401k Plan data: CLUB ONE 401(K) PLAN plan

CLUB ONE 401(K) PLAN 401k Plan overview

Plan Name	CLUB ONE 401(K) PLAN
Plan identification number	001

CLUB ONE 401(K) 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.

401k Sponsoring company profile

CLUB ONE INCORPORATED has sponsored the creation of one or more 401k plans.

Company Name: CLUB ONE INCORPORATED

Employer identification number (EIN): 943325765

NAIC Classification: 713900

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CLUB ONE 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2014-01-01 RICHARD PIEROTTI
001 2014-01-01 RICHARD PIEROTTI
001 2012-01-01 LESLEY DALE LESLEY DALE 2013-07-30
001 2011-01-01 LESLEY DALE
001 2009-01-01 DEBBIE VANDERPOOL

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
001	2014-01-01	RICHARD PIEROTTI
001	2014-01-01	RICHARD PIEROTTI
001	2012-01-01	LESLEY DALE	LESLEY DALE	2013-07-30
001	2011-01-01	LESLEY DALE
001	2009-01-01	DEBBIE VANDERPOOL

Plan Statistics for CLUB ONE 401(K) PLAN

401k plan membership statisitcs for CLUB ONE 401(K) PLAN

Measure Date Value
2014: CLUB ONE 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 1,945
Total of all active and inactive participants 2014-01-01 0
Total participants 2014-01-01 0
2012: CLUB ONE 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 2,161
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 2,322
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 21
Total of all active and inactive participants 2012-01-01 2,343
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 2,343
Number of participants with account balances 2012-01-01 607
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 132
2011: CLUB ONE 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 2,391
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 2,267
Number of retired or separated participants receiving benefits 2011-01-01 0
Number of other retired or separated participants entitled to future benefits 2011-01-01 179
Total of all active and inactive participants 2011-01-01 2,446
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 2,446
Number of participants with account balances 2011-01-01 728
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 29
2009: CLUB ONE 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 2,316
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 2,073
Number of retired or separated participants receiving benefits 2009-01-01 0
Number of other retired or separated participants entitled to future benefits 2009-01-01 399
Total of all active and inactive participants 2009-01-01 2,472
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 2,472
Number of participants with account balances 2009-01-01 1,407
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 137

Measure	Date	Value
2014: CLUB ONE 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	1,945
Total of all active and inactive participants	2014-01-01	0
Total participants	2014-01-01	0
2012: CLUB ONE 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	2,161
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	2,322
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	21
Total of all active and inactive participants	2012-01-01	2,343
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	2,343
Number of participants with account balances	2012-01-01	607
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	132
2011: CLUB ONE 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	2,391
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	2,267
Number of retired or separated participants receiving benefits	2011-01-01	0
Number of other retired or separated participants entitled to future benefits	2011-01-01	179
Total of all active and inactive participants	2011-01-01	2,446
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	2,446
Number of participants with account balances	2011-01-01	728
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	29
2009: CLUB ONE 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	2,316
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	2,073
Number of retired or separated participants receiving benefits	2009-01-01	0
Number of other retired or separated participants entitled to future benefits	2009-01-01	399
Total of all active and inactive participants	2009-01-01	2,472
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	2,472
Number of participants with account balances	2009-01-01	1,407
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	137

