2026-06-08T13:55:11-05:00 2025-08-31 562552172 INEICH & COMPANY LLP 950 TOWER LANE SUITE 780 FOSTER CITY CA 94404 990 2024-09-01 776019718 BD OF TRUSTEES EVERGREEN HEALTH AND WELFARE TRUST EVER 4082884400 6800 SANTA TERESA BLVD 100 SAN JOSE CA 95119 MARGARET HOANG TRUSTEE-CHAIRPERSON 4082884400 2026-06-08 1 0 MICHAEL T SAVASTA P01259186 6505738007 X 2024 2025-03-06 01:10:19Z MARGARET HOANG 6800 SANTA TERESA BLVD SUITE 100 SAN JOSE CA 95119 3221726 0 X N/A X 1985 CA PROVIDING HEALTH BENEFIT TO ELIGIBLE PARTICIPANTS 5 5 0 0 0 0 0 0 954668 1110686 559023 861211 0 0 1513691 1971897 0 0 1266327 1400683 0 0 0 0 0 140972 154530 1407299 1555213 106392 416684 10316988 10991081 115367 127530 10201621 10863551 THE PURPOSE OF THIS TRUST IS TO COLLECT EMPLOYER AND PARTICIPANT CONTRIBUTIONS FOR THE PURPOSE OF PROVIDING HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANT AND THEIR DEPENDENTS. 0 0 1016259 1110686 PROVIDE INSURED HEALTH BENEFITS TO PARTICIPANTS. 384424 PROVIDE SELF FUNDED HEALTH BENEFITS TO ELIGIBLE PARTICIPANTS 1400683 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 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 X 5 5 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 1 1 0 0 0 CA X UNITED ADMINISTRATIVE SERVICES 4082884400 6800 SANTA TERESA BLVD SUITE 100 SAN JOSE CA 95119 X ANDY SCHORR TRUSTEE 1.00 X 0 0 0 KIMBERLY GURLEY TRUSTEE 1.00 X 0 0 0 RAY MOCHERMAN TRUSTEE 1.00 X 0 0 0 MERRILEE CLAVERIE TRUSTEE 1.00 X 0 0 0 MARGARET HOANG TRUSTEE-CHAIRPERSON 1.00 X 0 0 0 0 0 0 0 0 0 0 0 DISTRICT CONTRIBUTIONS 611600 626296 626296 MEMBERS' CONTRIBUTIONS 611600 484390 484390 1110686 242483 242483 1868557 1249829 618728 618728 618728 1971897 1110686 0 861211 1400683 1400683 11550 11550 23790 23790 ADMINISTRATION 98833 98833 ACTUARY 13000 13000 INSURANCE 6589 6589 PRINTING, POSTAGE AND O 768 768 1555213 1400683 154530 0 15300 6116 27344 6547 4003 3295 10218986 10921874 51355 53249 10316988 10991081 6861 7802 108506 119728 115367 127530 X 0 0 0 0 10201621 10863551 10201621 10863551 10316988 10991081 416684 245246 0 X 0 1 X 1 0 0 MEMBERS' CONTRIBUTIONS RECEIVED IN ADVANCE 39728 PREMIUM REIMBURSEMENTS PAYABLE 80000 119728 2193353 245246 245246 1948107 23790 23790 1971897 1531478 0 1531478 23790 -55 23735 1555213 PART XII, LINE 4B - OTHER ADJUSTMENTS: CHANGE IN BENEFIT OBLIGATIONS PAYABLE FORM 990, PART VI, SECTION B, LINE 11B PROCESS TO REVIEW FORM 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 THE PLAN'S THIRD PARTY ADMINISTRATOR WHO REVIEWS THE RETURN. THE ADMINISTRATOR BRINGS THE RETURN TO THE PLAN'S NEXT BOARD MEETING WHERE IT IS SIGNED BY THE APPROPRIATE TRUSTEE. ONCE SIGNED, THE CPA FIRM ELECTRONICALLY FILES THE RETURN. 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.