401k Plan data: THE BRIDGE OF NORTHEAST FLORIDA INC RETIREMENT PLAN plan

THE BRIDGE OF NORTHEAST FLORIDA INC RETIREMENT PLAN 401k Plan overview

Plan Name	THE BRIDGE OF NORTHEAST FLORIDA INC RETIREMENT PLAN
Plan identification number	001

THE BRIDGE OF NORTHEAST FLORIDA INC RETIREMENT PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

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 403(b)(1) arrangement - See Limited Pension Plan Reporting instructions for Code section 403(b)(1) arrangements for certain exempt organizations.
Code section 403(b)(7) accounts - See Limited Pension Plan Reporting instructions for Code section 403(b)(7) custodial accounts for regulated investment company stock for certain exempt organizations.
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.

401k Sponsoring company profile

THE BRIDGE OF NORTHEAST FLORIDA INC has sponsored the creation of one or more 401k plans.

Company Name: THE BRIDGE OF NORTHEAST FLORIDA INC

Employer identification number (EIN): 591406016

NAIC Classification: 624100
NAIC Description: Individual and Family Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan THE BRIDGE OF NORTHEAST FLORIDA INC RETIREMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2017-01-01 BRIAN KING
001 2016-01-01 SHARON SCOTT
001 2015-01-01 IVAN GRANT
001 2015-01-01 SHARON SCOTT
001 2014-01-01 IVAN GRANT 2015-07-24
001 2013-01-01 DONNA ARIAS 2014-06-19 IVAN GRANT 2014-06-23
001 2012-01-01 DONNA ARIAS 2013-06-24 DONNA ARIAS 2013-06-24
001 2011-01-01 DONNA ARIAS 2012-07-12 DONNA ARIAS 2012-07-12
001 2010-01-01 DONNA ARIAS 2011-07-12 DONNA ARIAS 2011-07-12

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2017-01-01	BRIAN KING
001	2016-01-01	SHARON SCOTT
001	2015-01-01	IVAN GRANT
001	2015-01-01	SHARON SCOTT
001	2014-01-01	IVAN GRANT	2015-07-24
001	2013-01-01	DONNA ARIAS	2014-06-19	IVAN GRANT	2014-06-23
001	2012-01-01	DONNA ARIAS	2013-06-24	DONNA ARIAS	2013-06-24
001	2011-01-01	DONNA ARIAS	2012-07-12	DONNA ARIAS	2012-07-12
001	2010-01-01	DONNA ARIAS	2011-07-12	DONNA ARIAS	2011-07-12

Plan Statistics for THE BRIDGE OF NORTHEAST FLORIDA INC RETIREMENT PLAN

401k plan membership statisitcs for THE BRIDGE OF NORTHEAST FLORIDA INC RETIREMENT PLAN

Measure Date Value
2017: THE BRIDGE OF NORTHEAST FLORIDA INC RETIREMENT PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 127
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 0
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 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 0
Number of participants with account balances 2017-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 0
2016: THE BRIDGE OF NORTHEAST FLORIDA INC RETIREMENT PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 130
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 43
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 84
Total of all active and inactive participants 2016-01-01 127
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 127
Number of participants with account balances 2016-01-01 118
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 0
2015: THE BRIDGE OF NORTHEAST FLORIDA INC RETIREMENT PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 123
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 76
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 54
Total of all active and inactive participants 2015-01-01 130
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 130
Number of participants with account balances 2015-01-01 115
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0

Measure	Date	Value
2017: THE BRIDGE OF NORTHEAST FLORIDA INC RETIREMENT PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	127
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	0
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	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	0
Number of participants with account balances	2017-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	0
2016: THE BRIDGE OF NORTHEAST FLORIDA INC RETIREMENT PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	130
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	43
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	84
Total of all active and inactive participants	2016-01-01	127
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	127
Number of participants with account balances	2016-01-01	118
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	0
2015: THE BRIDGE OF NORTHEAST FLORIDA INC RETIREMENT PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	123
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	76
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	54
Total of all active and inactive participants	2015-01-01	130
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	130
Number of participants with account balances	2015-01-01	115
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0

