Common use of Collectively Bargained Employees Clause in Contracts

Collectively Bargained Employees. Party to a Master Agreement: Yes No If “yes,” name of Employer Association: Number of Collectively Bargained Employees: THE FUND REQUIRES THAT A COPY OF THE COLLECTIVE BARGAINING AGREEMENT BE PROVIDED TO THE PLAN ADMINISTRATION OFFICE. Non-Collectively Bargained Employees: IF ANY NON-COLLECTIVELY BARGAINED EMPLOYEES ARE COVERED, FUND RULES REQUIRE THAT ALL EMPLOYEES IN THAT GENERAL CATEGORY MUST BE COVERED: Supervisors - Number Clericals - Number Other (specify) Number Number of Non-Collectively Bargained Employees: Others: Retirees Number COBRA Participants Number Total Other Employees Covered: EMPLOYEE ELIGIBILITY REQUIRES RECEIPT OF THE FULL CONTRIBUTION. IF THE FULL CONTRIBUTION FOR THE PLAN IS NOT RECEIVED, THE EMPLOYEE WILL NOT BE ELIGIBLE FOR BENEFITS. Plan Name/Number: Retirement Security Plan? Yes No Current MONTHLY contribution rate: $ . Current HOURLY contribution rate: $ . Current HOURLY contribution rate: $ . The undersigned Employer has entered into a collective bargaining agreement or agreements with Teamsters Local Union No. under which it is required to contribute to the Trust Fund (“Fund”), and desires to apply for acceptance as a participating Employer in the Fund. The Employer hereby adopts the Trust Agreement providing for the Teamsters Benefit Trust and agrees to be bound by its terms and by any amendments adopted in the manner provided therein. The Employer hereby grants power of attorney to the Employer Trustees now in office, and their successors, to administer the Fund as the representatives of the Employer with full authority to act for the Employer in the administration of the Fund. Commencing on the first day of , (based on qualifying hours worked in the preceding month), the undersigned Employer shall contribute the amount specified by the Trustees to provide; (1) active Plan benefits and (2) post-retirement benefits in the Fund’s Retirement Security Plan, if provided for in the collective bargaining agreement (CBA), for each employee covered by the CBA and for such additional employees accepted by the Fund as participants in the Plan for the term of the agreement, pursuant to uniform rules. Contributions are due on the 1st day of the commencement month and payable no later than the 20th day of that month and each month thereafter. Contributions shall apply to the second month following the month of work (for example, contributions for hours worked in June are payable in July and are applied to August eligibility). The lag month always applies to Employer contributions. Eligibility for Plan coverage is based on the employee’s hour bank. Refer to the Plan’s Guide to Your Benefits for employee eligibility rules. The Retirement Security Plan’s eligibility rules are printed on the reverse side of this form. If the Employer fails to make proper contributions on time and in the manner specified in the Trust Agreement, the Employer understands and agrees that the Trustees may assess certain additional amounts as interest, liquidated damages, attorney’s fees and other collection costs. Excess contributions paid to the Fund shall be refunded or credited only for the 36 calendar months preceding the date the Fund receives notice of the error or, if discovered through a payroll audit by the Fund’s accountant, the 36 calendar months preceding the last month audited. Deductions shall be made from such refunds pursuant to the rules adopted by the Trustees. The Employer hereby agrees to make available in the State of California to the Trustees or their agents, all books, records, and papers necessary to conduct an audit to verify that the required contributions have been paid. The Employer hereby agrees that in the event it withdraws from the Fund, the Fund is entitled to assess a withdrawal premium in an amount determined under the Trust Agreement. It is the purpose and intent of the parties to maintain this Subscriber’s Agreement in full force and effect at all times during which the Employer is obligated, by contract or by law, to continue participation in the Fund. Accordingly, this Subscriber’s Agreement shall be effective for the term of the current collective bargaining agreement between the parties and shall continue in effect during the negotiations of the parties for a successor agreement during which negotiations the Employer agrees to make contributions to the Fund in the manner provided herein. The Employer may revoke this Subscriber’s Agreement by sending written notice thereof by certified mail to the Union and Fund Administrator not less than 30 days prior to the date upon which the Employer desires to make such revocation effective, which in no event shall be during the term of any collective bargaining agreement between the parties (or written extension thereto). By signing this agreement, the Employer acknowledges and agrees that it may not terminate its participation in the Fund during the life of the applicable collective bargaining agreement without the consent of the Trustees.

