U.S. Department of Labor
Office of Labor-Management Standards
Washington, DC 20210 		FORM LM-2 LABOR ORGANIZATION ANNUAL REPORT Form Approved
Office of Management and Budget
No. 1245-0003
Expires: 09-30-2021
MUST BE USED BY LABOR ORGANIZATIONS WITH $250,000 OR MORE IN TOTAL ANNUAL RECEIPTS AND LABOR ORGANIZATIONS IN TRUSTEESHIP

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.
READ THE INSTRUCTIONS CAREFULLY BEFORE PREPARING THIS REPORT.
For Official Use Only
1. FILE NUMBER
024-068
2. PERIOD COVERED
From07/01/2018
Through06/30/2019
3. (a) AMENDED - Is this an amended report:
No
(b) HARDSHIP - Filed under the hardship procedures:
No
(c) TERMINAL - This is a terminal report:No
4. AFFILIATION OR ORGANIZATION NAME
FOOD AND COMMERCIAL WKRS
5. DESIGNATION (Local, Lodge, etc.)
LOCAL UNION
 6. DESIGNATION NBR
648
7. UNIT NAME (if any)

8. MAILING ADDRESS (Type or print in capital letters)
First Name
DANIEL
 Last Name
LARSON
P.O Box - Building and Room Number

Number and Street
1980 MISSION ST
City
SAN FRANCISCO
State
CA		 ZIP Code + 4
941033405


9. Are your organization's records kept at its mailing address?


Yes

Each of the undersigned, duly authorized officers of the above labor organization, declares, under penalty of perjury and other applicable penalties of law, that all of the information submitted in this report (including information contained in any accompanying documents) has been examined by the signatory and is, to the best of the undersigned individual's knowledge and belief, true, correct and complete (See Section V on penalties in the instructions.)
70. SIGNED:DANIEL A LARSONPRESIDENT71. SIGNED:Milton HumTREASURER
Date:Sep 27, 2019Telephone Number:415-861-7840Date:Sep 27, 2019Telephone Number:415-861-7840
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
ITEMS 10 THROUGH 21 FILE NUMBER: 024-068
10. During the reporting period did the labor organization create or participate in the administration of a trust or a fund or organization, as defined in the instructions, which provides benefits for members or beneficiaries?Yes
11(a). During the reporting period did the labor organization have a political action committee (PAC) fund?Yes
11(b). During the reporting period did the labor organization have a subsidiary organization as defined in Section X of these Instructions?No
12. During the reporting period did the labor organization have an audit or review of its books and records by an outside accountant or by a parent body auditor/representative?Yes
13. During the reporting period did the labor organization discover any loss or shortage of funds or other assets? (Answer "Yes" even if there has been repayment or recovery.)No
14. What is the maximum amount recoverable under the labor organization's fidelity bond for a loss caused by any officer, employee or agent of the labor organization who handled union funds?$500,000
15. During the reporting period did the labor organization acquire or dispose of any assets in a manner other than purchase or sale?No
16. Were any of the labor organization's assets pledged as security or encumbered in any way at the end of the reporting period?No
17. Did the labor organization have any contingent liabilities at the end of the reporting period?Yes
18. During the reporting period did the labor organization have any changes in its constitution or bylaws, other than rates of dues and fees, or in practices/procedures listed in the instructions?No
19. What is the date of the labor organization's next regular election of officers?07/2019
20. How many members did the labor organization have at the end of the reporting period?3,218
21. What are the labor organization's rates of dues and fees?
Rates of Dues and Fees
Dues/FeesAmount UnitMinimumMaximum
(a) Regular Dues/Fees$34.50-$43.50per$34.50-$43.50$34.50$43.50
(b) Working Dues/FeesN/AperN/AN/AN/A
(c) Initiation Fees$210-$350perInitiation$210$350
(d) Transfer FeesN/AperN/AN/AN/A
(e) Work PermitsN/AperN/AN/AN/A

Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
STATEMENT A - ASSETS AND LIABILITIES FILE NUMBER: 024-068

ASSETS
ASSETS Schedule
Number 		Start of Reporting Period
(A) 		End of Reporting Period
(B)
22. Cash $1,378,801$1,061,907
23. Accounts Receivable1$0
24. Loans Receivable2
25. U.S. Treasury Securities $0$0
26. Investments5$278,443$641,671
27. Fixed Assets6$195,587$161,627
28. Other Assets7
29. TOTAL ASSETS $1,852,831$1,865,205

