGANIZATION 501(C) 0 SACRAMENTO AREA ROOFERS JATF-LOCAL 81 PO BOX 40 RANCHO CORDOVA CA 95741 237413581 APPRENTICESHIP TRAINING 501(C) 0 BUILDING & CONSTRUCTION TRADES COUNCIL ALAMEDA COUNTY 7750 PARDEE LANE SUITE 100 OAKLAND CA 94621 940272624 LABOR ORGANIZATION 501(C) 0 STATE OF CALIFORNIA-DEPARTMENT OF GENERAL SERVICES 1421 N MARKET BLVD SUITE 100 SACRAMENTO CA 95834 680142725 STATE AGENCY 0 ROOFERS UNION NO 81 8400 ENTERPRISE WAYSUITE 122 OAKLAND CA 94621 940814399 LABOR ORGANIZATION 501(C) 0 UNITED UNION OF ROOFERSWATER PROOFERS AND ALLIED WORKERS 1660 L ST NWSUITE 800 WASHINGTON DC 20036 530260605 LABOR ORGANIZATION 501(C)(5) 0 ALLIANCE CONTRACTING SERV 29334 PACIFIC ST HAYWARD CA 94544 272806387 0 0 AV ROOFING PO BOX 192 LANCASTER CA 93584 330986444 0 0 B&M TEAR OFF INC 2420 SAND CREEK ROAD PMB 280 BRENTWOOD CA 94513 271979079 0 0 BARNECUT ROOFING INC 1016 SEQUOIA AVENUE MILLBRAE CA 94030 943053284 0 0 BLUES ROOFING CO 182 TOPAZ MILPITAS CA 95035 942380665 0 0 CAMPANELLA CORPORATION 2216 DUNN ROAD HAYWARD CA 94545 943298640 0 0 COOKS COATINGS INC 33834 ZENDERSS RD MENIFEE CA 92584 330967440 0 0 COURTNEY INC 16781 MILLIKAN AVE IRVINE CA 92606 330624002 0 0 CRC ROOFING INC 3774 BRADVOEN DRIVE MILLBRAE CA 94030 943053284 0 0 DEBOIS ROOFING INC PO BOX 2697 FREMONT CA 94536 043633663 0 0 ET ABATEMENT INC PO BOX 3958 MODESTO CA 95352 770534670 0 0 EXCELLCO COATING INC 1176 QUESADA AVE SAN FRANCISCO CA 94124 454424215 0 0 HIGHEND DEVELOPMENT INC 5056 COMMERCIAL CIRCLE C CONCORD CA 94520 205946846 0 0 HOLLAND WATERPROOFING INC 501 CESAR CHAVEZ STREET 202A SAN FRANCISCO CA 94124 942581238 0 0 LETNER ROOFING COMPANY 1490 N GLASSELL ORANGE CA 92867 330603152 0 0 PENINSULA SECURITY BLD LTD 229 SOUTH RAILROAD AVENUE SAN MATEO CA 94401 941072211 0 0 PERFORMANCE CAULKING & WATERPROOFING INC 2190 MEEKLAND AVENUE HAYWARD CA 94541 943390746 0 0 PIONEER CONTRACTOR INC 1485 ARMSTRONG AVENUE SAN FRANCISCO CA 94124 943351330 0 0 PREMIUM ROOFING & WATERPROOFING INC 919 52ND AVENUE OAKLAND CA 94601 161704527 0 0 R BROTHERS WATERPROOFING INC 707 WEST HEADING STREET SAN JOSE CA 95110 320104645 0 0 RAINBOW WATERPROOFING & RESTORATION CO INC 610 TREAT AVENUE SAN FRANCISCO CA 94110 940791300 0 0 ROLAND CONSTRUCTION INC PO BOX 8607 STOCKTON CA 95028 680086362 0 0 RUDOLPH COMMERCIAL INTERIORS INC 1125 67TH STREET OAKLAND CA 94608 943186124 0 0 TECTA AMERICA SACRAMENTO INC 3257 FITZGERALD ROAD RANCHO CORDOVA CA 95742 202970607 0 0 TOM LEWIS RESTORATION & CONSULTING INC 768 BRANNAN STREET SAN FRANCISCO CA 94103 203587881 0 0 