401k Plan data: LEESE FLOORING SUPPLIES, INC. DEFINED BENEFIT PLAN plan

LEESE FLOORING SUPPLIES, INC. DEFINED BENEFIT PLAN 401k Plan overview

Plan Name	LEESE FLOORING SUPPLIES, INC. DEFINED BENEFIT PLAN
Plan identification number	002

LEESE FLOORING SUPPLIES, INC. DEFINED BENEFIT PLAN Benefits

401k Plan Type

Defined Benefit Pension

Plan Features/Benefits

Benefits are primarily pay related
Covered by PBGC - Plan is covered under the PBGC insurance program (see ERISA section 4021).
Plan covered by PBGC that was terminated and closed out for PBGC purposes - Before the end of the plan year (or a prior plan year), (1) the plan terminated in a standard (or distress) termination and completed the distribution of plan assets in satisfaction of all benefit liabilities (or all ERISA Title IV benefits for distress termination); or (2) a trustee was appointed for a terminated plan pursuant to ERISA section 4042.
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

LEESE FLOORING SUPPLIES, INC. has sponsored the creation of one or more 401k plans.

Company Name: LEESE FLOORING SUPPLIES, INC.

Employer identification number (EIN): 061111283

NAIC Classification: 424950
NAIC Description: Paint, Varnish, and Supplies Merchant Wholesalers

Form 5500 Filing Information

Submission information for form 5500 for 401k plan LEESE FLOORING SUPPLIES, INC. DEFINED BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2014-01-01 JAMES R. CONNORS 2014-10-10
002 2013-01-01 JAMES R. CONNORS 2014-05-05
002 2012-01-01 JAMES R. CONNORS 2013-04-24
002 2011-01-01 JAMES R. CONNORS 2012-06-20
002 2010-01-01 JAMES CONSOLATI

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
002	2014-01-01	JAMES R. CONNORS	2014-10-10
002	2013-01-01	JAMES R. CONNORS	2014-05-05
002	2012-01-01	JAMES R. CONNORS	2013-04-24
002	2011-01-01	JAMES R. CONNORS	2012-06-20
002	2010-01-01	JAMES CONSOLATI

Plan Statistics for LEESE FLOORING SUPPLIES, INC. DEFINED BENEFIT PLAN

401k plan membership statisitcs for LEESE FLOORING SUPPLIES, INC. DEFINED BENEFIT PLAN

Measure Date Value
2010: LEESE FLOORING SUPPLIES, INC. DEFINED BENEFIT PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 4
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 4
Number of retired or separated participants receiving benefits 2010-01-01 0
Number of other retired or separated participants entitled to future benefits 2010-01-01 0
Total of all active and inactive participants 2010-01-01 4
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 4
Number of participants with account balances 2010-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 0

Measure	Date	Value
2010: LEESE FLOORING SUPPLIES, INC. DEFINED BENEFIT PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	4
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	4
Number of retired or separated participants receiving benefits	2010-01-01	0
Number of other retired or separated participants entitled to future benefits	2010-01-01	0
Total of all active and inactive participants	2010-01-01	4
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	4
Number of participants with account balances	2010-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	0

Form 5500 Responses for LEESE FLOORING SUPPLIES, INC. DEFINED BENEFIT PLAN

2010: LEESE FLOORING SUPPLIES, INC. DEFINED BENEFIT PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Submission has been amended	No
2010-01-01	This submission is the final filing	No
2010-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-01-01	Plan is a collectively bargained plan	No
2010-01-01	Plan funding arrangement – Section 412(e)(3) insurance Contracts	Yes
2010-01-01	Plan benefit arrangement – Section 412(e)(3) insurance Contracts	Yes

Insurance Providers Used on plan

JOHN HANCOCK LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 90425 )

Policy contract number

60124

Policy instance

Insurance contract or identification number	60124
Number of Individuals Covered	4
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $7,068
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	Yes
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $7,068
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Insurance broker name	ALAN HUGHES

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Company Name:	LEESE FLOORING SUPPLIES, INC.
Employer identification number (EIN):	061111283
NAIC Classification:	424950
NAIC Description:	Paint, Varnish, and Supplies Merchant Wholesalers