401k Plan data: NORTHERN SAFETY SAVINGS & RETIREMENT PLAN plan

NORTHERN SAFETY SAVINGS & RETIREMENT PLAN 401k Plan overview

Plan Name	NORTHERN SAFETY SAVINGS & RETIREMENT PLAN
Plan identification number	001

NORTHERN SAFETY SAVINGS & RETIREMENT 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.
Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

NORTHERN SAFETY CO., INC. has sponsored the creation of one or more 401k plans.

Company Name: NORTHERN SAFETY CO., INC.

Employer identification number (EIN): 161214814

NAIC Classification: 423990
NAIC Description: Other Miscellaneous Durable Goods Merchant Wholesalers

Additional information about NORTHERN SAFETY CO., INC.

Jurisdiction of Incorporation: New York Department of State

Incorporation Date: 1983-10-27

Company Identification Number: 877215

Legal Registered Office Address: 80 STATE STREET
Herkimer
ALBANY
United States of America (USA)
12207

More information about NORTHERN SAFETY CO., INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan NORTHERN SAFETY SAVINGS & RETIREMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2017-01-01 AMY HRYB 2017-10-24
001 2016-01-01 AMY HRYB
001 2015-01-01 AMY HRYB
001 2014-01-01 AMY HRYB
001 2013-01-01 SALVATORE LONGO
001 2012-01-01 SALVATORE LONGO
001 2011-01-01 SALVATORE LONGO
001 2010-01-01 SALVATORE LONGO
001 2009-01-01 SALVATORE LONGO

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
001	2017-01-01	AMY HRYB	2017-10-24
001	2016-01-01	AMY HRYB
001	2015-01-01	AMY HRYB
001	2014-01-01	AMY HRYB
001	2013-01-01	SALVATORE LONGO
001	2012-01-01	SALVATORE LONGO
001	2011-01-01	SALVATORE LONGO
001	2010-01-01	SALVATORE LONGO
001	2009-01-01	SALVATORE LONGO

Plan Statistics for NORTHERN SAFETY SAVINGS & RETIREMENT PLAN

401k plan membership statisitcs for NORTHERN SAFETY SAVINGS & RETIREMENT PLAN

Measure Date Value
2016: NORTHERN SAFETY SAVINGS & RETIREMENT PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 415
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 48
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 0
Total of all active and inactive participants 2016-01-01 48
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 48
Number of participants with account balances 2016-01-01 48
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 6
2015: NORTHERN SAFETY SAVINGS & RETIREMENT PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 402
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 393
Number of retired or separated participants receiving benefits 2015-01-01 3
Number of other retired or separated participants entitled to future benefits 2015-01-01 19
Total of all active and inactive participants 2015-01-01 415
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 415
Number of participants with account balances 2015-01-01 261
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 12
2014: NORTHERN SAFETY SAVINGS & RETIREMENT PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 382
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 380
Number of retired or separated participants receiving benefits 2014-01-01 0
Number of other retired or separated participants entitled to future benefits 2014-01-01 15
Total of all active and inactive participants 2014-01-01 395
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 395
Number of participants with account balances 2014-01-01 245
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 12
2013: NORTHERN SAFETY SAVINGS & RETIREMENT PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 382
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 361
Number of retired or separated participants receiving benefits 2013-01-01 1
Number of other retired or separated participants entitled to future benefits 2013-01-01 20
Total of all active and inactive participants 2013-01-01 382
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 382
Number of participants with account balances 2013-01-01 238
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 11
2012: NORTHERN SAFETY SAVINGS & RETIREMENT PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 304
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 318
Number of retired or separated participants receiving benefits 2012-01-01 2
Number of other retired or separated participants entitled to future benefits 2012-01-01 17
Total of all active and inactive participants 2012-01-01 337
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 337
Number of participants with account balances 2012-01-01 215
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 3
2011: NORTHERN SAFETY SAVINGS & RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 216
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 279
Number of retired or separated participants receiving benefits 2011-01-01 2
Number of other retired or separated participants entitled to future benefits 2011-01-01 17
Total of all active and inactive participants 2011-01-01 298
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 1
Total participants 2011-01-01 299
Number of participants with account balances 2011-01-01 208
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 1
2010: NORTHERN SAFETY SAVINGS & RETIREMENT PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 223
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 199
Number of retired or separated participants receiving benefits 2010-01-01 2
Number of other retired or separated participants entitled to future benefits 2010-01-01 14
Total of all active and inactive participants 2010-01-01 215
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 215
Number of participants with account balances 2010-01-01 151
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 4
2009: NORTHERN SAFETY SAVINGS & RETIREMENT PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 263
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 200
Number of retired or separated participants receiving benefits 2009-01-01 2
Number of other retired or separated participants entitled to future benefits 2009-01-01 20
Total of all active and inactive participants 2009-01-01 222
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 222
Number of participants with account balances 2009-01-01 158
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 19

