401k Plan data: ASHLAND FOUNDRY AND MACHINE WORKS, INC. NON-UNION RETIREMENT PLAN plan

ASHLAND FOUNDRY AND MACHINE WORKS, INC. NON-UNION RETIREMENT PLAN 401k Plan overview

Plan Name	ASHLAND FOUNDRY AND MACHINE WORKS, INC. NON-UNION RETIREMENT PLAN
Plan identification number	002

ASHLAND FOUNDRY AND MACHINE WORKS, INC. NON-UNION RETIREMENT PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Profit-sharing
ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.
Plan sponsor(s) received services of leased employees, as defined in Code section 414(n), during the plan year.
Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

ASHLAND FOUNDRY AND MACHINE WORKS, INC. has sponsored the creation of one or more 401k plans.

Company Name: ASHLAND FOUNDRY AND MACHINE WORKS, INC.

Employer identification number (EIN): 271402653

NAIC Classification: 331500

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ASHLAND FOUNDRY AND MACHINE WORKS, INC. NON-UNION RETIREMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2018-01-01 SHARREL HEBERT 2019-06-26
002 2017-01-01 SHARREL HEBERT
002 2017-01-01
002 2016-01-01 LAURA WEAVER
002 2015-01-01 LAURA WEAVER
002 2014-01-01 LAURA WEAVER 2015-08-13
002 2013-01-01 LAURA WEAVER 2014-05-30
002 2012-01-01 LAURA WEAVER 2013-06-25
002 2011-01-01 TROY BROSIOUS 2012-10-12
002 2010-01-01 TROY BROSIOUS 2011-10-14

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
002	2018-01-01	SHARREL HEBERT	2019-06-26
002	2017-01-01	SHARREL HEBERT
002	2017-01-01
002	2016-01-01	LAURA WEAVER
002	2015-01-01	LAURA WEAVER
002	2014-01-01	LAURA WEAVER	2015-08-13
002	2013-01-01	LAURA WEAVER	2014-05-30
002	2012-01-01	LAURA WEAVER	2013-06-25
002	2011-01-01	TROY BROSIOUS	2012-10-12
002	2010-01-01	TROY BROSIOUS	2011-10-14

Plan Statistics for ASHLAND FOUNDRY AND MACHINE WORKS, INC. NON-UNION RETIREMENT PLAN

401k plan membership statisitcs for ASHLAND FOUNDRY AND MACHINE WORKS, INC. NON-UNION RETIREMENT PLAN

Measure Date Value
2017: ASHLAND FOUNDRY AND MACHINE WORKS, INC. NON-UNION RETIREMENT PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 124
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 0
Number of retired or separated participants receiving benefits 2017-01-01 16
Number of other retired or separated participants entitled to future benefits 2017-01-01 0
Total of all active and inactive participants 2017-01-01 16
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 16
Number of participants with account balances 2017-01-01 16
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 0
2016: ASHLAND FOUNDRY AND MACHINE WORKS, INC. NON-UNION RETIREMENT PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 139
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 104
Number of retired or separated participants receiving benefits 2016-01-01 0
Number of other retired or separated participants entitled to future benefits 2016-01-01 20
Total of all active and inactive participants 2016-01-01 124
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 124
Number of participants with account balances 2016-01-01 72
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 2
2015: ASHLAND FOUNDRY AND MACHINE WORKS, INC. NON-UNION RETIREMENT PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 145
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 118
Number of retired or separated participants receiving benefits 2015-01-01 0
Number of other retired or separated participants entitled to future benefits 2015-01-01 19
Total of all active and inactive participants 2015-01-01 137
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 137
Number of participants with account balances 2015-01-01 80
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 4

