LM21Form

FORM

LM-21 - RECEIPTS

& DISBURSEMENTS REPORT

OMB No. 1245-0003 . Expires 01-31-2025 .

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

OLMS

Read the instructions carefully before completing this report.

AMENDED

1. File Number: C-464 2. Period Covered by this report From: 01/01/2022 Through: 12/31/2022

A. Person Filing

3. Name and mailing address (including Zip Code):

Name:DAVID J BURKE

Title:President

Organization:LABOR INFORMATION SERVICES INC

P.O. Box., Bldg., Room No., if any:611

Street:5737 Kanan Road

City:AgouraState:CA

ZIP code:91301

4. Any 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:

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.)

17.

SIGNED: David Burke

Title: PRESIDENT

Date: Mar 22, 2023

Telephone Number: 310-589-5225

18.

SIGNED: David Burke

Title: TREASURER

Date: Mar 22, 2023

Telephone Number: 310-589-5225

Form LM-21 (2003)

Statement of Receipts Report all receipts from employers in connection with labor relations advice or services regardless of the purposes of the advice or services.

5.a.Name and Address of Employer (including trade name, if any).

Employer: Al Fire

Trade Name:

Name: Scott Pustizzi

Title: VP Human Resources

Mailing Address:

P.O. Box., Bldg., Room No., if any:

Street:3760 Kilroy Airport Way

City:Long BeachState:IL

ZIP code:90806

5.b.Termination Date: 10/16/22 5.c.Amount:$3,100 Non-Cash Payment:

Type of Payment: Payment on invoices issued.

5.a.Name and Address of Employer (including trade name, if any).

Employer: Amazon

Trade Name:

Name: Tiffany Blagmon

Title: Program Manager

Mailing Address:

P.O. Box., Bldg., Room No., if any:

Street:410 Terry Ave N

City:SeattleState:IL

ZIP code:96109

5.b.Termination Date: 3/23/22 5.c.Amount:$313,410 Non-Cash Payment:

Type of Payment: Payments on Invoices issued

5.a.Name and Address of Employer (including trade name, if any).

Employer: B Braun USA

Trade Name:

Name: Tricia Montgomery

Title: Exec. Asst/HR Coordinator

Mailing Address:

P.O. Box., Bldg., Room No., if any:

Street:824 121th Ave

City:BethlehemState:IL

ZIP code:18018

5.b.Termination Date: 2/2/22 5.c.Amount:$139,069 Non-Cash Payment:

Type of Payment: Payment on invoices issued

5.a.Name and Address of Employer (including trade name, if any).

Employer: Central Supply Company

Trade Name:

Name: Ray Abbott

Title: VP GM

Mailing Address:

P.O. Box., Bldg., Room No., if any:

Street:701 E Wallace Street

City:Fort WayneState:IL

ZIP code:46803

5.b.Termination Date: 5/13/22 5.c.Amount:$12,531 Non-Cash Payment:

Type of Payment: Payment for invoices issued

5.a.Name and Address of Employer (including trade name, if any).

Employer: Hornblower Group

Trade Name: City Experience

Name: Mitch Randall

Title: General Counsel

Mailing Address:

P.O. Box., Bldg., Room No., if any:Pier 3

Street:The Embarcadero

City:San FranciscoState:IL

ZIP code:94111

5.b.Termination Date: 9/18/22 5.c.Amount:$225,206 Non-Cash Payment:

Type of Payment: Payment for invoices issued

5.a.Name and Address of Employer (including trade name, if any).

Employer: IMEX USA

Trade Name:

Name: Robert Bullock

Title: Asst VP and HR Labor Relations

Mailing Address:

P.O. Box., Bldg., Room No., if any:

Street:7150 Phillips Highway

City:JacksonvilleState:IL

ZIP code:32256

5.b.Termination Date: 10/4/21 5.c.Amount:$1,244 Non-Cash Payment:

Type of Payment: Payment for all invoices issues

5.a.Name and Address of Employer (including trade name, if any).

Employer: Jim Fisher Volvo

Trade Name:

Name: Jim Fisher

Title:

Mailing Address:

P.O. Box., Bldg., Room No., if any:

Street:2108 West Burnside Street

City:PortlandState:IL

ZIP code:97210

5.b.Termination Date: 04/08/22 5.c.Amount:$22,334 Non-Cash Payment:

Type of Payment: Payment for all invoices issued

5.a.Name and Address of Employer (including trade name, if any).

Employer: Precision Castparts Corp

Trade Name:

Name: Ruth Beyer

Title: Sr. VP and GC

Mailing Address:

P.O. Box., Bldg., Room No., if any:Suite 620

Street:5885 Meadows Road

City:Lake OswegoState:IL

ZIP code:97035

5.b.Termination Date: 10/06/22 5.c.Amount:$80,777 Non-Cash Payment:

Type of Payment: Payment for all invoices issued

5.a.Name and Address of Employer (including trade name, if any).

Employer: Verano Holdings LLC

Trade Name:

Name: Josh Dalley

Title: VP of HR

Mailing Address:

P.O. Box., Bldg., Room No., if any:4th Floor

Street:415 North Dearboarn

City:ChicagoState:IL

ZIP code:60654

5.b.Termination Date: 01/20/22 5.c.Amount:$6,067 Non-Cash Payment:

Type of Payment: Payment for all Invoices Issued

6.TOTAL RECEIPTS FROM ALL EMPLOYERS: $803,738

Statement of Disbursements Report all disbursements made by the reporting organization in connection with labor relations advice or services rendered to the employers listed in Part B.