Measure	Date	Value
2016: NORTHERN SAFETY SAVINGS & RETIREMENT PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	415
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	48
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	0
Total of all active and inactive participants	2016-01-01	48
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	48
Number of participants with account balances	2016-01-01	48
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	6
2015: NORTHERN SAFETY SAVINGS & RETIREMENT PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	402
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	393
Number of retired or separated participants receiving benefits	2015-01-01	3
Number of other retired or separated participants entitled to future benefits	2015-01-01	19
Total of all active and inactive participants	2015-01-01	415
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	415
Number of participants with account balances	2015-01-01	261
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	12
2014: NORTHERN SAFETY SAVINGS & RETIREMENT PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	382
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	380
Number of retired or separated participants receiving benefits	2014-01-01	0
Number of other retired or separated participants entitled to future benefits	2014-01-01	15
Total of all active and inactive participants	2014-01-01	395
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	395
Number of participants with account balances	2014-01-01	245
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	12
2013: NORTHERN SAFETY SAVINGS & RETIREMENT PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	382
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	361
Number of retired or separated participants receiving benefits	2013-01-01	1
Number of other retired or separated participants entitled to future benefits	2013-01-01	20
Total of all active and inactive participants	2013-01-01	382
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	382
Number of participants with account balances	2013-01-01	238
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	11
2012: NORTHERN SAFETY SAVINGS & RETIREMENT PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	304
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	318
Number of retired or separated participants receiving benefits	2012-01-01	2
Number of other retired or separated participants entitled to future benefits	2012-01-01	17
Total of all active and inactive participants	2012-01-01	337
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	337
Number of participants with account balances	2012-01-01	215
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	3
2011: NORTHERN SAFETY SAVINGS & RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	216
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	279
Number of retired or separated participants receiving benefits	2011-01-01	2
Number of other retired or separated participants entitled to future benefits	2011-01-01	17
Total of all active and inactive participants	2011-01-01	298
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	1
Total participants	2011-01-01	299
Number of participants with account balances	2011-01-01	208
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	1
2010: NORTHERN SAFETY SAVINGS & RETIREMENT PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	223
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	199
Number of retired or separated participants receiving benefits	2010-01-01	2
Number of other retired or separated participants entitled to future benefits	2010-01-01	14
Total of all active and inactive participants	2010-01-01	215
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	215
Number of participants with account balances	2010-01-01	151
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	4
2009: NORTHERN SAFETY SAVINGS & RETIREMENT PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	263
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	200
Number of retired or separated participants receiving benefits	2009-01-01	2
Number of other retired or separated participants entitled to future benefits	2009-01-01	20
Total of all active and inactive participants	2009-01-01	222
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	222
Number of participants with account balances	2009-01-01	158
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	19

