401k Plan data: COSTAS PROVISIONS 401(K) & PROFIT SHARING PLAN plan

COSTAS PROVISIONS 401(K) & PROFIT SHARING PLAN 401k Plan overview

Plan Name	COSTAS PROVISIONS 401(K) & PROFIT SHARING PLAN
Plan identification number	001

COSTAS PROVISIONS 401(K) & PROFIT SHARING PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Age/Service Weighted or new comparability or similar plan - Age/Service Weighted Plan: Allocations are based on age, service, or age and service. New comparability or similar plan: Allocations are based on participant classifications and a classification(s) consists entirely or predominantly of highly compensated employees; or the plan provides an additional allocation rate on compensation above a specified threshold, and the theshold or additional rate exceeds the maximum threshold or rate allowed under the permitted disparity rules of section 401(l).
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

COSTAS PROVISIONS CORPORATION has sponsored the creation of one or more 401k plans.

Company Name: COSTAS PROVISIONS CORPORATION

Employer identification number (EIN): 043034611

NAIC Classification: 424400

Form 5500 Filing Information

Submission information for form 5500 for 401k plan COSTAS PROVISIONS 401(K) & PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2022-01-01 GEORGE DELIGIANNIDES 2023-10-11
001 2021-01-01 GEORGE DELIGIANNIDES 2022-10-14
001 2020-01-01 GEORGE DELIGIANNIDES 2021-10-11
001 2019-01-01 GEORGE DELIGIANNIDES 2020-10-08
001 2018-01-01 GEORGE DELIGIANNIDES 2019-10-15
001 2018-01-01 GEORGE DELIGIANNIDES 2019-10-30
001 2017-01-01
001 2016-01-01
001 2015-01-01
001 2015-01-01
001 2014-01-01 GEORGE DELIGIANNIDES 2015-09-10
001 2013-01-01 GEORGE DELIGIANNIDES 2014-09-30
001 2012-01-01 GEORGE DELIGIANNIDES 2013-10-09
001 2011-01-01 GEORGE DELIGIANNIDES 2012-10-01
001 2010-01-01 GEORGE DELIGIANNIDES 2011-09-26

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
001	2022-01-01	GEORGE DELIGIANNIDES	2023-10-11
001	2021-01-01	GEORGE DELIGIANNIDES	2022-10-14
001	2020-01-01	GEORGE DELIGIANNIDES	2021-10-11
001	2019-01-01	GEORGE DELIGIANNIDES	2020-10-08
001	2018-01-01	GEORGE DELIGIANNIDES	2019-10-15
001	2018-01-01	GEORGE DELIGIANNIDES	2019-10-30
001	2017-01-01
001	2016-01-01
001	2015-01-01
001	2015-01-01
001	2014-01-01	GEORGE DELIGIANNIDES	2015-09-10
001	2013-01-01	GEORGE DELIGIANNIDES	2014-09-30
001	2012-01-01	GEORGE DELIGIANNIDES	2013-10-09
001	2011-01-01	GEORGE DELIGIANNIDES	2012-10-01
001	2010-01-01	GEORGE DELIGIANNIDES	2011-09-26

Plan Statistics for COSTAS PROVISIONS 401(K) & PROFIT SHARING PLAN

401k plan membership statisitcs for COSTAS PROVISIONS 401(K) & PROFIT SHARING PLAN