LIABILITIES
LIABILITIES Schedule
Number 		Start of Reporting Period
(A) 		End of Reporting Period
(B)
30. Accounts Payable8$0
31. Loans Payable9
32. Mortgages Payable $0$0
33. Other Liabilities10$3,838$3,113
34. TOTAL LIABILITIES $3,838$3,113
35. NET ASSETS$1,848,993$1,862,092
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
STATEMENT B - RECEIPTS AND DISBURSEMENTS FILE NUMBER: 024-068

CASH RECEIPTSSCHAMOUNT
36. Dues and Agency Fees $1,914,105
37. Per Capita Tax $0
38. Fees, Fines, Assessments, Work Permits $150,448
39. Sale of Supplies $1,455
40. Interest $19,980
41. Dividends $6,723
42. Rents $84,134
43. Sale of Investments and Fixed Assets3$50,000
44. Loans Obtained9
45. Repayments of Loans Made2
46. On Behalf of Affiliates for Transmittal to Them $0
47. From Members for Disbursement on Their Behalf $0
48. Other Receipts14$247,759
49. TOTAL RECEIPTS $2,474,604
CASH DISBURSEMENTSSCHAMOUNT
50. Representational Activities15$695,770
51. Political Activities and Lobbying16$50,656
52. Contributions, Gifts, and Grants17$12,216
53. General Overhead18$391,671
54. Union Administration19$113,562
55. Benefits20$271,099
56. Per Capita Tax $766,412
57. Strike Benefits $0
58. Fees, Fines, Assessments, etc. $0
59. Supplies for Resale $2,981
60. Purchase of Investments and Fixed Assets4$406,723
61. Loans Made2
62. Repayment of Loans Obtained9
63. To Affiliates of Funds Collected on Their Behalf $0
64. On Behalf of Individual Members $0
65. Direct Taxes $79,683
  
66. Subtotal $2,790,773
67. Withholding Taxes and Payroll Deductions  
  67a. Total Withheld$231,655  
  67b. Less Total Disbursed$232,380  
  67c. Total Withheld But Not Disbursed -$725
68. TOTAL DISBURSEMENTS $2,791,498
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 1 - ACCOUNTS RECEIVABLE AGING SCHEDULE FILE NUMBER: 024-068

Entity or Individual Name
(A) 		Total Account Receivable
(B) 		90-180 Days
Past Due
(C) 		180+ Days
Past Due
(D) 		Liquidated Account
Receivable
(E)
Total of all itemized accounts receivable$0$0$0$0
Totals from all other accounts receivable    
Totals (Total of Column (B) will be automatically entered in Item 23, Column(B)) $0$0$0$0
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 2 - LOANS RECEIVABLE FILE NUMBER: 024-068

List below loans to officers, employees, or members which at any time during the reporting period exceeded $250 and list all loans to business enterprises regardless of amount.
(A) 		Loans
Outstanding at
Start of Period
(B) 		Loans Made
During Period
(C)
Repayments Received During Period
Cash
(D)(1) 		Other Than Cash
(D)(2)
Loans
Outstanding at
End of Period
(E)
Total of loans not listed above     
Total of all lines above$0$0$0$0$0
Totals will be automatically entered in... Item 24
Column (A) 		Item 61Item 45 Item 69
with Explanation 		Item 24
Column (B)
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 3 - SALE OF INVESTMENTS AND FIXED ASSETS FILE NUMBER: 024-068

Description (if land or buildings, give location)
(A) 		Cost
(B) 		Book Value
(C) 		Gross Sales Price
(D) 		Amount Received
(E)
Total of all lines above$54,281$50,000$50,000$50,000
Municipal Bonds$54,281$50,000$50,000$50,000
Less Reinvestments$0
(The total from Net Sales Line will be automatically entered in Item 43)Net Sales$50,000
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 4 - PURCHASE OF INVESTMENTS AND FIXED ASSETS FILE NUMBER: 024-068

Description (if land or buildings, give location)
(A) 		Cost
(B) 		Book Value
(C) 		Cash Paid
(D)
Total of all lines above$406,723$406,723$406,723
Mutual Fund$406,723$406,723$406,723
 Less Reinvestments$0
(The total from Net Purchases Line will be automatically entered in Item 60.)Net Purchases$406,723
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 5 - INVESTMENTS FILE NUMBER: 024-068