Collectively Bargained Employees. Party to a Master Agreement: 🞎 Yes No 🞎 No. If “yes,” name of Employer Association: Number of Collectively Bargained Employees: THE FUND REQUIRES THAT A COPY OF THE COLLECTIVE BARGAINING AGREEMENT BE PROVIDED TO THE PLAN ADMINISTRATION OFFICE. Non-🞎 Non- Collectively Bargained Employees: IF ANY NON-COLLECTIVELY BARGAINED EMPLOYEES ARE COVERED, FUND RULES REQUIRE THAT ALL EMPLOYEES IN THAT GENERAL CATEGORY MUST BE COVERED: 🞎 Supervisors - Number 🞎 Clericals - Number 🞎 Other (specify) Number Number of Non-Collectively Bargained Employees: 🞎 Others: Retirees 🞎 Number COBRA Participants 🞎 Number Total Other Employees Covered: EMPLOYEE ELIGIBILITY REQUIRES RECEIPT OF THE FULL CONTRIBUTION. IF THE FULL CONTRIBUTION FOR THE PLAN IS NOT RECEIVED, THE EMPLOYEE WILL NOT BE ELIGIBLE FOR BENEFITS. Plan Name/Number: (Current Contribution Rate): $ . Supplemental Benefit (SB): $ . Supplemental Benefit (SB): $ . Supplemental Benefit (SB): $ . Retirement Security Plan? 🞎 Yes 🞎 No (Current MONTHLY contribution rate: Contribution Rate): $ . Current HOURLY contribution rate: SB Benefits (Total Contribution Rate): $ . Current HOURLY contribution rateTotal Contribution on Commencement Date: $ . The undersigned Employer has entered into a collective bargaining agreement or agreements with Teamsters Local Union No. under which it is required to contribute to the Trust Fund (“Fund”), and desires to apply for acceptance as a participating Employer in the Fund. The Employer hereby adopts the Trust Agreement providing for the Teamsters Benefit Trust and agrees to be bound by its terms and by any amendments adopted in the manner provided therein. The Employer hereby grants power of attorney to the Employer Trustees now in office, and their successors, to administer the Fund as the representatives of the Employer with full authority to act for the Employer in the administration of the Fund. Commencing on the first day of , (based on qualifying hours worked in the preceding month), the undersigned Employer shall contribute the amount specified by the Trustees to provide; (1) active Plan benefits and (2) post-retirement benefits in the Fund’s Retirement Security Plan, if provided for in the collective bargaining agreement (CBA), for each employee covered by the CBA and for such additional employees accepted by the Fund as participants in the Plan for the term of the agreement, pursuant to uniform rules. Contributions are due on the 1st day of the commencement month and payable no later than the 20th day of that month and each month thereafter. Contributions shall apply to the second month following the month of work (for example, contributions for hours worked in June are payable in July and are applied to August eligibility). The lag month always applies to Employer contributions. Eligibility for Plan coverage is based on the employee’s hour bank. Refer to the Plan’s Guide to Your Benefits for employee eligibility rules. The Retirement Security Plan’s eligibility rules are printed on the reverse side of this form. If the Employer fails to make proper contributions on time and in the manner specified in the Trust Agreement, the Employer understands and agrees that the Trustees may assess certain additional amounts as interest, liquidated damages, attorney’s fees and other collection costs. Excess contributions paid to the Fund shall be refunded or credited only for the 36 calendar months preceding the date the Fund receives notice of the error or, if discovered through a payroll audit by the Fund’s accountant, the 36 calendar months preceding the last month audited. Deductions shall be made from such refunds pursuant to the rules adopted by the Trustees. The Employer hereby agrees to make available in the State of California to the Trustees or their agents, all books, records, and papers necessary to conduct an audit to verify that the required contributions have been paid. The Employer hereby agrees that in the event it withdraws from the Fund, the Fund is entitled to assess a withdrawal premium in an amount determined under the Trust Agreement. It is the purpose and intent of the parties to maintain this Subscriber’s Agreement in full force and