IMPORTANT: 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.
Required of persons, including Labor Relations Consultants and
Other Individuals and Organizations, under Section 203(b) of
the
Labor-Management Reporting and Disclosure Act of 1959, as
amended (LMRDA).
Office of Labor-Management Standards
U.S. Department of Labor
For Official Use Only
E
OLMS
Read the instructions carefully before completing this report.
1.a. File Number: C-322
Amended:
2.
Name and mailing address (including Zip Code):
Name:PETER A LIST
Title:Founder & CEO
Organization:KULTURE CONSULTING, LLC
P.O. Box., Bldg., Room No., if any:P.O. BOX 2877
Street:
City:PAWLEYS ISLANDState:SC
ZIP code:29585
3.
Other address where records necessary to
verify this report are kept:
Name:
Title:
Organization:
P.O. Box., Bldg., Room No., if any:
Street:
City:State:
ZIP code:
4.
Date fiscal year ends:Dec /21
5.
Type of person
a.
Individual b.
Partnership
c.
X
Corporation C d.
Other
Specify:
Nature of Agreement or Arrangement
6.
Full name and address of employer with whom made (include ZIP Code):
Name:Kim Bennett
Organization:KEURIG DR PEPPER INC.
Trade Name, if any:
P.O. Box., Bldg., Room No., if any:
Street:2825 S. Elm Ave.
City:FresnoState:CA
ZIP code:93706
7.
Date entered into07/26/2021
8.
Name of person(s) through whom made:
Name:Kim Bennett
Signature and Verification
Each
of the undersigned 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
VII on
penalties in the
instructions.)
13.
SIGNED:
Peter A List
Title:
PRESIDENT
Date:
Aug 27, 2021
Telephone Number:
843-314-0383
14.
SIGNED:
Stephanie B
Title:
TREASURER
Date:
Aug 27, 2021
Telephone Number:
843-314-0383
Form LM-20 (2003)
9.
Check the appropriate box(es) to indicate
whether an object
of the activities undertaken is directly
or
indirectly:
a.
X
To persuade employees to exercise or not to
exercise, or persuade employees as to the manner of
exercising, the right to organize and bargain collectively
through representatives of their own choosing.
b.
To supply an employer with information
concerning the activities of employees or a labor
organization in connection with a labor dispute involving
such employer, except information for use solely in
conjunction with an administrative or arbitral proceeding
or
a criminal or civil judicial proceeding.
10.
Terms and conditions.
(Explain in detail;
see
instructions.
Written agreements must
be attached.):
Written Agreement/Arrangement
Oral agreement made through Kulture Consulting, LLC $375.00 per hour, per consultant, plus actual and reasonable expenses.
Specific Activities to be performed
Activity1
11. For each activity, separately list in detail the information required.
(See instructions.)
a. Nature of activity:Traveled to employer; met with management personnel; Conducted classes to educate management and employees relative to the National Labor Relations Act, employees' Section Seven Rights, as well as information regarding the NLRB election process and collective bargaining; answered questions.
11.b.Period during which activities
performed:
Various dates beginning 7/26/2021
11.c. Extent of performance:
Completed
11.d.
Name and address of person(s) through
whom
activities were performed or will be performed:
P.O. Box, Bldg., Room No., If any:#300-722Street:15281 Summit AveCity:FontanaState:CAZip:92336
12.a. Identify subject groups of employees:
All full-time and regular part-time drivers, forklift drivers, and order selectors employed by the Employer at its facility located at 2825 S. Elm Ave., Fresno, California
Excluded: Managers, maintenance mechanics, cold service employees,
confidential employees, office clerical employees, guards, and supervisors as defined by the Act.