VALLEY WATERPROOFING INC 825 CIVIC CENTER DRIVE 6 SANTA CLARA CA 95050 942826595 0 0 MC CONSTRUCTION SERVICES INC PO BOX 964 LIVERMORE CA 94551 651175665 0 0 NEVADA PACIFIC BUILDERS & ROOFING DBA WSPROD FING 8150 SIERRA COLLEGE BLVD 200 ROSEVILLE CA 95661 912111467 0 0 NOR CAL WATERPROOFING INC 2545 WEST 10TH STREET H ANTIOCH CA 94509 800587541 0 0 PACIFIC VALLEY ROOFING 2905-A MCKITTRICK CT CERES CA 95307 595796178 0 0 ANGELUS WATER PROOFING & RESTORATION INC 17762 METZLER LANE HUNTINGTON BEACH CA 92647 953899284 0 0 COMMERCIAL WATER PROOFING SYSTEMS INC 1630 PALM STREET SANTA ANA CA 92701 330862606 0 0 NIR ROOF CARE INC 12191 REGENCY PARKWAY HUNTLEY IL 60142 363081981 0 0 RB ENVIRONMENTAL INC 4460 S HIGHWAY 99 STOCKTON CA 95215 680405081 0 0 BLUEWATER ENVIRONMENTAL SERVICES 2075 WILLIAMS ST SAN LEANDRO CA 94577 943186260 0 0 ROOFING & SOLAR CONSTRUCTION 27216 CONANT CT HAYWARD CA 94544 812580432 0 0 AICAI SPECIALTY CONTRACTING INC 946 N MARKET BLVD SACRANEBTI CA 95834 680526024 0 0 ALL SIERRA ROOF COMPANY INC PO BOX 331 JACKSON CA 95642 680469313 0 0 ARK DEISGN CONSTRUCTION AND ROOFING INC PO BOX 868 PALO CEDRO CA 96073 832519847 0 0 FLAT ROOF PRDS 3612 MADISON AVE 32 NORTH HIGHLANDS CA 95660 262142473 0 0 NATIONS ROOF WESTLLC 5463 EHEDGES AVE FRESNO CA 93727 812667009 0 0 ADVANCED ROOFING 7548 CRAWFORD AVENUE OAKDALE CA 95361 412273317 0 ALLIANCE ROOFING COMPANY INC 1250 CAMPBELL AVENUE SAN JOSE CA 95126 770100206 0 AMERICAN RIVER CAULKING 44 NORTH CANYON WAY COLFAX CA 95713 943306893 0 ANDERSON ROOFING CO INC 2940 SAN JOSE AVE SAN FRANCISCO CA 94112 200949858 0 ANDY'S ROOFING CO INC 897 AMES AVENUE MILPITAS CA 95035 770157073 0 AQUA PROOF INC PO BOX 1376 FRENCH CAMP CA 95231 942862054 0 BOHM ENVIRONMENTALSOLUTIONS PO BOX 24301 OAKLAND CA 94623 943410283 0 CALIFORNIA ROOFING CO INC 1595 S 10TH STREET SAN JOSE CA 95112 941420780 0 CWAC WATERPROOFING & RESTORATION 800 BURLWAY ROAD BURLINGAME CA 94010 941743410 0 CENTRAL BAY ROOFING 1814 CLEMENT AVENUE ALAMEDA CA 94501 942855821 0 CLARK ROOFING INC 2076 ACOMA STREET SACRAMENTO CA 95815 680027460 0 CRANSTON STEEL STRUCTURES INC PO BOX 1036 WOODLAND CA 95776 680113540 0 DANCO WATERPROOFING CORPORATION 3142 DIABLO AVENUE HAYWARD CA 94545 942457556 0 DELTA BAY WATERPROOFING 512 WEST FOURTH STREET ANTIOCH CA 94509 943326770 0 DEMELLO ROOFING INC 45 JORDAN STREET SAN RAFAEL CA 94901 942221475 0 DISSMERYER CORP DBA ACME ROOFING CO 1400 WALLACE AVENUE SAN FRANCISCO CA 94124 942521116 0 ENTERPRISE ROOFING SERVICES INC PO BOX 5130 CONCORD CA 94524 941551712 