Description
(A) 		Amount
(B)
Marketable Securities 
A. Total Cost$612,139
B. Total Book Value$641,671
C. List each marketable security which has a book value over $5,000 and exceeds 5% of Line B.  
  • Orange Cnty Wastewater REV-A 5.56% 02/01/2036
$131,184
  • California St Var Purp Genl Oblig 7.95% 03/01/2036
$103,764
  • MSILF Government PTF INST
$406,723
Other Investments 
D. Total Cost
E. Total Book Value
F. List each other investment which has a book value over $5,000 and exceeds 5% of Line E.  Also, list each subsidiary for which separate reports are attached.  
G. Total of Lines B and E (Total will be automatically entered in Item 26, Column(B)) $641,671
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 6 - FIXED ASSETS FILE NUMBER: 024-068

Description
(A) 		Cost or Other Basis
(B) 		Total Depreciation or
Amount Expensed
(C) 		Book Value
(D) 		Value
(E)
A. Land (give location)    
Land  1 :      1980 Mission Street, San Francisco, CA 94103$86,239 $86,239$86,239
B. Buildings (give location)    
Building  1 :      1980 Mission Street, San Francisco, CA 94103$689,169$613,991$75,178$75,178
C. Automobiles and Other Vehicles
D. Office Furniture and Equipment$177,272$177,062$210$210
E. Other Fixed Assets
F. Totals of Lines A through E (Column(D) Total will be automatically entered in Item 27, Column(B)) $952,680$791,053$161,627$161,627
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 7 - OTHER ASSETS FILE NUMBER: 024-068

Description
(A) 		Book Value
(B)
Total (Total will be automatically entered in Item 28, Column(B)) $0
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 8 - ACCOUNTS PAYABLE AGING SCHEDULE FILE NUMBER: 024-068

Entity or Individual Name
(A) 		Total Account
Payable
(B) 		90-180 Days
Past Due
(C) 		180+ Days Past
Due
(D)
Liquidated Account
Payable
(E)
Total for all itemized accounts payable$0$0$0$0
Total from all other accounts payable$0$0$0$0
Totals (Total for Column(B) will be automatically entered in Item 30, Column(D)) $0$0$0$0
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 9 - LOANS PAYABLE FILE NUMBER: 024-068

Source of Loans Payable at Any
Time During the Reporting Period
(A) 		Loans Owed at
Start of Period
(B) 		Loans Obtained
During Period
(C) 		Repayment
During Period
Cash
(D)(1) 		Repayment
During Period
Other Than Cash
(D)(2) 		Loans Owed at
End of Period
(E)
Total Loans Payable$0$0$0$0$0
Totals will be automatically entered in... Item 31
Column (C) 		Item 44Item 62 Item 69
with Explanation 		Item 31
Column (D)
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 10 - OTHER LIABILITIES FILE NUMBER: 024-068

Description
(A) 		Amount at End of Period
(B)
Total Other Liabilities (Total will be automatically entered in Item 33, Column(D)) $3,113
Payroll Liabilities$3,113
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 11 - ALL OFFICERS AND DISBURSEMENTS TO OFFICERS FILE NUMBER: 024-068

