401k Plan data: L & S MACHINE COMPANY, LLC 401(K) PROFIT SHARING PLAN plan

L & S MACHINE COMPANY, LLC 401(K) PROFIT SHARING PLAN 401k Plan overview

Plan Name	L & S MACHINE COMPANY, LLC 401(K) PROFIT SHARING PLAN
Plan identification number	001

L & S MACHINE COMPANY, LLC 401(K) PROFIT SHARING 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) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

L & S MACHINE COMPANY, LLC has sponsored the creation of one or more 401k plans.

Company Name: L & S MACHINE COMPANY, LLC

Employer identification number (EIN): 510578844

NAIC Classification: 333510

Form 5500 Filing Information

Submission information for form 5500 for 401k plan L & S MACHINE COMPANY, LLC 401(K) PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2017-01-01 JOHN LOTZ 2017-12-27
001 2016-01-01 JOHN LOTZ
001 2015-01-01 JOHN LOTZ
001 2014-01-01 JOHN LOTZ
001 2013-01-01
001 2012-01-01 ROBERT DINARDI ROBERT DINARDI 2013-10-15
001 2011-01-01 ROBERT DINARDI ROBERT DINARDI 2012-10-12

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2017-01-01	JOHN LOTZ	2017-12-27
001	2016-01-01	JOHN LOTZ
001	2015-01-01	JOHN LOTZ
001	2014-01-01	JOHN LOTZ
001	2013-01-01
001	2012-01-01	ROBERT DINARDI		ROBERT DINARDI	2013-10-15
001	2011-01-01	ROBERT DINARDI		ROBERT DINARDI	2012-10-12

Plan Statistics for L & S MACHINE COMPANY, LLC 401(K) PROFIT SHARING PLAN

401k plan membership statisitcs for L & S MACHINE COMPANY, LLC 401(K) PROFIT SHARING PLAN

Measure Date Value
2016: L & S MACHINE COMPANY, LLC 401(K) PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 120
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 0
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 90
Total of all active and inactive participants 2016-01-01 90
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 90
Number of participants with account balances 2016-01-01 90
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 0
2015: L & S MACHINE COMPANY, LLC 401(K) PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 111
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 119
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 4
Total of all active and inactive participants 2015-01-01 123
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 123
Number of participants with account balances 2015-01-01 98
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0
2014: L & S MACHINE COMPANY, LLC 401(K) PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 113
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 108
Number of retired or separated participants receiving benefits 2014-01-01 0
Number of other retired or separated participants entitled to future benefits 2014-01-01 3
Total of all active and inactive participants 2014-01-01 111
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 111
Number of participants with account balances 2014-01-01 34
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0
2013: L & S MACHINE COMPANY, LLC 401(K) PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 125
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 110
Number of retired or separated participants receiving benefits 2013-01-01 0
Number of other retired or separated participants entitled to future benefits 2013-01-01 4
Total of all active and inactive participants 2013-01-01 114
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 114
Number of participants with account balances 2013-01-01 36
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0
2012: L & S MACHINE COMPANY, LLC 401(K) PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 129
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 115
Number of retired or separated participants receiving benefits 2012-01-01 0
Number of other retired or separated participants entitled to future benefits 2012-01-01 11
Total of all active and inactive participants 2012-01-01 126
Total participants 2012-01-01 126
Number of participants with account balances 2012-01-01 46
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: L & S MACHINE COMPANY, LLC 401(K) PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 118
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 120
Number of other retired or separated participants entitled to future benefits 2011-01-01 12
Total of all active and inactive participants 2011-01-01 132
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 132
Number of participants with account balances 2011-01-01 47
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0

Measure	Date	Value
2016: L & S MACHINE COMPANY, LLC 401(K) PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	120
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	0
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	90
Total of all active and inactive participants	2016-01-01	90
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	90
Number of participants with account balances	2016-01-01	90
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	0
2015: L & S MACHINE COMPANY, LLC 401(K) PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	111
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	119
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	4
Total of all active and inactive participants	2015-01-01	123
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	123
Number of participants with account balances	2015-01-01	98
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0
2014: L & S MACHINE COMPANY, LLC 401(K) PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	113
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	108
Number of retired or separated participants receiving benefits	2014-01-01	0
Number of other retired or separated participants entitled to future benefits	2014-01-01	3
Total of all active and inactive participants	2014-01-01	111
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	111
Number of participants with account balances	2014-01-01	34
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2013: L & S MACHINE COMPANY, LLC 401(K) PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	125
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	110
Number of retired or separated participants receiving benefits	2013-01-01	0
Number of other retired or separated participants entitled to future benefits	2013-01-01	4
Total of all active and inactive participants	2013-01-01	114
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	114
Number of participants with account balances	2013-01-01	36
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0
2012: L & S MACHINE COMPANY, LLC 401(K) PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	129
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	115
Number of retired or separated participants receiving benefits	2012-01-01	0
Number of other retired or separated participants entitled to future benefits	2012-01-01	11
Total of all active and inactive participants	2012-01-01	126
Total participants	2012-01-01	126
Number of participants with account balances	2012-01-01	46
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: L & S MACHINE COMPANY, LLC 401(K) PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	118
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	120
Number of other retired or separated participants entitled to future benefits	2011-01-01	12
Total of all active and inactive participants	2011-01-01	132
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	132
Number of participants with account balances	2011-01-01	47
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0