effect at all times during which the Employer is obligated, by contract or by law, to continue participation in the Fund. Accordingly, this Subscriber’s Agreement shall be effective for the term of the current collective bargaining agreement between the parties and shall continue in effect during the negotiations of the parties for a successor agreement during which negotiations the Employer agrees to make contributions to the Fund in the manner provided herein. The Employer may revoke this Subscriber’s Agreement by sending written notice thereof by certified mail to the Union and Fund Administrator not less than 30 days prior to the date upon which the Employer desires to make such revocation effective, which in no event shall be during the term of any collective bargaining agreement between the parties (or written extension thereto). By signing this agreement, the Employer acknowledges and agrees that it may not terminate its participation in the Fund during the life of the applicable collective bargaining agreement without the consent of the Trustees.. For Employer For Union (Print or Type Name) (Print or Type Name) (Signature) (Signature) Date: Date: Accepted on , , on behalf of the Board of Trustees of the Teamsters Benefit Trust. Union Trustee: Employer Trustee: DISTRIBUTION: Send the signed two-page form to the TBT Plan Administration Office. Completed copies will be returned to Union & Employer. Eligibility Rules RETIREMENT SECURITY PLAN (RSP) You qualify for the Retirement Security Plan (Gold or Silver) if you meet all of the following eligibility rules:

Collectively Bargained Employees. Party to a Master Agreement:  Yes No  No. If “yes,” name of Employer Association: Number of Collectively Bargained Employees: THE FUND REQUIRES THAT A COPY OF THE COLLECTIVE BARGAINING AGREEMENT BE PROVIDED TO THE PLAN ADMINISTRATION OFFICE. Non- Non- Collectively Bargained Employees: IF ANY NON-COLLECTIVELY BARGAINED EMPLOYEES ARE COVERED, FUND RULES REQUIRE THAT ALL EMPLOYEES IN THAT GENERAL CATEGORY MUST BE COVERED:  Supervisors - Number  Clericals - Number  Other (specify) Number Number of Non-Collectively Bargained Employees:  Others: Retirees  Number COBRA Participants  Number Total Other Employees Covered: EMPLOYEE ELIGIBILITY REQUIRES RECEIPT OF THE FULL CONTRIBUTION. IF THE FULL CONTRIBUTION FOR THE PLAN IS NOT RECEIVED, THE EMPLOYEE WILL NOT BE ELIGIBLE FOR BENEFITS. Plan Name/Number: (Current Contribution Rate): $ . Supplemental Benefit (SB): $ . Supplemental Benefit (SB): $ . Supplemental Benefit (SB): $ . Retirement Security Plan?  Yes  No (Current MONTHLY contribution rate: Contribution Rate): $ . Current HOURLY contribution rate: SB Benefits (Total Contribution Rate): $ . Current HOURLY contribution rateTotal Contribution on Commencement Date: $ . The undersigned Employer has entered into a collective bargaining agreement or agreements with Teamsters Local Union No. under which it is required to contribute to the Trust Fund (“Fund”), and desires to apply for acceptance as a participating Employer in the Fund. The Employer hereby adopts the Trust Agreement providing for the Teamsters Benefit Trust and agrees to be bound by its terms and by any amendments adopted in the manner provided therein. The Employer hereby grants power of attorney to the Employer Trustees now in office, and their successors, to administer the Fund as the representatives of the Employer with full authority to act for the Employer in the administration of the Fund. Commencing on the first day of , (based on qualifying hours worked in the preceding month), the undersigned Employer shall contribute the amount specified by the Trustees to provide; (1) active Plan benefits and (2) post-retirement benefits in the Fund’s Retirement Security Plan, if provided for in the collective bargaining agreement (CBA), for each employee covered by the CBA and for such additional employees accepted by the Fund as participants in the Plan for the term of the agreement, pursuant to uniform rules. Contributions are due on the 1st day of the commencement month and payable no later than the 20th day of that month and each month thereafter. Contributions shall apply to the second month following