(A)
Name		(B)
Title		(C)
Status		 (D)
Gross Salary
Disbursements
(before any
deductions) 		(E)
Allowances
Disbursed 		(F)
Disbursements for Official Business 		(G)
Other
Disbursements not reported in
(D) through (F) 		(H)
TOTAL
A
B
C 		Larson ,  Daniel  
President
C		$113,086$540$18,343$0$131,969
I
Schedule 15
Representational Activities 		90 % Schedule 16
Political Activities and Lobbying 		1 % Schedule 17
Contributions 		1 % Schedule 18
General Overhead 		5 % Schedule 19
Administration 		3 %
A
B
C 		Hum ,  Milton  
Secretary-Treasurer
C		$98,967$495$7,362$0$106,824
I
Schedule 15
Representational Activities 		84 % Schedule 16
Political Activities and Lobbying 		5 % Schedule 17
Contributions 		1 % Schedule 18
General Overhead 		5 % Schedule 19
Administration 		5 %
A
B
C 		Salazar ,  Cynthia  
Recorder
C		$69,684$405$1,200$0$71,289
I
Schedule 15
Representational Activities 		25 % Schedule 16
Political Activities and Lobbying 		0 % Schedule 17
Contributions 		2 % Schedule 18
General Overhead 		68 % Schedule 19
Administration 		5 %
A
B
C 		Daniels ,  Bryant  
Vice President
C		$0$270$2,439$0$2,709
I
Schedule 15
Representational Activities 		0 % Schedule 16
Political Activities and Lobbying 		0 % Schedule 17
Contributions 		0 % Schedule 18
General Overhead 		0 % Schedule 19
Administration 		100 %
A
B
C 		Garcia ,  Jennifer  
Vice President
C		$86,664$0$5,076$0$91,740
I
Schedule 15
Representational Activities 		46 % Schedule 16
Political Activities and Lobbying 		46 % Schedule 17
Contributions 		0 % Schedule 18
General Overhead 		3 % Schedule 19
Administration 		5 %
A
B
C 		Gonzalez ,  Joel  
Vice President
C		$0$450$0$0$450
I
Schedule 15
Representational Activities 		0 % Schedule 16
Political Activities and Lobbying 		0 % Schedule 17
Contributions 		0 % Schedule 18
General Overhead 		0 % Schedule 19
Administration 		100 %
A
B
C 		Herbert ,  Michelle  
Vice President
C		$0$45$0$0$45
I
Schedule 15
Representational Activities 		0 % Schedule 16
Political Activities and Lobbying 		0 % Schedule 17
Contributions 		0 % Schedule 18
General Overhead 		0 % Schedule 19
Administration 		100 %
A
B
C 		Kwan ,  Andy  
Vice President
C		$0$270$0$0$270
I
Schedule 15
Representational Activities 		0 % Schedule 16
Political Activities and Lobbying 		0 % Schedule 17
Contributions 		0 % Schedule 18
General Overhead 		0 % Schedule 19
Administration 		100 %
A
B
C 		Latham ,  John  
Vice President
C		$0$315$0$0$315
I
Schedule 15
Representational Activities 		0 % Schedule 16
Political Activities and Lobbying 		0 % Schedule 17
Contributions 		0 % Schedule 18
General Overhead 		0 % Schedule 19
Administration 		100 %
A
B
C 		Ng ,  Barry  
Vice President
C		$0$540$0$0$540
I
Schedule 15
Representational Activities 		0 % Schedule 16
Political Activities and Lobbying 		0 % Schedule 17
Contributions 		0 % Schedule 18
General Overhead 		0 % Schedule 19
Administration 		100 %
A
B
C 		Ng ,  Steven  
Vice President
C		$0$540$0$0$540
I
Schedule 15
Representational Activities 		0 % Schedule 16
Political Activities and Lobbying 		0 % Schedule 17
Contributions 		0 % Schedule 18
General Overhead 		0 % Schedule 19
Administration 		100 %
A
B
C 		Pradia ,  Christian  
Vice President
C		$86,184$540$2,843$0$89,567
I
Schedule 15
Representational Activities 		91 % Schedule 16
Political Activities and Lobbying 		1 % Schedule 17
Contributions 		0 % Schedule 18
General Overhead 		3 % Schedule 19
Administration 		5 %
A
B
C 		Salazar ,  Michelle  
Vice President
C		$0$180$0$0$180
I
Schedule 15
Representational Activities 		0 % Schedule 16
Political Activities and Lobbying 		0 % Schedule 17
Contributions 		0 % Schedule 18
General Overhead 		0 % Schedule 19
Administration 		100 %
A
B
C 		Szeto ,  Raymond  
Vice President
C		$0$225$0$0$225
I
Schedule 15
Representational Activities 		0 % Schedule 16
Political Activities and Lobbying 		0 % Schedule 17
Contributions 		0 % Schedule 18
General Overhead 		0 % Schedule 19
Administration 		100 %
A
B
C 		Vasilevskaya ,  Polina  
Vice President
C		$0$270$0$0$270
I
Schedule 15
Representational Activities 		0 % Schedule 16
Political Activities and Lobbying 		0 % Schedule 17
Contributions 		0 % Schedule 18
General Overhead 		0 % Schedule 19
Administration 		100 %
A
B
C 		Villasin ,  Maria  
Vice President
C		$0$450$1,927$0$2,377
I
Schedule 15
Representational Activities 		0 % Schedule 16
Political Activities and Lobbying 		0 % Schedule 17
Contributions 		0 % Schedule 18
General Overhead 		0 % Schedule 19
Administration 		100 %
A
B
C 		Yuen ,  Dennis  
Vice President
C		$0$360$0$0$360
I
Schedule 15
Representational Activities 		0 % Schedule 16
Political Activities and Lobbying 		0 % Schedule 17
Contributions 		0 % Schedule 18
General Overhead 		0 % Schedule 19
Administration 		100 %
Total Officer Disbursements$454,585$5,895$39,190$0$499,670
Less Deductions    $137,349
Net Disbursements    $362,321
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 12 - DISBURSEMENTS TO EMPLOYEES FILE NUMBER: 024-068