Financial Data on L & S MACHINE COMPANY, LLC 401(K) PROFIT SHARING PLAN

Measure	Date	Value
2016 : L & S MACHINE COMPANY, LLC 401(K) PROFIT SHARING 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	$763,987
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$579,424
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$542,710
Value of total corrective distributions	2016-12-31	$583
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$542,149
Value of total assets at end of year	2016-12-31	$2,178,499
Value of total assets at beginning of year	2016-12-31	$1,993,936
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$36,131
Total interest from all sources	2016-12-31	$1,416
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$76,124
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-12-31	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2016-12-31	$0
Total dividends received from registered investment company shares (eg mutual funds)	2016-12-31	$76,124
Administrative expenses professional fees incurred	2016-12-31	$14,597
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$300,000
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	$266,558
Participant contributions at end of year	2016-12-31	$17,609
Participant contributions at beginning of year	2016-12-31	$36,980
Income. Received or receivable in cash from other sources (including rollovers)	2016-12-31	$155,063
Other income not declared elsewhere	2016-12-31	$39
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	$184,563
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$2,178,499
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$1,993,936
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
Investment advisory and management fees	2016-12-31	$20,324
Value of interest in registered invesment companies (eg mutual funds) at end of year	2016-12-31	$2,160,258
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-12-31	$1,956,502
Interest on participant loans	2016-12-31	$1,416
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-12-31	$632
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-12-31	$454
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2016-12-31	$144,259
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	$120,528
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$542,710
Contract administrator fees	2016-12-31	$1,210
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	MCCLINTOCK & ASSOCIATES, PC
Accountancy firm EIN	2016-12-31	251701013
2015 : L & S MACHINE COMPANY, LLC 401(K) PROFIT SHARING 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	$394,514
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$109,665
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$81,377
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$392,511
Value of total assets at end of year	2015-12-31	$1,993,936
Value of total assets at beginning of year	2015-12-31	$1,709,087
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$28,288
Total interest from all sources	2015-12-31	$2,024
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$78,928
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2015-12-31	$78,928
Administrative expenses professional fees incurred	2015-12-31	$11,589
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$200,000
If this is an individual account plan, was there a blackout period	2015-12-31	Yes
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	$263,221
Participant contributions at end of year	2015-12-31	$36,980
Participant contributions at beginning of year	2015-12-31	$45,803
Other income not declared elsewhere	2015-12-31	$626
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	$284,849
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$1,993,936
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$1,709,087
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
Investment advisory and management fees	2015-12-31	$16,579
Value of interest in registered invesment companies (eg mutual funds) at end of year	2015-12-31	$1,956,502
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-12-31	$1,618,395
Interest on participant loans	2015-12-31	$2,024
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-12-31	$454
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-12-31	$44,889
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2015-12-31	$-79,325
Net investment gain/loss from pooled separate accounts	2015-12-31	$-250
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	No
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	$129,290
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$81,377
Contract administrator fees	2015-12-31	$120
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	Yes
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	MCCLINTOCK & ASSOCIATES, PC
Accountancy firm EIN	2015-12-31	251701013
2014 : L & S MACHINE COMPANY, LLC 401(K) PROFIT SHARING PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets	2014-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Total income from all sources (including contributions)	2014-12-31	$203,033
Total loss/gain on sale of assets	2014-12-31	$0
Total of all expenses incurred	2014-12-31	$45,242
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$20,016
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$119,378
Value of total assets at end of year	2014-12-31	$1,709,087
Value of total assets at beginning of year	2014-12-31	$1,551,296
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$25,226
Total interest from all sources	2014-12-31	$2,387
Total dividends received (eg from common stock, registered investment company shares)	2014-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-12-31	No
Administrative expenses professional fees incurred	2014-12-31	$14,655
Was this plan covered by a fidelity bond	2014-12-31	Yes
Value of fidelity bond cover	2014-12-31	$200,000
If this is an individual account plan, was there a blackout period	2014-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2014-12-31	No
Contributions received from participants	2014-12-31	$119,378
Participant contributions at end of year	2014-12-31	$45,803
Participant contributions at beginning of year	2014-12-31	$68,547
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Value of net income/loss	2014-12-31	$157,791
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$1,709,087
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$1,551,296
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2014-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2014-12-31	No
Were any leases to which the plan was party in default or uncollectible	2014-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2014-12-31	$1,618,395