Measure Date Value
2022: COSTAS PROVISIONS 401(K) & PROFIT SHARING PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 207
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 123
Number of retired or separated participants receiving benefits 2022-01-01 0
Number of other retired or separated participants entitled to future benefits 2022-01-01 89
Total of all active and inactive participants 2022-01-01 212
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 0
Total participants 2022-01-01 212
Number of participants with account balances 2022-01-01 201
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 5
2021: COSTAS PROVISIONS 401(K) & PROFIT SHARING PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 201
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 125
Number of retired or separated participants receiving benefits 2021-01-01 0
Number of other retired or separated participants entitled to future benefits 2021-01-01 78
Total of all active and inactive participants 2021-01-01 203
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 203
Number of participants with account balances 2021-01-01 199
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 2
2020: COSTAS PROVISIONS 401(K) & PROFIT SHARING PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 203
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 124
Number of retired or separated participants receiving benefits 2020-01-01 0
Number of other retired or separated participants entitled to future benefits 2020-01-01 77
Total of all active and inactive participants 2020-01-01 201
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 201
Number of participants with account balances 2020-01-01 187
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 3
2019: COSTAS PROVISIONS 401(K) & PROFIT SHARING PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 195
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 117
Number of retired or separated participants receiving benefits 2019-01-01 0
Number of other retired or separated participants entitled to future benefits 2019-01-01 76
Total of all active and inactive participants 2019-01-01 193
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 193
Number of participants with account balances 2019-01-01 176
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 7
2018: COSTAS PROVISIONS 401(K) & PROFIT SHARING PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 174
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 108
Number of retired or separated participants receiving benefits 2018-01-01 0
Number of other retired or separated participants entitled to future benefits 2018-01-01 76
Total of all active and inactive participants 2018-01-01 184
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 184
Number of participants with account balances 2018-01-01 165
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 9
2017: COSTAS PROVISIONS 401(K) & PROFIT SHARING PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 168
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 100
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 65
Total of all active and inactive participants 2017-01-01 165
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 165
Number of participants with account balances 2017-01-01 151
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 11
2016: COSTAS PROVISIONS 401(K) & PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 150
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 94
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 61
Total of all active and inactive participants 2016-01-01 155
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 155
Number of participants with account balances 2016-01-01 144
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 8
2015: COSTAS PROVISIONS 401(K) & PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 128
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 91
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 53
Total of all active and inactive participants 2015-01-01 144
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 1
Total participants 2015-01-01 145
Number of participants with account balances 2015-01-01 131
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 11

Measure	Date	Value
2022: COSTAS PROVISIONS 401(K) & PROFIT SHARING PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	207
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	123
Number of retired or separated participants receiving benefits	2022-01-01	0
Number of other retired or separated participants entitled to future benefits	2022-01-01	89
Total of all active and inactive participants	2022-01-01	212
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	0
Total participants	2022-01-01	212
Number of participants with account balances	2022-01-01	201
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	5
2021: COSTAS PROVISIONS 401(K) & PROFIT SHARING PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	201
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	125
Number of retired or separated participants receiving benefits	2021-01-01	0
Number of other retired or separated participants entitled to future benefits	2021-01-01	78
Total of all active and inactive participants	2021-01-01	203
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	203
Number of participants with account balances	2021-01-01	199
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	2
2020: COSTAS PROVISIONS 401(K) & PROFIT SHARING PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	203
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	124
Number of retired or separated participants receiving benefits	2020-01-01	0
Number of other retired or separated participants entitled to future benefits	2020-01-01	77
Total of all active and inactive participants	2020-01-01	201
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	201
Number of participants with account balances	2020-01-01	187
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	3
2019: COSTAS PROVISIONS 401(K) & PROFIT SHARING PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	195
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	117
Number of retired or separated participants receiving benefits	2019-01-01	0
Number of other retired or separated participants entitled to future benefits	2019-01-01	76
Total of all active and inactive participants	2019-01-01	193
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	193
Number of participants with account balances	2019-01-01	176
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	7
2018: COSTAS PROVISIONS 401(K) & PROFIT SHARING PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	174
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	108
Number of retired or separated participants receiving benefits	2018-01-01	0
Number of other retired or separated participants entitled to future benefits	2018-01-01	76
Total of all active and inactive participants	2018-01-01	184
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	184
Number of participants with account balances	2018-01-01	165
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	9
2017: COSTAS PROVISIONS 401(K) & PROFIT SHARING PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	168
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	100
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	65
Total of all active and inactive participants	2017-01-01	165
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	165
Number of participants with account balances	2017-01-01	151
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	11
2016: COSTAS PROVISIONS 401(K) & PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	150
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	94
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	61
Total of all active and inactive participants	2016-01-01	155
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	155
Number of participants with account balances	2016-01-01	144
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	8
2015: COSTAS PROVISIONS 401(K) & PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	128
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	91
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	53
Total of all active and inactive participants	2015-01-01	144
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	1
Total participants	2015-01-01	145
Number of participants with account balances	2015-01-01	131
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	11