(A)
Name		(B)
Title		(C)
Other Payer		 (D)
Gross Salary
Disbursements
(before any
deductions) 		(E)
Allowances Disbursed 		(F)
Disbursements for Official Business 		(G)
Other Disbursements not reported in
(D) through (F) 		(H)
TOTAL
A
B
C 		Flores ,  Marco   A
Membership Director
N/A		$89,385$0$4,142$0$93,527
I
Schedule 15
Representational Activities 		20 % Schedule 16
Political Activities and Lobbying 		0 % Schedule 17
Contributions 		0 % Schedule 18
General Overhead 		80 % Schedule 19
Administration 		0 %
A
B
C 		Li ,  Hai Lan  
Office Manager
N/A		$92,548$0$1,200$0$93,748
I
Schedule 15
Representational Activities 		25 % Schedule 16
Political Activities and Lobbying 		0 % Schedule 17
Contributions 		0 % Schedule 18
General Overhead 		70 % Schedule 19
Administration 		5 %
A
B
C 		Krug ,  Maggie  
Bus Rep
N/A		$34,830$0$6,394$0$41,224
I
Schedule 15
Representational Activities 		91 % Schedule 16
Political Activities and Lobbying 		0 % Schedule 17
Contributions 		1 % Schedule 18
General Overhead 		3 % Schedule 19
Administration 		5 %
A
B
C 		Flores ,  Sonia  
Spur
N/A		$3,546$0$0$0$3,546
I
Schedule 15
Representational Activities 		100 % Schedule 16
Political Activities and Lobbying 		0 % Schedule 17
Contributions 		0 % Schedule 18
General Overhead 		0 % Schedule 19
Administration 		0 %
A
B
C 		Tolentino ,  Rosalina  
Dues Clerk
N/A		$72,109$0$0$0$72,109
I
Schedule 15
Representational Activities 		0 % Schedule 16
Political Activities and Lobbying 		0 % Schedule 17
Contributions 		0 % Schedule 18
General Overhead 		0 % Schedule 19
Administration 		100 %
A
B
C 		McLaughlin ,  Timothy  
Bus Rep
N/A		$85,744$0$4,157$0$89,901
I
Schedule 15
Representational Activities 		94 % Schedule 16
Political Activities and Lobbying 		1 % Schedule 17
Contributions 		0 % Schedule 18
General Overhead 		0 % Schedule 19
Administration 		5 %
A
B
C 		Louie ,  Nancy  
Bus Rep
Part time Secretary		$19,450$0$0$0$19,450
I
Schedule 15
Representational Activities 		20 % Schedule 16
Political Activities and Lobbying 		0 % Schedule 17
Contributions 		0 % Schedule 18
General Overhead 		80 % Schedule 19
Administration 		0 %
TOTALS RECEIVED BY EMPLOYEES MAKING $10,000 OR LESS$0
I Schedule 15
Representational Activities 		Schedule 16
Political Activities and Lobbying 		Schedule 17
Contributions 		Schedule 18
General Overhead 		Schedule 19
Administration
Total Employee Disbursements$397,612$0$15,893$0$413,505
Less Deductions    $94,306
Net Disbursements    $319,199
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 13 - MEMBERSHIP STATUS FILE NUMBER: 024-068

Category of Membership
(A) 		Number
(B) 		Voting Eligibility
(C)
Members (Total of all lines above) 3,218 
Agency Fee Payers*2
Total Members/Fee Payers3,220 
*Agency Fee Payers are not considered members of the labor organization.
Food Clerk1,061Yes
Courtesy Clerk209Yes
Bakery Clerk62Yes
Pharmacy Member103Yes
Drug Clerk1,039Yes
Candy Clerk24Yes
Liquor Clerk3Yes
Utility Clerk18Yes
GMC (General Merchandise Clerk)697Yes
Cigar Clerk2Yes
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
DETAILED SUMMARY PAGE - SCHEDULES 14 THROUGH 19 FILE NUMBER: 024-068

SCHEDULE 14   OTHER RECEIPTS
1. Named Payer Itemized Receipts$227,128
2. Named Payer Non-itemized Receipts$15,782
3. All Other Receipts$4,849
4. Total Receipts$247,759
     
