This report is mandatory under P.L. 86-257, as amended.
Failure to comply may result in criminal prosecution,
fines, or civil penalties as provided by 29 U.S.C. 439
or 440.
Form Approved
Office of Management and Budget
OMB No.
1245-0003
.
Expires
01-31-2025
.
For Official Use Only
E
READ THE INSTRUCTIONS CAREFULLY BEFORE COMPLETING THIS REPORT.
PART A
1. File Number: E-70220
2. Fiscal Year CoveredFrom:07/01/2021Through:06/30/2022
Month/Day/YearMonth/Day/Year
3. Name and address of Reporting Employer (inc. trade name, if any).
Employer:Sysco Louisville, Inc.
Trade Name:
Attention To:Wayne
E
Clark
Title:VP, OPERATIONS
Mailing Address
P.O. Box., Bldg., Room No., if any:
Street:7705 National Turnpike
City:LouisvilleState:KY
ZIP Code + 4:40214
4. Name and address of President or corresponding principal officer, if
different from address in Item 3.
Name:
P.O. Box., Bldg., Room No., if any:
Street:
City:State:
ZIP Code + 4:
5.
Any other address where records necessary to verify this report will be
available for examination.
Name:
Title:
Organization:
P.O. Box., Bldg., Room No., if any:
Street:
City:State:
ZIP Code + 4:
6.
Indicate by checking the appropriate box or boxes where records
necessary to verify this report will be available for examination.
X Address in Item 3
Address in Item 4
Address in Item 5
7. Type of organization.
X
Corporation
Partnership
Individual
Other
(specify)
Signatures
Each of the undersigned, duly authorized officers of the above employer declares, under penalty of perjury and other
applicable penalties of law, that all of the information submitted in this report (including the information contained
in any accompanying documents) has been examined by the signatory and is, to the best of the undersigned's knowledge and
belief, true, correct, and complete. (See Section VIII on penalties in the instructions.)
13.
SIGNED:
Wayne E Clark
Title:
VP, OPERATIONS
On Date:
Jul 21, 2022
Telephone Number:
502-376-2758
14.
SIGNED:
Wayne E Clark
Title:
VP, OPERATIONS
On Date:
Jul 21, 2022
Telephone Number:
502-376-2758
Form LM-10 (2003)
8.
Type of Reportable Activity Engaged In By Employer
Read the following questions and the accompanying instructions carefully, taking into consideration the exclusions listed in
the instructions for these items, and check either ''Yes" or ''No'' for each item. For each item that is answered ''Yes'', you must
attach a Part B which appears on Page 3. Complete a separate Part B for each ''Yes'' answer to any of Items 8.a. through 8.f.
Also, if the answer is ''Yes'' for more than one person or organization, complete a separate Part B for each person or
organization. If you answer ''Yes'', enter the number of Part Bs that are submitted for that item in the line indicated.
DURING THE FISCAL YEAR COVERED BY THIS REPORT:
If "Yes", number of Part Bs attached
8.a
Did you make or promise or agree to make, directly or indirectly, any payment or loan of
money or other thing of value (including reimbursed expenses) to any labor organization or
to any officer, agent, shop steward, or other representative or employee of any labor
organization?
YESNOX
0
8.b
Did you make, directly or indirectly, any payment (including reimbursed expenses) to any
of your employees, or to any group or committee of your employees, for the purpose of
causing them to persuade other employees to exercise or not to exercise, or as to the
manner of exercising, the right to organize and bargain collectively through representatives
of their own choosing without previously or at the same time disclosing such payment to all
such other employees?
YESNOX
0
8.c
Did you make any expenditure where an object thereof, directly or indirectly, was to
interfere with, restrain, or coerce employees in the right to organize and bargain collectively
through representatives of their own choosing?
YESNOX
0
8.d
Did you make any expenditure where an object thereof, directly or indirectly, was to obtain
information concerning the activities of employees or of a labor organization in connection
with a labor dispute in which you were involved?
YESNOX
0
8.e
Did you make any agreement or arrangement with a labor relations consultant or other
independent contractor or organization pursuant to which such person undertook activities
where an object thereof, directly or indirectly, was to persuade employees to exercise or not
to exercise, or as to the manner of exercising, the right to organize and bargain collectively
through representatives of their own choosing; or did you make any payment (including
reimbursed expenses) pursuant to such an agreement or arrangement?
YESXNO
1
8.f
Did you make any agreement or arrangement with a labor relations consultant or other
independent contractor or organization pursuant to which such person undertook activities
where an object thereof, directly or indirectly, was to furnish you with information concerning
activities of employees or of a labor organization in connection with a labor dispute in which
you were involved; or did you make any payment pursuant to such agreement or
arrangement?
YESNOX
0
TOTAL NUMBER OF PART Bs FOR THIS REPORT IS:1
Form LM-10 (2003)
Check Item Number(from Page 2) to which this Part B applies
ITEM 8.a.
ITEM 8.b.
ITEM 8.c.
ITEM 8.d.
ITEM 8.e.
X
ITEM 8.f.
9.a.X
Agreement
Payment
Both
9.c. Position In labor organization or with employer (if an independent labor consultant, so state).Treasurer
9.b. Name and address of person with whom or through whom a separate agreement was made or to whom payments were made.
Name:Raymond Rosenbach
P.O. Box., Bldg., Room No., if any:434
Street:75 Commerce Dr
City:GrayslakeState:IL
ZIP Code + 4:60030
9.d. Name and address of firm or labor organization with whom
employed or affiliated.
Organization: Government Resources Consultants of America Inc
P.O. Box., Bldg., Room No., if any:434
Street:75 Commerce Dr
City:GrayslakeState:IL
ZIP Code + 4:60030
10.a.
Date of the promise, agreement, or arrangement pursuant to
which payments or expenditures were agreed to or made.
04/26/2022
10.b.
The promise, agreement, or arrangement was:
X
Oral
Written*
Both
(*Written agreements entered into during the fiscal year must be attached.)
11.a. Date of each payment or expenditure (mm/dd/yyyy).
11.b. Amount of each payment or expenditure
11.c. Kind of each payment or expenditure (Specify whether payment or loan, and whether in cash or property)
12.
Explain fully the circumstances of all payments, including the terms of any oral agreement or understanding pursuant to which they were made : Conduct employee meetings and one-on-one conversations to inform and educate employees about their rights, duties, and responsibilities as pertain to the National Labor Relations Act and National Labor Relations Board procedures, such as secret ballot elections, collective bargaining representation, collective bargaining procedures, unfair labor practices, union rules, and union finances.