Financial Data on COSTAS PROVISIONS 401(K) & PROFIT SHARING PLAN

Measure	Date	Value
2022 : COSTAS PROVISIONS 401(K) & PROFIT SHARING PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets	2022-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$0
Total income from all sources (including contributions)	2022-12-31	$-260,026
Total loss/gain on sale of assets	2022-12-31	$0
Total of all expenses incurred	2022-12-31	$104,242
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-31	$39,252
Expenses. Certain deemed distributions of participant loans	2022-12-31	$6,762
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-12-31	$1,010,317
Value of total assets at end of year	2022-12-31	$11,720,952
Value of total assets at beginning of year	2022-12-31	$12,085,220
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-12-31	$58,228
Total interest from all sources	2022-12-31	$7,541
Total dividends received (eg from common stock, registered investment company shares)	2022-12-31	$195,006
Total dividends received from registered investment company shares (eg mutual funds)	2022-12-31	$195,006
Was this plan covered by a fidelity bond	2022-12-31	Yes
Value of fidelity bond cover	2022-12-31	$500,000
If this is an individual account plan, was there a blackout period	2022-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2022-12-31	No
Contributions received from participants	2022-12-31	$439,790
Participant contributions at end of year	2022-12-31	$178,248
Participant contributions at beginning of year	2022-12-31	$213,184
Participant contributions at end of year	2022-12-31	$129,571
Participant contributions at beginning of year	2022-12-31	$0
Administrative expenses (other) incurred	2022-12-31	$58,228
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-12-31	No
Value of net income/loss	2022-12-31	$-364,268
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$11,720,952
Value of net assets at beginning of year (total assets less liabilities)	2022-12-31	$12,085,220
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2022-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2022-12-31	No
Were any leases to which the plan was party in default or uncollectible	2022-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2022-12-31	$10,982,755
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2022-12-31	$11,467,625
Interest on participant loans	2022-12-31	$7,541
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2022-12-31	$-1,472,890
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2022-12-31	No
Was there a failure to transmit to the plan any participant contributions	2022-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2022-12-31	No
Contributions received in cash from employer	2022-12-31	$570,527
Employer contributions (assets) at end of year	2022-12-31	$430,378
Employer contributions (assets) at beginning of year	2022-12-31	$404,411
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-12-31	$39,252
Did the plan have assets held for investment	2022-12-31	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	2022-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2022-12-31	No
Opinion of an independent qualified public accountant for this plan	2022-12-31	Unqualified
Accountancy firm name	2022-12-31	AAFCPAS, INC.
Accountancy firm EIN	2022-12-31	042571780
2021 : COSTAS PROVISIONS 401(K) & PROFIT SHARING PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets	2021-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$0
Total income from all sources (including contributions)	2021-12-31	$1,689,858
Total loss/gain on sale of assets	2021-12-31	$0
Total of all expenses incurred	2021-12-31	$620,265
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$593,150
Expenses. Certain deemed distributions of participant loans	2021-12-31	$3,318
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$957,626
Value of total assets at end of year	2021-12-31	$12,085,220
Value of total assets at beginning of year	2021-12-31	$11,015,627
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$23,797
Total interest from all sources	2021-12-31	$8,624
Total dividends received (eg from common stock, registered investment company shares)	2021-12-31	$204,745
Total dividends received from registered investment company shares (eg mutual funds)	2021-12-31	$204,745
Was this plan covered by a fidelity bond	2021-12-31	Yes
Value of fidelity bond cover	2021-12-31	$500,000
If this is an individual account plan, was there a blackout period	2021-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2021-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2021-12-31	No
Contributions received from participants	2021-12-31	$412,311
Participant contributions at end of year	2021-12-31	$213,184
Participant contributions at beginning of year	2021-12-31	$225,100
Participant contributions at end of year	2021-12-31	$0
Participant contributions at beginning of year	2021-12-31	$113,332
Administrative expenses (other) incurred	2021-12-31	$23,797
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Value of net income/loss	2021-12-31	$1,069,593
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$12,085,220
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$11,015,627
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2021-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2021-12-31	No
Were any leases to which the plan was party in default or uncollectible	2021-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2021-12-31	$11,467,625
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-12-31	$10,300,904
Interest on participant loans	2021-12-31	$8,624
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2021-12-31	$518,863
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2021-12-31	No
Was there a failure to transmit to the plan any participant contributions	2021-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2021-12-31	No
Contributions received in cash from employer	2021-12-31	$545,315
Employer contributions (assets) at end of year	2021-12-31	$404,411
Employer contributions (assets) at beginning of year	2021-12-31	$376,291
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$593,150
Did the plan have assets held for investment	2021-12-31	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	2021-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2021-12-31	No
Opinion of an independent qualified public accountant for this plan	2021-12-31	Unqualified
Accountancy firm name	2021-12-31	AAFCPAS, INC.
Accountancy firm EIN	2021-12-31	042571780