     
SCHEDULE 17   CONTRIBUTIONS, GIFTS & GRANTS
1. Named Payee Itemized Disbursements$0
2. Named Payee Non-itemized Disbursements$0
3. To Officers$3,814
4. To Employees$412
5. All Other Disbursements$7,990
6. Total Disbursements$12,216
SCHEDULE 15   REPRESENTATIONAL ACTIVITIES
1. Named Payee Itemized Disbursements$70,709
2. Named Payee Non-itemized Disbursements$71,925
3. To Officers$350,032
4. To Employees$171,599
5. All Other Disbursements$31,505
6. Total Disbursements$695,770
SCHEDULE 18   GENERAL OVERHEAD
1. Named Payee Itemized Disbursements$35,437
2. Named Payee Non-itemized Disbursements$84,607
3. To Officers$65,855
4. To Employees$157,243
5. All Other Disbursements$48,529
6. Total Disbursements$391,671
SCHEDULE 16   POLITICAL ACTIVITIES AND LOBBYING
1. Named Payee Itemized Disbursements$0
2. Named Payee Non-itemized Disbursements$0
3. To Officers$49,757
4. To Employees$899
5. All Other Disbursements$0
6. Total Disbursements$50,656
SCHEDULE 19   UNION ADMINISTRATION
1. Named Payee Itemized Disbursements$0
2. Named Payee Non-itemized Disbursements$0
3. To Officers$30,210
4. To Employees$83,352
5. All Other Disbursements$0
6. Total Disbursements$113,562
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 14 - OTHER RECEIPTS FILE NUMBER: 024-068

Name and Address
(A)
UFCW & EMPLOYER TRUSTS, LLC

1000 BURNETT AVE
CONCORD
CA
94520
Type or Classification
(B)
TRUST FUNDS
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$112,428
Total Non-Itemized Transactions with this Payee/Payer$14,622
Total of All Transactions with this Payee/Payer for This Schedule$127,050
Reimbursement from Trust Fd07/31/2018$9,369
Reimbursement from Trust Fd08/31/2018$9,369
Reimbursement from Trust Fd09/30/2018$9,098
Reimbursement from Trust Fd10/31/2018$9,640
Reimbursement from Trust Fd11/30/2018$9,369
Reimbursement from Trust Fd12/31/2018$9,369
Reimbursement from Trust Fd01/31/2019$9,369
Reimbursement from Trust Fd02/28/2019$9,369
Reimbursement from Trust Fd03/31/2019$9,369
Reimbursement from Trust Fd04/30/2019$9,369
Reimbursement from Trust Fd05/31/2019$9,369
Reimbursement from Trust Fd06/30/2019$9,369
Name and Address
(A)
UFCW INTERNATIONAL UNION
PO BOX 17504

BALTIMORE
MD
21279-1504
Type or Classification
(B)
INTERNATIONAL UNION
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$114,700
Total Non-Itemized Transactions with this Payee/Payer$1,160
Total of All Transactions with this Payee/Payer for This Schedule$115,860
Reimbursement from Int'l08/31/2018$23,280
Reimbursement from Int'l10/31/2018$17,360
Reimbursement from Int'l11/30/2018$6,000
Reimbursement from Int'l12/31/2018$10,680
Reimbursement from Int'l01/31/2019$10,880
Reimbursement from Int'l02/28/2019$8,680
Reimbursement from Int'l03/31/2019$17,360
Reimbursement from Int'l05/31/2019$8,680
Reimbursement from Int'l06/30/2019$6,180
Reimbursement from Int'l07/31/2018$5,600
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 15 - REPRESENTATIONAL ACTIVITIES FILE NUMBER: 024-068

Name and Address
(A)
DAVIS RENO ATTORNEYS AT LAW

22 BATTERY ST
SAN FRANCISCO
CA
94111
Type or Classification
(B)
LEGAL COUNSEL
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$18,209
Total Non-Itemized Transactions with this Payee/Payer$32,886
Total of All Transactions with this Payee/Payer for This Schedule$51,095
NEGOTIATIONS 201807/10/2018$7,825
NEGOTIATIONS 201809/04/2018$5,222
NEGOTIATIONS 201811/13/2018$5,162
Name and Address
(A)
Platinum Advisors, LLC