Measure	Date	Value
2017: ASHLAND FOUNDRY AND MACHINE WORKS, INC. NON-UNION RETIREMENT PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	124
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	0
Number of retired or separated participants receiving benefits	2017-01-01	16
Number of other retired or separated participants entitled to future benefits	2017-01-01	0
Total of all active and inactive participants	2017-01-01	16
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	16
Number of participants with account balances	2017-01-01	16
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	0
2016: ASHLAND FOUNDRY AND MACHINE WORKS, INC. NON-UNION RETIREMENT PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	139
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	104
Number of retired or separated participants receiving benefits	2016-01-01	0
Number of other retired or separated participants entitled to future benefits	2016-01-01	20
Total of all active and inactive participants	2016-01-01	124
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	124
Number of participants with account balances	2016-01-01	72
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	2
2015: ASHLAND FOUNDRY AND MACHINE WORKS, INC. NON-UNION RETIREMENT PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	145
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	118
Number of retired or separated participants receiving benefits	2015-01-01	0
Number of other retired or separated participants entitled to future benefits	2015-01-01	19
Total of all active and inactive participants	2015-01-01	137
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	137
Number of participants with account balances	2015-01-01	80
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	4

Financial Data on ASHLAND FOUNDRY AND MACHINE WORKS, INC. NON-UNION RETIREMENT PLAN

Measure	Date	Value
2017 : ASHLAND FOUNDRY AND MACHINE WORKS, INC. NON-UNION RETIREMENT PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets	2017-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$0
Total income from all sources (including contributions)	2017-12-31	$450,417
Total loss/gain on sale of assets	2017-12-31	$0
Total of all expenses incurred	2017-12-31	$3,255,760
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$3,254,937
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$101,846
Value of total assets at end of year	2017-12-31	$817,684
Value of total assets at beginning of year	2017-12-31	$3,623,027
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$823
Total interest from all sources	2017-12-31	$3,699
Total dividends received (eg from common stock, registered investment company shares)	2017-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-12-31	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2017-12-31	$0
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2017-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2017-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2017-12-31	No
Contributions received from participants	2017-12-31	$74,074
Participant contributions at end of year	2017-12-31	$0
Participant contributions at beginning of year	2017-12-31	$132,310
Total non interest bearing cash at end of year	2017-12-31	$0
Total non interest bearing cash at beginning of year	2017-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Value of net income/loss	2017-12-31	$-2,805,343
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$817,684
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$3,623,027
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2017-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2017-12-31	No
Were any leases to which the plan was party in default or uncollectible	2017-12-31	No
Value of interest in pooled separate accounts at end of year	2017-12-31	$817,684
Value of interest in pooled separate accounts at beginning of year	2017-12-31	$3,490,717
Interest on participant loans	2017-12-31	$3,699
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2017-12-31	$344,872
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2017-12-31	No
Was there a failure to transmit to the plan any participant contributions	2017-12-31	No
Has the plan failed to provide any benefit when due under the plan	2017-12-31	No
Contributions received in cash from employer	2017-12-31	$27,772
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$3,254,937
Contract administrator fees	2017-12-31	$823
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2017-12-31	No
Did the plan have assets held for investment	2017-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2017-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2017-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2017-12-31	Disclaimer
Accountancy firm name	2017-12-31	CARON & BLETZER, PLLC
Accountancy firm EIN	2017-12-31	043499945
2016 : ASHLAND FOUNDRY AND MACHINE WORKS, INC. NON-UNION RETIREMENT PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets	2016-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total income from all sources (including contributions)	2016-12-31	$525,197
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$687,439
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$680,072
Expenses. Certain deemed distributions of participant loans	2016-12-31	$2,405
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$275,734
Value of total assets at end of year	2016-12-31	$3,623,027
Value of total assets at beginning of year	2016-12-31	$3,785,269
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$4,962
Total interest from all sources	2016-12-31	$6,477
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2016-12-31	$0
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$500,000
If this is an individual account plan, was there a blackout period	2016-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Contributions received from participants	2016-12-31	$228,084
Participant contributions at end of year	2016-12-31	$132,310
Participant contributions at beginning of year	2016-12-31	$142,373
Total non interest bearing cash at end of year	2016-12-31	$3
Total non interest bearing cash at beginning of year	2016-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Value of net income/loss	2016-12-31	$-162,242
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$3,623,027
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$3,785,269
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2016-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2016-12-31	No
Were any leases to which the plan was party in default or uncollectible	2016-12-31	No
Value of interest in pooled separate accounts at end of year	2016-12-31	$3,490,714
Value of interest in pooled separate accounts at beginning of year	2016-12-31	$3,642,896
Interest on participant loans	2016-12-31	$6,477
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2016-12-31	$242,986
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2016-12-31	No
Was there a failure to transmit to the plan any participant contributions	2016-12-31	No
Has the plan failed to provide any benefit when due under the plan	2016-12-31	No
Contributions received in cash from employer	2016-12-31	$47,650
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$680,072
Contract administrator fees	2016-12-31	$4,962
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2016-12-31	No
Did the plan have assets held for investment	2016-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2016-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2016-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2016-12-31	Disclaimer
Accountancy firm name	2016-12-31	CARON & BLETZER, PLLC
Accountancy firm EIN	2016-12-31	043499945
2015 : ASHLAND FOUNDRY AND MACHINE WORKS, INC. NON-UNION RETIREMENT PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets	2015-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Total income from all sources (including contributions)	2015-12-31	$267,000
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$271,401
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$266,634
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$351,804
Value of total assets at end of year	2015-12-31	$3,785,269
Value of total assets at beginning of year	2015-12-31	$3,789,670
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$4,767
Total interest from all sources	2015-12-31	$6,275
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-12-31	No
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2015-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2015-12-31	No
Contributions received from participants	2015-12-31	$292,329
Participant contributions at end of year	2015-12-31	$142,373
Participant contributions at beginning of year	2015-12-31	$97,856
Income. Received or receivable in cash from other sources (including rollovers)	2015-12-31	$4,067
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Value of net income/loss	2015-12-31	$-4,401
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$3,785,269
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$3,789,670
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2015-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2015-12-31	No
Were any leases to which the plan was party in default or uncollectible	2015-12-31	No
Value of interest in pooled separate accounts at end of year	2015-12-31	$3,642,896
Value of interest in pooled separate accounts at beginning of year	2015-12-31	$3,691,814
Interest on participant loans	2015-12-31	$6,275
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2015-12-31	$-91,079
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2015-12-31	No
Was there a failure to transmit to the plan any participant contributions	2015-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2015-12-31	No
Contributions received in cash from employer	2015-12-31	$55,408
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$266,634
Contract administrator fees	2015-12-31	$4,767
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2015-12-31	No
Did the plan have assets held for investment	2015-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2015-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2015-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2015-12-31	Disclaimer
Accountancy firm name	2015-12-31	CARON & BLETZER, PLLC
Accountancy firm EIN	2015-12-31	043499945