2020 : COSTAS PROVISIONS 401(K) & PROFIT SHARING PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets	2020-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total income from all sources (including contributions)	2020-12-31	$1,401,214
Total loss/gain on sale of assets	2020-12-31	$0
Total of all expenses incurred	2020-12-31	$147,785
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$115,932
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$883,232
Value of total assets at end of year	2020-12-31	$11,015,627
Value of total assets at beginning of year	2020-12-31	$9,762,198
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$31,853
Total interest from all sources	2020-12-31	$8,656
Total dividends received (eg from common stock, registered investment company shares)	2020-12-31	$0
Was this plan covered by a fidelity bond	2020-12-31	Yes
Value of fidelity bond cover	2020-12-31	$500,000
If this is an individual account plan, was there a blackout period	2020-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2020-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2020-12-31	No
Contributions received from participants	2020-12-31	$383,963
Participant contributions at end of year	2020-12-31	$225,100
Participant contributions at beginning of year	2020-12-31	$172,947
Participant contributions at end of year	2020-12-31	$113,332
Participant contributions at beginning of year	2020-12-31	$113,136
Administrative expenses (other) incurred	2020-12-31	$31,853
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Value of net income/loss	2020-12-31	$1,253,429
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$11,015,627
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$9,762,198
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2020-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2020-12-31	No
Were any leases to which the plan was party in default or uncollectible	2020-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2020-12-31	$10,300,904
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-12-31	$9,133,017
Interest on participant loans	2020-12-31	$8,656
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2020-12-31	$509,326
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2020-12-31	No
Was there a failure to transmit to the plan any participant contributions	2020-12-31	No
Has the plan failed to provide any benefit when due under the plan	2020-12-31	No
Contributions received in cash from employer	2020-12-31	$499,269
Employer contributions (assets) at end of year	2020-12-31	$376,291
Employer contributions (assets) at beginning of year	2020-12-31	$343,098
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$115,932
Did the plan have assets held for investment	2020-12-31	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	2020-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2020-12-31	No
Opinion of an independent qualified public accountant for this plan	2020-12-31	Disclaimer
Accountancy firm name	2020-12-31	AAFCPAS, INC.
Accountancy firm EIN	2020-12-31	042571780
2019 : COSTAS PROVISIONS 401(K) & PROFIT SHARING PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets	2019-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total income from all sources (including contributions)	2019-12-31	$1,982,381
Total loss/gain on sale of assets	2019-12-31	$0
Total of all expenses incurred	2019-12-31	$408,459
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$373,551
Expenses. Certain deemed distributions of participant loans	2019-12-31	$5,397
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$839,450
Value of total assets at end of year	2019-12-31	$9,762,198
Value of total assets at beginning of year	2019-12-31	$8,188,276
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$29,511
Total interest from all sources	2019-12-31	$5,398
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$0
Was this plan covered by a fidelity bond	2019-12-31	Yes
Value of fidelity bond cover	2019-12-31	$500,000
If this is an individual account plan, was there a blackout period	2019-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2019-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Contributions received from participants	2019-12-31	$379,213
Participant contributions at end of year	2019-12-31	$172,947
Participant contributions at beginning of year	2019-12-31	$156,577
Participant contributions at end of year	2019-12-31	$113,136
Participant contributions at beginning of year	2019-12-31	$113,229
Administrative expenses (other) incurred	2019-12-31	$29,511
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Value of net income/loss	2019-12-31	$1,573,922
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$9,762,198
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$8,188,276
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-12-31	No
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$9,133,017
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$7,616,071
Interest on participant loans	2019-12-31	$5,398
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$1,137,533
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-12-31	No
Was there a failure to transmit to the plan any participant contributions	2019-12-31	No
Has the plan failed to provide any benefit when due under the plan	2019-12-31	No
Contributions received in cash from employer	2019-12-31	$460,237
Employer contributions (assets) at end of year	2019-12-31	$343,098
Employer contributions (assets) at beginning of year	2019-12-31	$302,399
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$373,551
Did the plan have assets held for investment	2019-12-31	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	2019-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2019-12-31	Disclaimer
Accountancy firm name	2019-12-31	AAFCPAS, INC.
Accountancy firm EIN	2019-12-31	042571780
2018 : COSTAS PROVISIONS 401(K) & PROFIT SHARING PLAN 2018 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2018-12-31	$0
2017 : COSTAS PROVISIONS 401(K) & PROFIT SHARING PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets	2017-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$0
Total income from all sources (including contributions)	2017-12-31	$1,539,346
Total loss/gain on sale of assets	2017-12-31	$0
Total of all expenses incurred	2017-12-31	$120,721
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$92,184
Expenses. Certain deemed distributions of participant loans	2017-12-31	$3,548
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$756,484
Value of total assets at end of year	2017-12-31	$8,404,842