170 Columbus Ave Ste 240
San Francisco
CA
94133
Type or Classification
(B)
Consultant
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$52,500
Total Non-Itemized Transactions with this Payee/Payer 
Total of All Transactions with this Payee/Payer for This Schedule$52,500
Consulting Services08/02/2018$15,000
Consulting Services09/06/2018$7,500
Consulting Services11/01/2018$15,000
Consulting Services11/27/2018$7,500
Consulting Services12/28/2018$7,500
Name and Address
(A)
WEINBERG, ROGER & ROSENFELD

1001 MARINA VILLAGE PRKWY
ALAMEDA
CA
94501-1091
Type or Classification
(B)
LEGAL COUNSEL
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer 
Total Non-Itemized Transactions with this Payee/Payer$39,039
Total of All Transactions with this Payee/Payer for This Schedule$39,039
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 16 - POLITICAL ACTIVITIES AND LOBBYING FILE NUMBER 024-068

There was no data found for this schedule.

SCHEDULE 17 - CONTRIBUTIONS, GIFTS & GRANTS FILE NUMBER: 024-068

There was no data found for this schedule.

SCHEDULE 18 - GENERAL OVERHEAD FILE NUMBER: 024-068

Name and Address
(A)
Bayside Printed Products

430 N Canal St Unit 9
South San Francisco
CA
94080
Type or Classification
(B)
Printer
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer 
Total Non-Itemized Transactions with this Payee/Payer$9,242
Total of All Transactions with this Payee/Payer for This Schedule$9,242
Name and Address
(A)
CLEAN A RAMA

526 COLUMBUS AVE 2ND FL
SAN FRANCISCO
CA
94133
Type or Classification
(B)
CLEANING SERVICE
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer 
Total Non-Itemized Transactions with this Payee/Payer$7,280
Total of All Transactions with this Payee/Payer for This Schedule$7,280
Name and Address
(A)
DE LAGE LANDEN
PO BOX 41602

PHILADELPHIA
PA
19101-1602
Type or Classification
(B)
COPIER LEASE
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$0
Total Non-Itemized Transactions with this Payee/Payer$8,305
Total of All Transactions with this Payee/Payer for This Schedule$8,305
Name and Address
(A)
HEARTLAND PAYMENT SYSTEMS

1 HEARTLAND WAY
JEFFERSONVILLE
IN
47130
Type or Classification
(B)
CREDIT CARD PROCESSOR
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$0
Total Non-Itemized Transactions with this Payee/Payer$24,190
Total of All Transactions with this Payee/Payer for This Schedule$24,190
Name and Address
(A)
Highfive

500 Arguello St Ste 300
Redwood City
CA
94063
Type or Classification
(B)
Video Meeting Rental
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$5,725
Total Non-Itemized Transactions with this Payee/Payer$0
Total of All Transactions with this Payee/Payer for This Schedule$5,725
Video Conferencing Rental08/07/2018$5,725
Name and Address
(A)
MILLER KAPLAN ARASE LLP

4123 LANKERSHIM BLVD
NORTH HOLLYWOOD
CA
91602-2828
Type or Classification
(B)
CPA
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$24,360
Total Non-Itemized Transactions with this Payee/Payer$0
Total of All Transactions with this Payee/Payer for This Schedule$24,360
AUDIT AND TAX RETURNS06/04/2019$17,362
AUDIT AND TAX RETURNS10/29/2018$6,998
Name and Address
(A)
OFFICE DEPOT
PO BOX 78004

PHOENIX
AZ
85062
Type or Classification
(B)
OFFICE SUPPLIES
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer 
Total Non-Itemized Transactions with this Payee/Payer$6,621
Total of All Transactions with this Payee/Payer for This Schedule$6,621
Name and Address
(A)
Prime Pay Payroll Service

5600 Mowry School Rd
Newark
CA
94560
Type or Classification
(B)
Payroll Service
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer 
Total Non-Itemized Transactions with this Payee/Payer$5,183
Total of All Transactions with this Payee/Payer for This Schedule$5,183
Name and Address
(A)
SONIC.NET, INC

2260 APOLLO WAY
SANTA ROSA
CA
95407
Type or Classification
(B)
TELEPHONE PROVIDER
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$0
Total Non-Itemized Transactions with this Payee/Payer$17,786
Total of All Transactions with this Payee/Payer for This Schedule$17,786
Name and Address
(A)
STATE FARM GENERAL INSURANCE COMPANY
PO BOX 680001

Dallas
TX
75368-0001
Type or Classification
(B)
INSURANCE
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$5,352
Total Non-Itemized Transactions with this Payee/Payer$0
Total of All Transactions with this Payee/Payer for This Schedule$5,352
GENERAL INSURANCE COMMERCIAL PACKAGE01/04/2019$5,352
Name and Address
(A)
U.S. POSTMASTER

3540 W LINCOLN ST
PHOENIX
AZ
85009
Type or Classification
(B)
POSTAGE
Purpose
(C) 		Date
(D) 		Amount
(E)
Total Itemized Transactions with this Payee/Payer$0
Total Non-Itemized Transactions with this Payee/Payer$6,000
Total of All Transactions with this Payee/Payer for This Schedule$6,000
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
SCHEDULE 19 - UNION ADMINISTRATION FILE NUMBER: 024-068

There was no data found for this schedule.