Financial Data on CLUB ONE 401(K) PLAN

Measure	Date	Value
2014 : CLUB ONE 401(K) PLAN 2014 401k financial data
Total income from all sources (including contributions)	2014-12-31	$529,162
Total of all expenses incurred	2014-12-31	$10,571,556
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$10,519,779
Value of total corrective distributions	2014-12-31	$21,222
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$120,812
Value of total assets at end of year	2014-12-31	$0
Value of total assets at beginning of year	2014-12-31	$10,042,394
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$30,555
Total interest from all sources	2014-12-31	$1,631
Total dividends received (eg from common stock, registered investment company shares)	2014-12-31	$780
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-12-31	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2014-12-31	$0
Total dividends received from registered investment company shares (eg mutual funds)	2014-12-31	$780
Was this plan covered by a fidelity bond	2014-12-31	Yes
Value of fidelity bond cover	2014-12-31	$500,000
If this is an individual account plan, was there a blackout period	2014-12-31	No
Funding deficiency by the employer to the plan for this plan year	2014-12-31	$0
Minimum employer required contribution for this plan year	2014-12-31	$0
Amount contributed by the employer to the plan for this plan year	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	$120,812
Participant contributions at beginning of year	2014-12-31	$129,148
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	$-10,042,394
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$10,042,394
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 beginning of year	2014-12-31	$398,384
Interest on participant loans	2014-12-31	$1,534
Interest earned on other investments	2014-12-31	$97
Value of interest in common/collective trusts at end of year	2014-12-31	$0
Value of interest in common/collective trusts at beginning of year	2014-12-31	$9,502,902
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-12-31	$11,960
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2014-12-31	$5,118
Net investment gain or loss from common/collective trusts	2014-12-31	$400,821
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	$10,519,779
Contract administrator fees	2014-12-31	$30,555
Did the plan have assets held for investment	2014-12-31	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	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	Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2014-12-31	No
Opinion of an independent qualified public accountant for this plan	2014-12-31	Disclaimer
Accountancy firm name	2014-12-31	NO AUDIT-BANKRUPTCY PETITION FILING
Accountancy firm EIN	2014-12-31	941138201
2012 : CLUB ONE 401(K) PLAN 2012 401k financial data
Unrealized appreciation/depreciation of real estate assets	2012-12-31	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2012-12-31	$0
Total unrealized appreciation/depreciation of assets	2012-12-31	$0
Total transfer of assets to this plan	2012-12-31	$0
Total transfer of assets from this plan	2012-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$21,847
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$0
Expenses. Interest paid	2012-12-31	$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2012-12-31	$0
Total income from all sources (including contributions)	2012-12-31	$1,897,755
Total loss/gain on sale of assets	2012-12-31	$0
Total of all expenses incurred	2012-12-31	$921,197
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$900,428
Expenses. Certain deemed distributions of participant loans	2012-12-31	$0
Value of total corrective distributions	2012-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$996,106
Value of total assets at end of year	2012-12-31	$9,024,996
Value of total assets at beginning of year	2012-12-31	$8,026,591
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$20,769
Total income from rents	2012-12-31	$0
Total interest from all sources	2012-12-31	$23,927
Total dividends received (eg from common stock, registered investment company shares)	2012-12-31	$119
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2012-12-31	$119
Administrative expenses professional fees incurred	2012-12-31	$0
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	Yes
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2012-12-31	No
Amount of non-exempt transactions with any party-in-interest	2012-12-31	$0
Contributions received from participants	2012-12-31	$785,043
Participant contributions at end of year	2012-12-31	$212,569
Participant contributions at beginning of year	2012-12-31	$228,010
Participant contributions at end of year	2012-12-31	$0
Participant contributions at beginning of year	2012-12-31	$108
Income. Received or receivable in cash from other sources (including rollovers)	2012-12-31	$211,063
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2012-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2012-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2012-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2012-12-31	$21,847
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2012-12-31	$0
Other income not declared elsewhere	2012-12-31	$0
Administrative expenses (other) incurred	2012-12-31	$0
Liabilities. Value of operating payables at beginning of year	2012-12-31	$0
Total non interest bearing cash at end of year	2012-12-31	$0
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
Income. Non cash contributions	2012-12-31	$0
Value of net income/loss	2012-12-31	$976,558
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$9,003,149
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$8,026,591
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
Amount of loans by the plan or fixed income obligations due to the plan which were in default/classified-as-uncollectible as of the close of the plan year	2012-12-31	$0
Were any leases to which the plan was party in default or uncollectible	2012-12-31	No
Amount of leases to which the plan was a party which were in default/classified-as-uncollectible during the year	2012-12-31	$0
Investment advisory and management fees	2012-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2012-12-31	$161,449
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-12-31	$0
Value of interest in pooled separate accounts at end of year	2012-12-31	$0
Value of interest in pooled separate accounts at beginning of year	2012-12-31	$6,901,573
Interest on participant loans	2012-12-31	$6,605
Income. Interest from loans (other than to participants)	2012-12-31	$0
Interest earned on other investments	2012-12-31	$17,322
Income. Interest from US Government securities	2012-12-31	$0
Income. Interest from corporate debt instruments	2012-12-31	$0
Value of interest in common/collective trusts at end of year	2012-12-31	$8,614,409
Value of interest in common/collective trusts at beginning of year	2012-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2012-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-12-31	$36,569
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-12-31	$896,900
Expenses. Payments to insurance carriers foe the provision of benefits	2012-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2012-12-31	$218
Net investment gain/loss from pooled separate accounts	2012-12-31	$865,917