0 EXCELSIOR ROOFING CO 1340 UNDERWOOD AVENUE SAN FRANCISCO CA 94124 942907081 0 FD THOMAS INC 217 BATEMAN DRIVE CENTRAL POINT OR 97502 931017129 0 FOUR SEASONS ROOFING 11 COMMERCE COURT 1 CHICO CA 95928 680287517 0 GENESIS ONE GROUP INC 1698 ROGERS AVE 60 SAN JOSE CA 95112 800547128 0 GIAMPOLINI & CO INC 1482 67TH STREET EMERYVILLE CA 94608 942350740 0 GLEN PARK RFG CO INC 1601 DONNER AVENUE 1 SAN FRANCISCO CA 94124 942234955 0 HABITAT GARDENS 2108 SUNSET DRIVE PACIFIC GROVE CA 95950 200460571 0 HORIZON ROOFING INC PO BOX 4346 GEORGETOWN CA 95634 943403388 0 JEFFCO ROOFING CO PO BOX 554 SUNOL CA 94586 942927239 0 JOHNSTON ROOFING INC 201 BERRELLESA STREET MARTINEZ CA 94553 911747576 0 KODIAK UNION ROOFING SERVICES INC 1903 AVIATION BLVD LINCOLN CA 94501 261442514 0 LEO ROOFING INC 1285 PETALUMA HILL RD B SANTA ROSA CA 95404 571188522 0 LOTUS GENERAL CONTRACTORS INC 1485 BAYSHORE BLVD SAN FRANCISCO CA 94124 943300803 0 MORRIS ROOFING CO 1435 FRANCISCO BLVD SAN RAFAEL CA 94901 941693748 0 NAPA-SOLANO BLDG TRADES COUNCIL 2540 N WATNEY WAY FAIRFIELD CA 94533 941000835 0 PARC SPECIALTY CONTRACTORS 1400 VINCI AVE SACRAMENTO CA 95838 943259455 0 PETER ROSS CA INC 848 RANCHEROS DR STE B SAN MARCOS CA 92069 760720451 0 R GOMEZ ROOFING CO 20249 CONCORD AVE HAYWARD CA 94541 943280308 0 R TOWNLEY ROOFING CO PO BOX 587 LINDEN CA 95236 880402297 0 ROOFING CONSTRUCTORS INC DBA WESTERN ROOFING SERVICES 15002 WICKS BLVD SAN LEANDRO CA 94577 941431517 0 SOLANO COUNTY ROOFING INC 4349 CORDELEA ROAD FAIRFIELD CA 94534 680087794 0 SRS ROOFING INC 4100 10 REDWOOD ROAD PMB 403 OAKLAND CA 94619 753230710 0 STRONGE BUILDING SERVICES 31119 SAN BENITO STREET HAYWARD CA 94544 273999990 0 SUNTEK ROOFING PO BOX 460623 ESCONDIDO CA 92046 264217030 0 TECTA AMERICA SAC INC 3257 FITZGERALD RD RANCHO CORDOVA CA 95742 202970607 0 THE LAWSON ROOFING CO INC 1495 TENNESSEE STREET SAN FRANCISCO CA 94107 942401421 0 URBAN WATERPROOFING INC 40 LISBON STREET SAN RAFAEL CA 94901 680372572 0 WATERPROOFING ASSOCIATES INC 975 TERRA BELLA AVENUE MOUNTAIN VIEW CA 94043 770304667 0 WATERTIGHT RESTORATION INC 1380 GREG STREET 222 SPARKS NV 89431 680972572 0 WATERTIGHT RESTORATION INC 501 CESAR CHAVEZ 202A SAN FRANCISCO CA 94124 942584238 0 AKTOS INCORPORATED 4061 E CASTRO VALLEY BLVD 406 CASTRO VALLEY CA 94552 201471301 0 CENTURY ROOF AND SOLAR INC 23135 SAKLAN ROAD HAYWARD CA 94545 611432702 0 DELTA PAINTING & COATING INC DBA TRU-TECH 1700 RELIANCE STREET MODESTO CA 95358 770113955 0 DK ENTERPRISES INC 520 S 3RD STREET PATTERSON CA 95363 770467753 