Form 5500 Responses for ASHLAND FOUNDRY AND MACHINE WORKS, INC. NON-UNION RETIREMENT PLAN

2017: ASHLAND FOUNDRY AND MACHINE WORKS, INC. NON-UNION RETIREMENT PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	No
2017-01-01	This submission is the final filing	No
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2016: ASHLAND FOUNDRY AND MACHINE WORKS, INC. NON-UNION RETIREMENT PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2015: ASHLAND FOUNDRY AND MACHINE WORKS, INC. NON-UNION RETIREMENT PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

GA-820776

Policy instance

Insurance contract or identification number	GA-820776
Number of Individuals Covered	15
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $13,700
Total amount of fees paid to insurance company	USD $1,739
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $13,700
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	COMMISSION
Insurance broker organization code?	3
Insurance broker name	THE RETIREMENT ADVANTAGE

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

GA-820776

Policy instance

Insurance contract or identification number	GA-820776
Number of Individuals Covered	83
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $14,524
Total amount of fees paid to insurance company	USD $1,815
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $14,524
Insurance broker organization code?	3
Amount paid for insurance broker fees	1815
Additional information about fees paid to insurance broker	THIRD-PARTY ADMINISTRATIVE SERVICES
Insurance broker name	THE RETIREMENT ADVANTAGE

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Company Name:	ASHLAND FOUNDRY AND MACHINE WORKS, INC.
Employer identification number (EIN):	271402653
NAIC Classification:	331500