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-12-31	$0
Value of interest in pooled separate accounts at end of year	2014-12-31	$0
Value of interest in pooled separate accounts at beginning of year	2014-12-31	$1,441,673
Interest on participant loans	2014-12-31	$2,336
Interest earned on other investments	2014-12-31	$51
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-12-31	$44,889
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-12-31	$41,076
Net investment gain/loss from pooled separate accounts	2014-12-31	$81,268
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2014-12-31	No
Was there a failure to transmit to the plan any participant contributions	2014-12-31	No
Has the plan failed to provide any benefit when due under the plan	2014-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$20,016
Contract administrator fees	2014-12-31	$10,571
Did the plan have assets held for investment	2014-12-31	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	2014-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2014-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2014-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2014-12-31	Disclaimer
Accountancy firm name	2014-12-31	MCCLINTOCK & ASSOCIATES, PC
Accountancy firm EIN	2014-12-31	251701013
2013 : L & S MACHINE COMPANY, LLC 401(K) PROFIT SHARING PLAN 2013 401k financial data
Total income from all sources (including contributions)	2013-12-31	$328,127
Total of all expenses incurred	2013-12-31	$59,693
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$49,301
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$100,247
Value of total assets at end of year	2013-12-31	$1,551,296
Value of total assets at beginning of year	2013-12-31	$1,282,862
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$10,392
Total interest from all sources	2013-12-31	$3,151
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-12-31	No
Administrative expenses professional fees incurred	2013-12-31	$770
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$500,000
If this is an individual account plan, was there a blackout period	2013-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2013-12-31	No
Contributions received from participants	2013-12-31	$100,247
Participant contributions at end of year	2013-12-31	$68,547
Participant contributions at beginning of year	2013-12-31	$74,626
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Value of net income/loss	2013-12-31	$268,434
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$1,551,296
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$1,282,862
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2013-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2013-12-31	No
Were any leases to which the plan was party in default or uncollectible	2013-12-31	No
Investment advisory and management fees	2013-12-31	$0
Value of interest in pooled separate accounts at end of year	2013-12-31	$1,441,673
Value of interest in pooled separate accounts at beginning of year	2013-12-31	$1,165,871
Interest on participant loans	2013-12-31	$3,078
Interest earned on other investments	2013-12-31	$73
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2013-12-31	$41,076
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-12-31	$42,365
Net investment gain/loss from pooled separate accounts	2013-12-31	$224,729
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2013-12-31	No
Was there a failure to transmit to the plan any participant contributions	2013-12-31	No
Has the plan failed to provide any benefit when due under the plan	2013-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$49,301
Contract administrator fees	2013-12-31	$9,622
Did the plan have assets held for investment	2013-12-31	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	2013-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2013-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2013-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2013-12-31	Disclaimer
Accountancy firm name	2013-12-31	MCCLINTOCK & ASSOCIATES, PC
Accountancy firm EIN	2013-12-31	251701013
2012 : L & S MACHINE COMPANY, LLC 401(K) PROFIT SHARING PLAN 2012 401k financial data
Total income from all sources (including contributions)	2012-12-31	$247,303
Total of all expenses incurred	2012-12-31	$64,293
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$47,196
Expenses. Certain deemed distributions of participant loans	2012-12-31	$1,546
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$117,577
Value of total assets at end of year	2012-12-31	$1,282,862
Value of total assets at beginning of year	2012-12-31	$1,099,852
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$15,551
Total interest from all sources	2012-12-31	$2,902
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-12-31	No
Administrative expenses professional fees incurred	2012-12-31	$6,847
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$500,000
If this is an individual account plan, was there a blackout period	2012-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2012-12-31	No
Contributions received from participants	2012-12-31	$117,577
Participant contributions at end of year	2012-12-31	$74,626
Participant contributions at beginning of year	2012-12-31	$59,944
Total non interest bearing cash at beginning of year	2012-12-31	$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	2012-12-31	No
Value of net income/loss	2012-12-31	$183,010
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$1,282,862
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$1,099,852
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-12-31	No
Were any leases to which the plan was party in default or uncollectible	2012-12-31	No
Value of interest in pooled separate accounts at end of year	2012-12-31	$1,165,871
Value of interest in pooled separate accounts at beginning of year	2012-12-31	$1,003,609
Interest on participant loans	2012-12-31	$2,786
Income. Interest from loans (other than to participants)	2012-12-31	$0
Interest earned on other investments	2012-12-31	$116
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-12-31	$42,365
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-12-31	$36,299
Net investment gain/loss from pooled separate accounts	2012-12-31	$126,824
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-12-31	No
Was there a failure to transmit to the plan any participant contributions	2012-12-31	No
Has the plan failed to provide any benefit when due under the plan	2012-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$47,196
Contract administrator fees	2012-12-31	$8,704
Did the plan have assets held for investment	2012-12-31	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	2012-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2012-12-31	Disclaimer