SCHEDULE 20 - BENEFITS FILE NUMBER: 024-068

Description
(A) 		To Whom Paid
(B) 		Amount
(C)
Total of all lines above (Total will be automatically entered in Item 55.)$271,099
WORKERS' COMPENSATION INSURANCEINSURANCE CARRIER$9,588
PENSION CONTRIBUTIONSMULTIEMPLOYER TRUST PENSION PLANS$66,494
HEALTH CONTRIBUTIONSMULTIEMPLOYER TRUST HEALTH PLANS$195,017
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)
69. ADDITIONAL INFORMATION SUMMARY FILE NUMBER: 024-068


Question 10: UFCW-Northern California Employers Pension Plan, EIN 94-6313554; Plan No. 001; Provides pension benefits, PO Box 4102, Concord, CA 94524-4102. Northern California Pharmacists Clerks and Drug Employers Pension Fund, EIN 94-6313555; Plan No. 001; Provides retirement benefits, PO Box 8082, Concord, CA 94524-8082. Walgreen Company & Local 648 Welfare Trust Fund, EIN 94-3087852; Plan No. 501; Provides medical, dental and vision benefits, 1640 S Loop Road, Alameda, CA 94502-7089. UFCW-Northern California Food Employers Joint Individual Account Pension Plan, EIN 68-0161773; Plan No. 002; Provides benefits upon retirement, death, total disability or job termination, PO Box 4102, Concord, CA 94524-4102. UFCW & Employers Benefit Fund, EIN 94-6078804; Plan No. 501; Provides medical, dental prescription drug, vision, member assistance program, sick leave and death benefits, PO Box 4100, Concord, CA 94524-4100. Retail Clerks Specialty Stores Pension Plan, EIN 94-2518316; Plan No. 001; Provides retirement benefits, PO Box 8082, Concord, CA 94524-8082.

Question 11(a):

Question 11(a): : United Food and Commercial Workers Local 648 PAC Fund, EIN 51-0449851. The PAC Fund files with Secretary of State, Political Reform Division, Los Angeles County Registrar - Recorder, City and County of San Francisco.

Question 12: Annual audit performed by independent certified public accounting firm, Miller Kaplan Arase LLP, Two Embarcadero Center, Suite 2280, San Francisco, CA 94111-3916.

Question 17: Vacation Benefits - Current Employees - certain current employees of the Local Union earn vacation benefits. The estimated liability for vacation benefits as of June 30, 2019 is approximately $196,000.

Schedule 13, Row2::

Schedule 13, Row3:Bakery clerk member working as a cashier/stocker in an independent bakery - full dues.

Schedule 13, Row3::

Schedule 13, Row4:Pharmacy member working as a pharmacist filling prescriptions - full dues.

Schedule 13, Row4::

Schedule 13, Row1:Food clerk member working as a cashier/stocker in a grocery store - full dues.

Schedule 13, Row1::

Schedule 13, Row2:Courtesy clerk member working as a bagger in a grocery store - full dues.

Schedule 13, Row9:GMC member working in the deli/floral/bakery in a grocery store - full dues.

Schedule 13, Row9::

Schedule 13, Row10:Cigar clerk member working as a cashier/stocker in a cigar store - full dues.

Schedule 13, Row10::

Schedule 13, Row5:Drug clerk member working as a cashier/stocker working in a drug store - full dues.

Schedule 13, Row5::

Schedule 13, Row6:Candy clerk member working as a cashier/stocker in a candy store - full dues.

Schedule 13, Row6::

Schedule 13, Row7:Liquor clerk member working as a cashier/stocker in a liquor store - full dues.

Schedule 13, Row7::

Schedule 13, Row8:Utility clerk member performing warehouse duties as well as a cashier - full dues.

Schedule 13, Row8::
Form LM-2 (Revised 2010); (Tech. Rev. 2/2013)