the month of work (for example, contributions for hours worked in June are payable in July and are applied to August eligibility). The lag month always applies to Employer contributions. Eligibility for Plan coverage is based on the employee’s hour bank. Refer to the Plan’s Guide to Your Benefits for employee eligibility rules. The Retirement Security Plan’s eligibility rules are printed on the reverse side of this form. If the Employer fails to make proper contributions on time and in the manner specified in the Trust Agreement, the Employer understands and agrees that the Trustees may assess certain additional amounts as interest, liquidated damages, attorney’s fees and other collection costs. Excess contributions paid to the Fund shall be refunded or credited only for the 36 calendar months preceding the date the Fund receives notice of the error or, if discovered through a payroll audit by the Fund’s accountant, the 36 calendar months preceding the last month audited. Deductions shall be made from such refunds pursuant to the rules adopted by the Trustees. The Employer hereby agrees to make available in the State of California to the Trustees or their agents, all books, records, and papers necessary to conduct an audit to verify that the required contributions have been paid. The Employer hereby agrees that in the event it withdraws from the Fund, the Fund is entitled to assess a withdrawal premium in an amount determined under the Trust Agreement. It is the purpose and intent of the parties to maintain this Subscriber’s Agreement in full force and effect at all times during which the Employer is obligated, by contract or by law, to continue participation in the Fund. Accordingly, this Subscriber’s Agreement shall be effective for the term of the current collective bargaining agreement between the parties and shall continue in effect during the negotiations of the parties for a successor agreement during which negotiations the Employer agrees to make contributions to the Fund in the manner provided herein. The Employer may revoke this Subscriber’s Agreement by sending written notice thereof by certified mail to the Union and Fund Administrator not less than 30 days prior to the date upon which the Employer desires to make such revocation effective, which in no event shall be during the term of any collective bargaining agreement between the parties (or written extension thereto). By signing this agreement, the Employer acknowledges and agrees that it may not terminate its participation in the Fund during the life of the applicable collective bargaining agreement without the consent of the Trustees.. For Employer For Union (Print or Type Name) (Print or Type Name) (Signature) (Signature) Date: Date: Accepted on , , on behalf of the Board of Trustees of the Teamsters Benefit Trust. Union Trustee: Employer Trustee: DISTRIBUTION: Send the signed two-page form to the TBT Plan Administration Office. Completed copies will be returned to Union & Employer. Eligibility Rules RETIREMENT SECURITY PLAN (RSP) You qualify for the Retirement Security Plan (Gold or Silver) if you meet all of the following eligibility rules:

Collectively Bargained Employees. Party to a Master Agreement: Yes No No. If “yes,” name of Employer Association: Number of Collectively Bargained Employees: THE FUND REQUIRES THAT A COPY OF THE COLLECTIVE BARGAINING AGREEMENT MUST BE PROVIDED TO THE PLAN ADMINISTRATION OFFICE. Non-Non- Collectively Bargained Employees: IF ANY NON-COLLECTIVELY BARGAINED EMPLOYEES ARE COVERED, FUND RULES REQUIRE THAT ALL EMPLOYEES IN THAT GENERAL CATEGORY MUST BE COVERED: Supervisors - Number Clericals - Number Other (specify) Number Others: Retirees Number COBRA Participants Number Number of Non-Collectively Bargained Employees: Others: Retirees Number COBRA Participants Number Total Other Employees Covered: Current Health & Welfare Plan: TBT Plan Non-TBT Plan (specify) RSP (Current Contribution Rate): $ . . EMPLOYEE ELIGIBILITY REQUIRES RECEIPT OF THE FULL CONTRIBUTION. IF THE FULL CONTRIBUTION FOR THE PLAN IS NOT RECEIVED, THE EMPLOYEE WILL NOT BE ELIGIBLE FOR BENEFITS. Plan Name/Number: Retirement Security Plan? Yes No Current MONTHLY contribution rate: $ . Current HOURLY contribution rate: $ . Current HOURLY contribution rate: $ . The undersigned Employer has entered into a collective bargaining agreement or agreements with Teamsters Local Union No. under which it is required to contribute to the Trust Fund (“"Fund”"), and desires to apply for acceptance as a participating Employer in the Fund. The Employer hereby adopts the Trust Agreement providing for the Teamsters Benefit Trust and agrees to be bound by its terms and by any amendments adopted in the manner provided therein. The Employer hereby grants power of attorney to the Employer Trustees now in office, and their successors, to administer the Fund as the representatives of the Employer with full authority to act for the Employer in the administration of the Fund. Commencing on the first day of , (based on qualifying hours worked in the preceding month), the undersigned Employer shall contribute the amount specified by the Trustees to provide; (1) active Plan benefits and (2) provide post-retirement benefits in the Fund’s Retirement Security Plan, if provided for in the collective bargaining agreement (CBA), Plan for each employee covered by the CBA collective bargaining agreement and for such additional employees accepted by the Fund as participants in the Plan for the term of the agreement, pursuant to uniform rules. Contributions are due on the 1st day of the commencement month and payable no later than the 20th day of that month and each month thereafter. Contributions shall apply to the second month following the month of work (for example, contributions for hours worked in June are payable in July and are applied to August eligibility). The lag month always applies to Employer contributions. Eligibility for Plan coverage is based on the employee’s hour bank. Refer to the Plan’s Guide to Your Benefits for employee eligibility rules. The Retirement Security Plan’s eligibility rules are printed on the reverse side of this form. If the Employer fails to make proper contributions on time and in the manner specified in the Trust Agreement, the Employer understands and agrees that the Trustees may assess certain additional amounts as interest, liquidated damages, attorney’s 's fees and other collection costs. Excess contributions paid to the Fund shall be refunded or credited only for the 36 calendar months preceding the date the Fund receives notice of the error or, if discovered through a payroll audit test by the Fund’s 's accountant, the 36 calendar months preceding the last month auditedtested. Deductions shall be made from such refunds pursuant to the rules adopted by the Trustees. The Employer hereby agrees to make available in the State of California to the Trustees or their agents, all books, records, and papers necessary to conduct an audit to verify that the required contributions have been paid. The Employer hereby agrees that in the event it withdraws from the Fund, the Fund is entitled to assess a withdrawal premium in an amount determined under the Trust Agreement. It is the purpose and intent of the parties to maintain this Subscriber’s 's Agreement in full force and effect at all times during which the Employer is obligated, by contract or by law, to continue participation in the Fund. Accordingly, this Subscriber’s 's Agreement shall be effective for the term of the current collective bargaining agreement between the parties and shall continue in effect during the negotiations of the parties for a successor agreement during which negotiations the Employer agrees to make contributions to the Fund in the manner provided herein. The Employer may revoke this Subscriber’s 's Agreement by sending written notice thereof by certified mail to the Union and Fund Administrator not less than 30 days prior to the date upon which the Employer desires to make such revocation effective, which in no event shall be during the term of any collective bargaining agreement between the parties (or written extension thereto). By signing this agreement, the Employer acknowledges and agrees that it may not terminate its participation in the Fund during the life of the applicable collective bargaining agreement without the consent of the Trustees.