Accountancy firm name	2012-12-31	KISIEL & ASSOCIATES, PC
Accountancy firm EIN	2012-12-31	200016833
2011 : L & S MACHINE COMPANY, LLC 401(K) PROFIT SHARING PLAN 2011 401k financial data
Total income from all sources (including contributions)	2011-12-31	$85,580
Total of all expenses incurred	2011-12-31	$114,073
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$93,523
Value of total corrective distributions	2011-12-31	$8,884
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$103,995
Value of total assets at end of year	2011-12-31	$1,099,852
Value of total assets at beginning of year	2011-12-31	$1,128,345
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$11,666
Total interest from all sources	2011-12-31	$2,931
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-12-31	No
Administrative expenses professional fees incurred	2011-12-31	$3,300
Was this plan covered by a fidelity bond	2011-12-31	Yes
Value of fidelity bond cover	2011-12-31	$500,000
If this is an individual account plan, was there a blackout period	2011-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2011-12-31	No
Contributions received from participants	2011-12-31	$103,995
Participant contributions at end of year	2011-12-31	$59,944
Participant contributions at beginning of year	2011-12-31	$55,867
Other income not declared elsewhere	2011-12-31	$0
Total non interest bearing cash at end of year	2011-12-31	$0
Total non interest bearing cash at beginning of year	2011-12-31	$1,150
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Value of net income/loss	2011-12-31	$-28,493
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$1,099,852
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$1,128,345
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2011-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2011-12-31	No
Were any leases to which the plan was party in default or uncollectible	2011-12-31	No
Value of interest in pooled separate accounts at end of year	2011-12-31	$1,003,609
Value of interest in pooled separate accounts at beginning of year	2011-12-31	$1,027,320
Interest on participant loans	2011-12-31	$2,673
Interest earned on other investments	2011-12-31	$258
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2011-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-12-31	$36,299
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-12-31	$44,008
Net investment gain/loss from pooled separate accounts	2011-12-31	$-21,346
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-12-31	No
Was there a failure to transmit to the plan any participant contributions	2011-12-31	No
Has the plan failed to provide any benefit when due under the plan	2011-12-31	No
Employer contributions (assets) at beginning of year	2011-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$93,523
Contract administrator fees	2011-12-31	$8,366
Did the plan have assets held for investment	2011-12-31	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	2011-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2011-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2011-12-31	Disclaimer
Accountancy firm name	2011-12-31	KISIEL & ASSOCIATES, PC
Accountancy firm EIN	2011-12-31	200016833
2010 : L & S MACHINE COMPANY, LLC 401(K) PROFIT SHARING PLAN 2010 401k financial data
Total unrealized appreciation/depreciation of assets	2010-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$0
Total income from all sources (including contributions)	2010-12-31	$220,130
Total loss/gain on sale of assets	2010-12-31	$0
Total of all expenses incurred	2010-12-31	$37,228
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$27,758
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$112,958
Value of total assets at end of year	2010-12-31	$1,128,345
Value of total assets at beginning of year	2010-12-31	$945,443
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$9,470
Total interest from all sources	2010-12-31	$2,418
Total dividends received (eg from common stock, registered investment company shares)	2010-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2010-12-31	No
Administrative expenses professional fees incurred	2010-12-31	$1,593
Was this plan covered by a fidelity bond	2010-12-31	Yes
Value of fidelity bond cover	2010-12-31	$500,000
If this is an individual account plan, was there a blackout period	2010-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2010-12-31	No
Contributions received from participants	2010-12-31	$112,958
Participant contributions at end of year	2010-12-31	$55,867
Participant contributions at beginning of year	2010-12-31	$9,777
Income. Received or receivable in cash from other sources (including rollovers)	2010-12-31	$0
Administrative expenses (other) incurred	2010-12-31	$1
Total non interest bearing cash at end of year	2010-12-31	$1,150
Total non interest bearing cash at beginning of year	2010-12-31	$2,742
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Income. Non cash contributions	2010-12-31	$0
Value of net income/loss	2010-12-31	$182,902
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$1,128,345
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$945,443
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2010-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2010-12-31	No
Were any leases to which the plan was party in default or uncollectible	2010-12-31	No
Value of interest in pooled separate accounts at end of year	2010-12-31	$1,027,320
Value of interest in pooled separate accounts at beginning of year	2010-12-31	$887,270
Interest on participant loans	2010-12-31	$1,267
Interest earned on other investments	2010-12-31	$1,151
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2010-12-31	$44,008
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2010-12-31	$45,654
Net investment gain/loss from pooled separate accounts	2010-12-31	$104,754
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2010-12-31	No
Was there a failure to transmit to the plan any participant contributions	2010-12-31	No
Has the plan failed to provide any benefit when due under the plan	2010-12-31	No
Contributions received in cash from employer	2010-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$27,758
Contract administrator fees	2010-12-31	$7,876
Did the plan have assets held for investment	2010-12-31	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	2010-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2010-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2010-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2010-12-31	Disclaimer
Accountancy firm name	2010-12-31	KISIEL & ASSOCIATES, PC
Accountancy firm EIN	2010-12-31	200016833