Financial Data on NORTHERN SAFETY SAVINGS & RETIREMENT PLAN

Measure	Date	Value
2016 : NORTHERN SAFETY SAVINGS & RETIREMENT PLAN 2016 401k financial data
Total transfer of assets from this plan	2016-12-31	$11,127,145
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$1,863
Total income from all sources (including contributions)	2016-12-31	$1,428,328
Total of all expenses incurred	2016-12-31	$305,647
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$286,549
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$811,785
Value of total assets at end of year	2016-12-31	$3,660
Value of total assets at beginning of year	2016-12-31	$10,006,261
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$19,098
Total interest from all sources	2016-12-31	$17,759
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$18,913
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2016-12-31	$18,913
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	Yes
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Contributions received from participants	2016-12-31	$566,057
Participant contributions at end of year	2016-12-31	$0
Participant contributions at beginning of year	2016-12-31	$374,688
Participant contributions at end of year	2016-12-31	$0
Participant contributions at beginning of year	2016-12-31	$15,551
Income. Received or receivable in cash from other sources (including rollovers)	2016-12-31	$134,709
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2016-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2016-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2016-12-31	$3,285
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2016-12-31	$1,863
Other income not declared elsewhere	2016-12-31	$3,898
Liabilities. Value of operating payables at end of year	2016-12-31	$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	2016-12-31	No
Value of net income/loss	2016-12-31	$1,122,681
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$1,797
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$10,006,261
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	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-12-31	$2,251,513
Value of interest in pooled separate accounts at end of year	2016-12-31	$0
Value of interest in pooled separate accounts at beginning of year	2016-12-31	$5,536,442
Interest on participant loans	2016-12-31	$11,989
Interest earned on other investments	2016-12-31	$5,770
Value of interest in common/collective trusts at end of year	2016-12-31	$0
Value of interest in common/collective trusts at beginning of year	2016-12-31	$1,167,620
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-12-31	$652,068
Expenses. Payments to insurance carriers foe the provision of benefits	2016-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2016-12-31	$121,443
Net investment gain/loss from pooled separate accounts	2016-12-31	$376,094
Net investment gain or loss from common/collective trusts	2016-12-31	$78,436
Net gain/loss from 103.12 investment entities	2016-12-31	$0
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	$111,019
Employer contributions (assets) at end of year	2016-12-31	$3,660
Employer contributions (assets) at beginning of year	2016-12-31	$5,094
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$286,549
Contract administrator fees	2016-12-31	$19,098
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2016-12-31	Yes
Did the plan have assets held for investment	2016-12-31	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	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	Yes
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	BONADIO & CO., LLP
Accountancy firm EIN	2016-12-31	161131146
2015 : NORTHERN SAFETY SAVINGS & RETIREMENT PLAN 2015 401k financial data
Unrealized appreciation/depreciation of real estate assets	2015-12-31	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2015-12-31	$0
Total unrealized appreciation/depreciation of assets	2015-12-31	$0
Total transfer of assets to this plan	2015-12-31	$0
Total transfer of assets from this plan	2015-12-31	$0
Expenses. Interest paid	2015-12-31	$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2015-12-31	$0
Total income from all sources (including contributions)	2015-12-31	$1,070,413
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$652,152
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$621,705
Expenses. Certain deemed distributions of participant loans	2015-12-31	$0
Value of total corrective distributions	2015-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$1,059,622
Value of total assets at end of year	2015-12-31	$10,006,261
Value of total assets at beginning of year	2015-12-31	$9,588,000
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$30,447
Total income from rents	2015-12-31	$0
Total interest from all sources	2015-12-31	$27,802
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$35,004
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2015-12-31	$35,004
Administrative expenses professional fees incurred	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
Were there any nonexempt tranactions with any party-in-interest	2015-12-31	No
Contributions received from participants	2015-12-31	$811,490
Participant contributions at end of year	2015-12-31	$374,688
Participant contributions at beginning of year	2015-12-31	$485,487
Participant contributions at end of year	2015-12-31	$15,551
Participant contributions at beginning of year	2015-12-31	$12,682
Income. Received or receivable in cash from other sources (including rollovers)	2015-12-31	$97,018