0 GENERAL ROOFING COMPANY 3309 ELMWOOD AVENUE OAKLAND CA 94601 941318200 0 GUDGEL ROOFING INC 5321 84TH STREET SACRAMENTO CA 95826 680173659 0 JM ENVIRONMENTAL INC PO BOX 2189 GRANITE BAY CA 95746 680481718 0 CLASS A ROOFING LLC PO BOX 6500 INCLINE VILLAGE NV 89450 470886458 0 TA KRAUSE INC 11275 N LEACH ROAD LODI CA 95240 208144305 0 CALIFORNIA ENGINEERING INC 1560 W HACIENDA AVE CAMPBELL CA 95008 770583667 0 GRAHAM PREWETT INC 2773 N BUSINESS PARK AVE 102 FRESNO CA 93727 770565773 0 MARCO ROOFING CO 43230 OSGOOD ROAD FREMONT CA 94538 942592355 0 RANKER AMG INC 9210 BEATTY DRIVE SACRAMENTO CA 95826 203213165 0 STATE ROOFING SYSTEMS INC 15444 HESPERIAN BLVD SAN LEANDRO CA 94578 942743961 0 THERMAL ROOF SYSTEMS INC 800 BERRY AVE 180 SACRAMENTO CA 95828 721612050 0 WATERPROOFING EXPERTS INC 7736 DEERING AVE CANOGA PARK CA 91304 954196150 0 WESTECH ROOFING INC 220 CUTTING BLVD RICHMOND CA 94804 943021453 0 DON C GEORGE INC 6810 LINCOLN BLVD OROVILLE CA 95966 982848037 0 MALOTT & PETERSON ROOFING CO 801 VIRGINIA BERKELEY CA 94710 943047136 0 PATRIOT CONTRACTING INC 19031 S HAMILTON AVE GARDENA CA 90248 800230427 0 ROTH BROS INC 3847 CRUM RD YOUNGSTOWN OH 44515 340676951 0 BEST CONTRACTING SERVICES INC 19027 S HAMILTON AVE GARDENA CA 90248 953781209 0 BOOTH & LITTLE ROOFING INC 2150 REDWOOD HIGHWAY GREENBRAE CA 94904 BRAZOS URETHANE INC 1031 6TH ST NORTH TEXAS CITY TX 77590 742466058 0 IQA CONTRACTOR INC 3158 SPRING ST REDWOOD CITY CA 94063 471262753 0 MURPHY INDUSTRIAL COATINGS INC 2704 GUNDRY AVE SIGNAL HILL CA 90755 952932681 0 MURPHY 3160 CROW CANYON PLSTE 230 SAN RAMON CA 94583 203100547 0 PAC SHIELD ROOF SERVICES INC 5151 PENTECOST DRSTE A1 MODESTO CA 95356 834074883 0 PROFESSIONAL ASBESTOS REMOVAL CORP 2864 EDOROTHY AVE FRESNO CA 93706 770129910 0 WESTERN WATERPROOFING COMPANYINCDBAWESTERN SPECIALTY CONTRACTORS 15061 WICKS BLVD SAN LEANDRO CA 94577 430634668 0 HENRIS SUPPLY INC PO BOX 138 PETALUMA CA 94953 941558409 0 IZMIRIAN ROOFING & SHEET METAL 229 S RAILROAD AVENUE SAN MATEO CA 94401 941072211 0 MTN INC WATERPROOFING 8585 CONCORD CENTER DR STE 300 ENGLEWOOD CO 80112 863867139 0 TOP BUIET INC 3324 MONIER CIRCLE 9 RANCHO CORDOVA CA 95742 263517625 0 STERLING ENVIRONMENTAL CORPORATION 10203 E ST OAKLAND CA 94603 943073256 0 STRAIGHT EDGE ROOFING INC 5248 SULTANA AVE ATWATER CA 95301 475353491 0 FC AND SONS ROOFING INC 6508 CLARA ST BELL GARDENS CA 90201 954818611 0 INT'L WATERPROOFING INC 1616 16TH ST 200 SAN FRANCISCO CA 94103 943229028 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0