Value of total assets at beginning of year	2017-12-31	$6,986,217
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$24,989
Total interest from all sources	2017-12-31	$7,618
Total dividends received (eg from common stock, registered investment company shares)	2017-12-31	$0
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$500,000
If this is an individual account plan, was there a blackout period	2017-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2017-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2017-12-31	No
Contributions received from participants	2017-12-31	$344,637
Participant contributions at end of year	2017-12-31	$238,894
Participant contributions at beginning of year	2017-12-31	$161,296
Participant contributions at end of year	2017-12-31	$95,079
Participant contributions at beginning of year	2017-12-31	$40,665
Administrative expenses (other) incurred	2017-12-31	$24,989
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Value of net income/loss	2017-12-31	$1,418,625
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$8,404,842
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$6,986,217
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2017-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2017-12-31	No
Were any leases to which the plan was party in default or uncollectible	2017-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2017-12-31	$7,768,963
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-12-31	$6,515,333
Interest on participant loans	2017-12-31	$7,618
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2017-12-31	$775,244
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2017-12-31	No
Was there a failure to transmit to the plan any participant contributions	2017-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2017-12-31	No
Contributions received in cash from employer	2017-12-31	$411,847
Employer contributions (assets) at end of year	2017-12-31	$301,906
Employer contributions (assets) at beginning of year	2017-12-31	$268,923
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$92,184
Did the plan have assets held for investment	2017-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2017-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2017-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2017-12-31	Disclaimer
Accountancy firm name	2017-12-31	ALEXANDER, ARONSON, FINNING & CO.
Accountancy firm EIN	2017-12-31	042571780
2016 : COSTAS PROVISIONS 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	$820,264
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$107,483
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$107,346
Expenses. Certain deemed distributions of participant loans	2016-12-31	$137
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$647,645
Value of total assets at end of year	2016-12-31	$6,986,217
Value of total assets at beginning of year	2016-12-31	$6,273,436
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$0
Total interest from all sources	2016-12-31	$5,338
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$0
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$500,000
If this is an individual account plan, was there a blackout period	2016-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Contributions received from participants	2016-12-31	$281,317
Participant contributions at end of year	2016-12-31	$161,296
Participant contributions at beginning of year	2016-12-31	$89,392
Participant contributions at end of year	2016-12-31	$40,665
Participant contributions at beginning of year	2016-12-31	$40,746
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	$712,781
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$6,986,217
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$6,273,436
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	$6,515,333
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-12-31	$5,888,622
Interest on participant loans	2016-12-31	$5,338
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2016-12-31	$167,281
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	$366,328
Employer contributions (assets) at end of year	2016-12-31	$268,923
Employer contributions (assets) at beginning of year	2016-12-31	$254,676
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$107,346
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	ALEXANDER, ARONSON, FINNING & CO.
Accountancy firm EIN	2016-12-31	042571780
2015 : COSTAS PROVISIONS 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	$361,656
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$79,796
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$79,417
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$525,558
Value of total assets at end of year	2015-12-31	$5,978,014
Value of total assets at beginning of year	2015-12-31	$5,696,154
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$379
Total interest from all sources	2015-12-31	$3,346
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$0
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$500,000
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	$225,473
Participant contributions at end of year	2015-12-31	$89,392
Participant contributions at beginning of year	2015-12-31	$116,073
Participant contributions at end of year	2015-12-31	$40,746
Participant contributions at beginning of year	2015-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2015-12-31	$1,964
Administrative expenses (other) incurred	2015-12-31	$379
Total non interest bearing cash at end of year	2015-12-31	$0
Total non interest bearing cash at beginning of year	2015-12-31	$655
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	$281,860
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$5,978,014
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$5,696,154
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	$5,888,622
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-12-31	$5,579,426
Value of interest in pooled separate accounts at end of year	2015-12-31	$0
Value of interest in pooled separate accounts at beginning of year	2015-12-31	$0
Interest on participant loans	2015-12-31	$3,346
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2015-12-31	$-167,248
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	$298,121
Employer contributions (assets) at end of year	2015-12-31	$254,676
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	$79,417
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	ALEXANDER, ARONSON, FINNING & CO.,
Accountancy firm EIN	2015-12-31	042571780