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2015-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2015-12-31	$3,285
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2015-12-31	$3,644
Other income not declared elsewhere	2015-12-31	$681
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
Income. Non cash contributions	2015-12-31	$0
Value of net income/loss	2015-12-31	$418,261
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$10,006,261
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$9,588,000
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	$2,251,513
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-12-31	$2,187,629
Value of interest in pooled separate accounts at end of year	2015-12-31	$5,536,442
Value of interest in pooled separate accounts at beginning of year	2015-12-31	$5,390,999
Interest on participant loans	2015-12-31	$22,416
Income. Interest from loans (other than to participants)	2015-12-31	$0
Interest earned on other investments	2015-12-31	$5,386
Income. Interest from US Government securities	2015-12-31	$0
Income. Interest from corporate debt instruments	2015-12-31	$0
Value of interest in common/collective trusts at end of year	2015-12-31	$1,167,620
Value of interest in common/collective trusts at beginning of year	2015-12-31	$1,193,829
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2015-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-12-31	$652,068
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-12-31	$310,549
Expenses. Payments to insurance carriers foe the provision of benefits	2015-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2015-12-31	$-63,447
Net investment gain/loss from pooled separate accounts	2015-12-31	$27,970
Net investment gain or loss from common/collective trusts	2015-12-31	$-17,219
Net gain/loss from 103.12 investment entities	2015-12-31	$0
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	$151,114
Employer contributions (assets) at end of year	2015-12-31	$5,094
Employer contributions (assets) at beginning of year	2015-12-31	$3,181
Income. Dividends from preferred stock	2015-12-31	$0
Income. Dividends from common stock	2015-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$621,705
Contract administrator fees	2015-12-31	$30,447
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
Aggregate proceeds on sale of assets	2015-12-31	$0
Aggregate carrying amount (costs) on sale of assets	2015-12-31	$0
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	BONADIO & CO., LLP
Accountancy firm EIN	2015-12-31	161131146
2014 : NORTHERN SAFETY SAVINGS & RETIREMENT PLAN 2014 401k financial data
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$36
Total income from all sources (including contributions)	2014-12-31	$1,488,211
Total of all expenses incurred	2014-12-31	$469,357
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$438,201
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$906,509
Value of total assets at end of year	2014-12-31	$9,588,000
Value of total assets at beginning of year	2014-12-31	$8,569,182
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$31,156
Total interest from all sources	2014-12-31	$25,585
Total dividends received (eg from common stock, registered investment company shares)	2014-12-31	$38,288
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2014-12-31	$38,288
Administrative expenses professional fees incurred	2014-12-31	$2,400
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
Were there any nonexempt tranactions with any party-in-interest	2014-12-31	No
Contributions received from participants	2014-12-31	$751,552
Participant contributions at end of year	2014-12-31	$485,487
Participant contributions at beginning of year	2014-12-31	$311,989
Participant contributions at end of year	2014-12-31	$12,682
Participant contributions at beginning of year	2014-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2014-12-31	$8,986
Value of other receiveables (less allowance for doubtful accounts) at end of year	2014-12-31	$3,644
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2014-12-31	$0
Liabilities. Value of operating payables at beginning of year	2014-12-31	$36
Total non interest bearing cash at beginning of year	2014-12-31	$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	2014-12-31	No
Value of net income/loss	2014-12-31	$1,018,854
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$9,588,000
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$8,569,146
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 end of year	2014-12-31	$2,187,629
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-12-31	$2,103,379
Value of interest in pooled separate accounts at end of year	2014-12-31	$5,390,999
Value of interest in pooled separate accounts at beginning of year	2014-12-31	$4,654,364
Interest on participant loans	2014-12-31	$21,138
Interest earned on other investments	2014-12-31	$4,447
Value of interest in common/collective trusts at end of year	2014-12-31	$1,193,829
Value of interest in common/collective trusts at beginning of year	2014-12-31	$1,193,345
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-12-31	$310,549
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-12-31	$305,751
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2014-12-31	$-11,844
Net investment gain/loss from pooled separate accounts	2014-12-31	$461,905
Net investment gain or loss from common/collective trusts	2014-12-31	$67,768
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	Yes
