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| Plan Name | BLACK GOLD OILFIELD SERVICES, LLC |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | BLACK GOLD OILFIELD SERVICES, LLC |
| Employer identification number (EIN): | 900448543 |
| NAIC Classification: | 211110 |
| NAIC Description: | Oil and Gas Extraction, Oil |
Additional information about BLACK GOLD OILFIELD SERVICES, LLC
| Jurisdiction of Incorporation: | Alaska Department Commerce, Community & Economic Development |
| Incorporation Date: | 2009-01-02 |
| Company Identification Number: | 119952 |
| Legal Registered Office Address: |
150 EAGLE AVE BOX 3 FAIRBANKS United States of America (USA) 99701 |
More information about BLACK GOLD OILFIELD SERVICES, LLC
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 501 | 2016-01-01 | JUDY HOWARD | |||
| 501 | 2015-01-01 | JUDY HOWARD | JUDY HOWARD | 2016-10-24 |
| Measure | Date | Value |
|---|---|---|
| 2016: BLACK GOLD OILFIELD SERVICES, LLC 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 | 36 |
| Total of all active and inactive participants | 2016-01-01 | 36 |
| Total participants | 2016-01-01 | 36 |
| 2015: BLACK GOLD OILFIELD SERVICES, LLC 2015 401k membership | ||
| Total participants, beginning-of-year | 2015-01-01 | 165 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 127 |
| 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 | 0 |
| Total of all active and inactive participants | 2015-01-01 | 127 |
| Total participants | 2015-01-01 | 127 |
| 2016: BLACK GOLD OILFIELD SERVICES, LLC 2016 form 5500 responses | ||
|---|---|---|
| 2016-01-01 | Type of plan entity | Single employer plan |
| 2016-01-01 | First time form 5500 has been submitted | Yes |
| 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 – General assets of the sponsor | Yes |
| 2016-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2015: BLACK GOLD OILFIELD SERVICES, LLC 2015 form 5500 responses | ||
| 2015-01-01 | Type of plan entity | Single employer plan |
| 2015-01-01 | First time form 5500 has been submitted | Yes |
| 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 |
| PREMERA BLUE CROSS BLUE SHIELD OF ALASKA, INC. (National Association of Insurance Commissioners NAIC id number: 11677 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 4004546 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 47201 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 30055603 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 2 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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