Form 5500 Responses for L & S MACHINE COMPANY, LLC 401(K) PROFIT SHARING PLAN

2016: L & S MACHINE COMPANY, LLC 401(K) PROFIT SHARING 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 funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: L & S MACHINE COMPANY, LLC 401(K) PROFIT SHARING 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 funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: L & S MACHINE COMPANY, LLC 401(K) PROFIT SHARING PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: L & S MACHINE COMPANY, LLC 401(K) PROFIT SHARING PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	Yes
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: L & S MACHINE COMPANY, LLC 401(K) PROFIT SHARING PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: L & S MACHINE COMPANY, LLC 401(K) PROFIT SHARING PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	Yes
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

13991

Policy instance

Insurance contract or identification number	13991
Number of Individuals Covered	0
Insurance policy start date	2015-01-01
Insurance policy end date	2015-01-12
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?	Yes
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

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

809567

Policy instance

Insurance contract or identification number	809567
Number of Individuals Covered	1
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
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	1
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

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

13991

Policy instance

Insurance contract or identification number	13991
Number of Individuals Covered	34
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $4,093
Total amount of fees paid to insurance company	USD $849
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?	Yes
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 $4,093
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	BROKER COMMISSION
Insurance broker organization code?	4
Insurance broker name	DUNBAR, BENDER & ZAPF, INC

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

13991

Policy instance

Insurance contract or identification number	13991
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $3,457
Total amount of fees paid to insurance company	USD $1,463
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	1463
Additional information about fees paid to insurance broker	TPA FEES
Insurance broker organization code?	5
Commission paid to Insurance Broker	USD $3,457
Insurance broker name	ADIRONDACK TRADING GROUP, LLC

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

13991

Policy instance

Insurance contract or identification number	13991
Number of Individuals Covered	49
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $2,943
Total amount of fees paid to insurance company	USD $835
Amount paid for insurance broker fees	835
Additional information about fees paid to insurance broker	TPA FEES
Insurance broker organization code?	5
Commission paid to Insurance Broker	USD $2,943
Insurance broker name	ADIRONDACK TRADING GROUP, LLC

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

13991

Policy instance

Insurance contract or identification number	13991
Number of Individuals Covered	55
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $2,812
Total amount of fees paid to insurance company	USD $3,300
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

13991

Policy instance

Insurance contract or identification number	13991
Number of Individuals Covered	53
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $2,498
Total amount of fees paid to insurance company	USD $1,593
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

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The information provided on this website is not advice, endorsement or recommendation
The information published is supplied by third parties so we make no warranty on the accuracy, completeness etc. This information is provided "as-is". The information is subject to change as we obtain updates and corrections from the primary information sources.
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Company Name:	L & S MACHINE COMPANY, LLC
Employer identification number (EIN):	510578844
NAIC Classification:	333510