Form 5500 Responses for COSTAS PROVISIONS 401(K) & PROFIT SHARING PLAN

2022: COSTAS PROVISIONS 401(K) & PROFIT SHARING PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Submission has been amended	No
2022-01-01	This submission is the final filing	No
2022-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2022-01-01	Plan is a collectively bargained plan	No
2022-01-01	Plan funding arrangement – Trust	Yes
2022-01-01	Plan benefit arrangement - Trust	Yes
2021: COSTAS PROVISIONS 401(K) & PROFIT SHARING PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Submission has been amended	No
2021-01-01	This submission is the final filing	No
2021-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-01-01	Plan is a collectively bargained plan	No
2021-01-01	Plan funding arrangement – Trust	Yes
2021-01-01	Plan benefit arrangement - Trust	Yes
2020: COSTAS PROVISIONS 401(K) & PROFIT SHARING PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Submission has been amended	No
2020-01-01	This submission is the final filing	No
2020-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-01-01	Plan is a collectively bargained plan	No
2020-01-01	Plan funding arrangement – Trust	Yes
2020-01-01	Plan benefit arrangement - Trust	Yes
2019: COSTAS PROVISIONS 401(K) & PROFIT SHARING PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Submission has been amended	No
2019-01-01	This submission is the final filing	No
2019-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-01-01	Plan is a collectively bargained plan	No
2019-01-01	Plan funding arrangement – Trust	Yes
2019-01-01	Plan benefit arrangement - Trust	Yes
2018: COSTAS PROVISIONS 401(K) & PROFIT SHARING PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Submission has been amended	No
2018-01-01	This submission is the final filing	No
2018-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-01-01	Plan is a collectively bargained plan	No
2018-01-01	Plan funding arrangement – Trust	Yes
2018-01-01	Plan benefit arrangement - Trust	Yes
2017: COSTAS PROVISIONS 401(K) & PROFIT SHARING PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	No
2017-01-01	This submission is the final filing	No
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes
2016: COSTAS PROVISIONS 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 – Trust	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: COSTAS PROVISIONS 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	Yes
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 – Trust	Yes
2015-01-01	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

59255

Policy instance

Insurance contract or identification number	59255
Number of Individuals Covered	0
Insurance policy start date	2015-01-01
Insurance policy end date	2015-05-18
Total amount of commissions paid to insurance broker	USD $5,829
Total amount of fees paid to insurance company	USD $1,217
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 $5,829
Insurance broker organization code?	4
Amount paid for insurance broker fees	1217
Additional information about fees paid to insurance broker	TPA FEES
Insurance broker name	THE ANGELL PENSION GROUP, INC

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Company Name:	COSTAS PROVISIONS CORPORATION
Employer identification number (EIN):	043034611
NAIC Classification:	424400