Financial Data on THE BRIDGE OF NORTHEAST FLORIDA INC RETIREMENT PLAN

Measure	Date	Value
2017 : THE BRIDGE OF NORTHEAST FLORIDA INC RETIREMENT PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets	2017-07-20	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-07-20	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-07-20	$0
Total income from all sources (including contributions)	2017-07-20	$104,879
Total loss/gain on sale of assets	2017-07-20	$0
Total of all expenses incurred	2017-07-20	$1,023,177
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-07-20	$1,010,722
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-07-20	$41,476
Value of total assets at end of year	2017-07-20	$0
Value of total assets at beginning of year	2017-07-20	$918,298
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-07-20	$12,455
Total interest from all sources	2017-07-20	$5,916
Total dividends received (eg from common stock, registered investment company shares)	2017-07-20	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-07-20	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2017-07-20	$0
Administrative expenses professional fees incurred	2017-07-20	$9,171
Was this plan covered by a fidelity bond	2017-07-20	Yes
Value of fidelity bond cover	2017-07-20	$100,000
If this is an individual account plan, was there a blackout period	2017-07-20	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2017-07-20	$0
Were there any nonexempt tranactions with any party-in-interest	2017-07-20	No
Contributions received from participants	2017-07-20	$15,095
Participant contributions at end of year	2017-07-20	$0
Participant contributions at beginning of year	2017-07-20	$1,459
Income. Received or receivable in cash from other sources (including rollovers)	2017-07-20	$7,000
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-07-20	No
Value of net income/loss	2017-07-20	$-918,298
Value of net assets at end of year (total assets less liabilities)	2017-07-20	$0
Value of net assets at beginning of year (total assets less liabilities)	2017-07-20	$918,298
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2017-07-20	No
Were any loans by the plan or fixed income obligations due to the plan in default	2017-07-20	No
Were any leases to which the plan was party in default or uncollectible	2017-07-20	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2017-07-20	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-07-20	$551,424
Interest earned on other investments	2017-07-20	$5,916
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2017-07-20	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-07-20	$363,558
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2017-07-20	$57,487
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2017-07-20	No
Was there a failure to transmit to the plan any participant contributions	2017-07-20	No
Has the plan failed to provide any benefit when due under the plan	2017-07-20	No
Contributions received in cash from employer	2017-07-20	$19,381
Employer contributions (assets) at end of year	2017-07-20	$0
Employer contributions (assets) at beginning of year	2017-07-20	$1,857
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-07-20	$1,010,722
Contract administrator fees	2017-07-20	$3,284
Did the plan have assets held for investment	2017-07-20	No
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	2017-07-20	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2017-07-20	Yes
Accountancy firm name	2017-07-20	CARON AND BLETZER, PLLC
Accountancy firm EIN	2017-07-20	043499945
2016 : THE BRIDGE OF NORTHEAST FLORIDA INC 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	$170,310
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$188,884
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$186,034
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$131,157
Value of total assets at end of year	2016-12-31	$918,298
Value of total assets at beginning of year	2016-12-31	$936,872
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$2,850
Total interest from all sources	2016-12-31	$10,729
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
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$100,000
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	$59,908
Participant contributions at end of year	2016-12-31	$1,459
Participant contributions at beginning of year	2016-12-31	$2,798
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	$-18,574
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$918,298
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$936,872
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 registered invesment companies (eg mutual funds) at end of year	2016-12-31	$551,424
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-12-31	$574,753
Interest earned on other investments	2016-12-31	$10,729
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-12-31	$363,558
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-12-31	$356,249
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2016-12-31	$28,424
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	Yes
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	$71,249
Employer contributions (assets) at end of year	2016-12-31	$1,857
Employer contributions (assets) at beginning of year	2016-12-31	$3,072
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$186,034
Contract administrator fees	2016-12-31	$2,850
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 AND BLETZER, PLLC
Accountancy firm EIN	2016-12-31	043499945
2015 : THE BRIDGE OF NORTHEAST FLORIDA INC 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	$152,719
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$534,414
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$531,563
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$145,654
Value of total assets at end of year	2015-12-31	$931,002
Value of total assets at beginning of year	2015-12-31	$1,312,697
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$2,851
Total interest from all sources	2015-12-31	$14,944
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	$100,000
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	$65,887
Participant contributions at end of year	2015-12-31	$2,798
Participant contributions at beginning of year	2015-12-31	$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	2015-12-31	No
Value of net income/loss	2015-12-31	$-381,695
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$931,002
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$1,312,697
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 registered invesment companies (eg mutual funds) at end of year	2015-12-31	$574,753
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-12-31	$829,656
Interest earned on other investments	2015-12-31	$14,944
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-12-31	$356,249
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-12-31	$483,041
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2015-12-31	$-7,879
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	$79,767
Employer contributions (assets) at end of year	2015-12-31	$3,072
Employer contributions (assets) at beginning of year	2015-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$531,563
Contract administrator fees	2015-12-31	$2,851
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 AND BLETZER, PLLC
Accountancy firm EIN	2015-12-31	043499945

Form 5500 Responses for THE BRIDGE OF NORTHEAST FLORIDA INC RETIREMENT PLAN

2017: THE BRIDGE OF NORTHEAST FLORIDA INC 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	Yes
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2017-01-01	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes
2016: THE BRIDGE OF NORTHEAST FLORIDA INC 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 funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: THE BRIDGE OF NORTHEAST FLORIDA INC 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 funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

2638

Policy instance

Insurance contract or identification number	2638
Number of Individuals Covered	0
Insurance policy start date	2017-01-01
Insurance policy end date	2017-07-20
Total amount of commissions paid to insurance broker	USD $1,344
Total amount of fees paid to insurance company	USD $0
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?	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 $1,344
Insurance broker organization code?	4
Insurance broker name	NY LIFE SECURITIES LLC

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

2638

Policy instance

Insurance contract or identification number	2638
Number of Individuals Covered	115
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $4,370
Total amount of fees paid to insurance company	USD $0
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 $4,370
Insurance broker organization code?	4
Insurance broker name	NY LIFE SECURITIES LLC

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Company Name:	THE BRIDGE OF NORTHEAST FLORIDA INC
Employer identification number (EIN):	591406016
NAIC Classification:	624100
NAIC Description:	Individual and Family Services