Disbursements to Officers and Employees:

(a) Name	(b) Salary	(c) Expense	(d) Totals

8. Total disbursements to officers and employees:	$0
9. Officer and Administrative Expenses:
10. Publicity:
11. Fees for Professional Services:	$315,732
12. Loans Made:
13. Other Disbursements:
14. Total Disbursements (Sum of Items 8-13):	$315,732

Form LM-21 (2003)

Schedule of Disbursements for Reportable Activity Use this schedule to report only disbursements made for the purposes described in Part D of the instructions.

15.a. Employer Name: B Braun USA

15.c. To Whom Paid:

Name: David Acosta

Title:

Organization: Labor Information Services, Inc.

P.O. Box., Bldg., Room No., if any:Suite 611

Street:5737 Kanan Road

City:AgouraState:CA

ZIP code:91301

15.b. Trade Name, If any:

15.d.Amount:$33,600

15.e.Purpose: To meet directly with employees either individually or in a group meeting to discuss issues and answer questions regarding union issues. Also to discuss their legal rights to make an informed choice.

15.a. Employer Name: Hornblower Group

15.c. To Whom Paid:

Name: Jose Agraz

Title:

Organization: Labor Information Services, Inc.

P.O. Box., Bldg., Room No., if any:Suite 611

Street:5737 Kanan Road

City:AgouraState:CA

ZIP code:91301

15.b. Trade Name, If any:

City Experiences

15.d.Amount:$54,225

15.a. Employer Name: Precision Castparts Corp

15.c. To Whom Paid:

Name: Chuck Ahern

Title:

Organization: Labor Information Services, Inc.

P.O. Box., Bldg., Room No., if any:Suite 611

Street:5737 Kanan Road

City:AgouraState:CA

ZIP code:91301

15.b. Trade Name, If any:

15.d.Amount:$3,805

15.a. Employer Name: Central Supply Company

15.c. To Whom Paid:

Name: Chuck Ahern

Title:

Organization: Labor Information Services, Inc.

P.O. Box., Bldg., Room No., if any:Suite 511

Street:5737 Kanan Road

City:AgouraState:CA

ZIP code:91301

15.b. Trade Name, If any:

15.d.Amount:$839

15.a. Employer Name: Precision Castparts Corporation

15.c. To Whom Paid:

Name: Phillip Brown

Title:

Organization: Labor Information Services, Inc.

P.O. Box., Bldg., Room No., if any:Suite 611

Street:5737 Kanan Road

City:AgouraState:CA

ZIP code:91301

15.b. Trade Name, If any:

15.d.Amount:$4,463

15.a. Employer Name: Precision Castparts Corp

15.c. To Whom Paid:

Name: Danielle Burke

Title:

Organization: Labor Information Services, Inc.

P.O. Box., Bldg., Room No., if any:Suite 611

Street:5737 Kanan Road

City:AgouraState:CA

ZIP code:91301

15.b. Trade Name, If any:

15.d.Amount:$5,775

15.a. Employer Name: Amazon

15.c. To Whom Paid:

Name: Mark Lema

Title:

Organization: Labor Information Services, Inc.

P.O. Box., Bldg., Room No., if any:Suite 611

Street:5737 Kanan Road

City:AgouraState:CA

ZIP code:91301

15.b. Trade Name, If any:

15.d.Amount:$116,800

15.a. Employer Name: Amazon

15.c. To Whom Paid:

Name: Bradley Moss

Title:

Organization: Labor Information Services, Inc.

P.O. Box., Bldg., Room No., if any:Suite 611

Street:5737 Kanan Road

City:AgouraState:CA

ZIP code:91301

15.b. Trade Name, If any:

15.d.Amount:$33,750

15.a. Employer Name: Verano Holding LLC

15.c. To Whom Paid:

Name: Jesse Rojas

Title:

Organization: Labor Information Services, Inc.

P.O. Box., Bldg., Room No., if any:Suite 611

Street:5737 Kanan Road

City:AgouraState:CA

ZIP code:91301

15.b. Trade Name, If any:

15.d.Amount:$875

15.a. Employer Name: Jim Fisher Volvo

15.c. To Whom Paid:

Name: Jesse Rojas

Title:

Organization: Labor Information Services, Inc.

P.O. Box., Bldg., Room No., if any:Suite 611

Street:5737 Kanan Road

City:AgouraState:CA

ZIP code:91301

15.b. Trade Name, If any:

15.d.Amount:$8,925

15.a. Employer Name: Hornblower Group

15.c. To Whom Paid:

Name: Jess Rojas

Title:

Organization: Labor Information Services, Inc.

P.O. Box., Bldg., Room No., if any:Suite 611

Street:5737 Kanan Road

City:AgouraState:CA

ZIP code:91301

15.b. Trade Name, If any:

City Experiences

15.d.Amount:$52,675

16.TOTAL DISBURSEMENTS FOR ALL REPORTABLE ACTIVITY: $315,732

Form LM-21 (2003)