Net investment gain or loss from common/collective trusts	2012-12-31	$11,468
Net gain/loss from 103.12 investment entities	2012-12-31	$0
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	Yes
Has the plan failed to provide any benefit when due under the plan	2012-12-31	No
Contributions received in cash from employer	2012-12-31	$0
Employer contributions (assets) at end of year	2012-12-31	$0
Employer contributions (assets) at beginning of year	2012-12-31	$0
Income. Dividends from preferred stock	2012-12-31	$0
Income. Dividends from common stock	2012-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$900,428
Contract administrator fees	2012-12-31	$20,769
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	2012-12-31	Yes
Liabilities. Value of benefit claims payable at beginning of year	2012-12-31	$0
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
Aggregate proceeds on sale of assets	2012-12-31	$0
Aggregate carrying amount (costs) on sale of assets	2012-12-31	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2012-12-31	$0
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	SHEA LABAGH DOBBERSTEIN
Accountancy firm EIN	2012-12-31	942290202
2011 : CLUB ONE 401(K) PLAN 2011 401k financial data
Total unrealized appreciation/depreciation of assets	2011-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$0
Total income from all sources (including contributions)	2011-12-31	$759,771
Total loss/gain on sale of assets	2011-12-31	$0
Total of all expenses incurred	2011-12-31	$1,074,900
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$1,049,795
Expenses. Certain deemed distributions of participant loans	2011-12-31	$6,307
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$838,184
Value of total assets at end of year	2011-12-31	$8,026,591
Value of total assets at beginning of year	2011-12-31	$8,341,720
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$18,798
Total interest from all sources	2011-12-31	$32,606
Total dividends received (eg from common stock, registered investment company shares)	2011-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-12-31	No
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
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2011-12-31	No
Contributions received from participants	2011-12-31	$808,923
Participant contributions at end of year	2011-12-31	$228,010
Participant contributions at beginning of year	2011-12-31	$361,065
Participant contributions at end of year	2011-12-31	$108
Participant contributions at beginning of year	2011-12-31	$401
Income. Received or receivable in cash from other sources (including rollovers)	2011-12-31	$20,235
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
Income. Non cash contributions	2011-12-31	$0
Value of net income/loss	2011-12-31	$-315,129
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$8,026,591
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$8,341,720
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	$6,901,573
Value of interest in pooled separate accounts at beginning of year	2011-12-31	$7,083,962
Interest on participant loans	2011-12-31	$11,298
Interest earned on other investments	2011-12-31	$21,308
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-12-31	$896,900
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-12-31	$896,292
Net investment gain/loss from pooled separate accounts	2011-12-31	$-111,019
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	Yes
Has the plan failed to provide any benefit when due under the plan	2011-12-31	No
Contributions received in cash from employer	2011-12-31	$9,026
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$1,049,795
Contract administrator fees	2011-12-31	$18,798
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	SHEA LABAGH DOBBERSTEIN
Accountancy firm EIN	2011-12-31	942290202
2010 : CLUB ONE 401(K) 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	$1,788,666
Total loss/gain on sale of assets	2010-12-31	$0
Total of all expenses incurred	2010-12-31	$616,419
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$566,287
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$900,453
Value of total assets at end of year	2010-12-31	$8,341,720
Value of total assets at beginning of year	2010-12-31	$7,169,473
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$50,132
Total interest from all sources	2010-12-31	$35,246
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
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
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2010-12-31	No
Contributions received from participants	2010-12-31	$883,218
Participant contributions at end of year	2010-12-31	$361,065
Participant contributions at beginning of year	2010-12-31	$196,037
Participant contributions at end of year	2010-12-31	$401
Participant contributions at beginning of year	2010-12-31	$37,654
Income. Received or receivable in cash from other sources (including rollovers)	2010-12-31	$17,235
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
Value of net income/loss	2010-12-31	$1,172,247
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$8,341,720
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$7,169,473
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	$7,083,962
Value of interest in pooled separate accounts at beginning of year	2010-12-31	$6,100,456
Interest on participant loans	2010-12-31	$10,939
Interest earned on other investments	2010-12-31	$24,307
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2010-12-31	$896,292
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2010-12-31	$835,326
Net investment gain/loss from pooled separate accounts	2010-12-31	$852,967
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	Yes
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	$566,287
Contract administrator fees	2010-12-31	$50,132
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	SHEA LABAGH DOBBERSTEIN
Accountancy firm EIN	2010-12-31	942290202
2009 : CLUB ONE 401(K) PLAN 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2009-12-31	$0

Form 5500 Responses for CLUB ONE 401(K) PLAN

2014: CLUB ONE 401(K) PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	This submission is the final filing	Yes
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
2012: CLUB ONE 401(K) PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
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: CLUB ONE 401(K) PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	No
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 funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2009: CLUB ONE 401(K) PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	No
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	No
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number	613953
Policy instance	1
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number	802268
Policy instance	1
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number	613953
Policy instance	2
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number	802268
Policy instance	1
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number	802268
Policy instance	1

Potentially related plans

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Company Name:	CLUB ONE INCORPORATED
Employer identification number (EIN):	943325765
NAIC Classification:	713900