Has the plan failed to provide any benefit when due under the plan	2014-12-31	No
Contributions received in cash from employer	2014-12-31	$145,971
Employer contributions (assets) at end of year	2014-12-31	$3,181
Employer contributions (assets) at beginning of year	2014-12-31	$354
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$438,201
Contract administrator fees	2014-12-31	$28,756
Did the plan have assets held for investment	2014-12-31	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	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	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2014-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2014-12-31	Disclaimer
Accountancy firm name	2014-12-31	BONADIO & CO., LLP
Accountancy firm EIN	2014-12-31	161131146
2013 : NORTHERN SAFETY SAVINGS & RETIREMENT PLAN 2013 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$36
Total income from all sources (including contributions)	2013-12-31	$2,510,276
Total of all expenses incurred	2013-12-31	$116,480
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$102,170
Expenses. Certain deemed distributions of participant loans	2013-12-31	$3,161
Value of total corrective distributions	2013-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$933,053
Value of total assets at end of year	2013-12-31	$8,569,182
Value of total assets at beginning of year	2013-12-31	$6,175,350
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$11,149
Total interest from all sources	2013-12-31	$15,837
Total dividends received (eg from common stock, registered investment company shares)	2013-12-31	$15,673
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2013-12-31	$15,673
Assets. Real estate other than employer real property at beginning of year	2013-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year	2013-12-31	$0
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$500,000
If this is an individual account plan, was there a blackout period	2013-12-31	Yes
Were there any nonexempt tranactions with any party-in-interest	2013-12-31	No
Contributions received from participants	2013-12-31	$698,154
Participant contributions at end of year	2013-12-31	$311,989
Participant contributions at beginning of year	2013-12-31	$220,805
Participant contributions at end of year	2013-12-31	$0
Participant contributions at beginning of year	2013-12-31	$11,214
Assets. Other investments not covered elsewhere at beginning of year	2013-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2013-12-31	$99,517
Value of other receiveables (less allowance for doubtful accounts) at end of year	2013-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2013-12-31	$1,829
Assets. Loans (other than to participants) at beginning of year	2013-12-31	$0
Other income not declared elsewhere	2013-12-31	$1,466
Liabilities. Value of operating payables at end of year	2013-12-31	$36
Total non interest bearing cash at end of year	2013-12-31	$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	2013-12-31	No
Value of net income/loss	2013-12-31	$2,393,796
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$8,569,146
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$6,175,350
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2013-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2013-12-31	No
Were any leases to which the plan was party in default or uncollectible	2013-12-31	No
Assets. partnership/joint venture interests at beginning of year	2013-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2013-12-31	$2,103,379
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2013-12-31	$0
Value of interest in pooled separate accounts at end of year	2013-12-31	$4,654,364
Value of interest in pooled separate accounts at beginning of year	2013-12-31	$5,887,233
Interest on participant loans	2013-12-31	$13,028
Interest earned on other investments	2013-12-31	$1,403
Value of interest in master investment trust accounts at beginning of year	2013-12-31	$0
Value of interest in common/collective trusts at end of year	2013-12-31	$1,193,345
Value of interest in common/collective trusts at beginning of year	2013-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2013-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2013-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2013-12-31	$1,406
Assets. Value of investments in 103.12 investment entities at beginning of year	2013-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2013-12-31	$305,751
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-12-31	$52,105
Asset value of US Government securities at beginning of year	2013-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2013-12-31	$136,912
Net investment gain/loss from pooled separate accounts	2013-12-31	$1,329,534
Net investment gain or loss from common/collective trusts	2013-12-31	$77,801
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2013-12-31	No
Was there a failure to transmit to the plan any participant contributions	2013-12-31	No
Has the plan failed to provide any benefit when due under the plan	2013-12-31	No
Contributions received in cash from employer	2013-12-31	$135,382
Employer contributions (assets) at end of year	2013-12-31	$354
Employer contributions (assets) at beginning of year	2013-12-31	$2,164
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$102,170
Asset. Corporate debt instrument preferred debt at beginning of year	2013-12-31	$0
Asset. Corporate debt instrument debt (other) at beginning of year	2013-12-31	$0
Contract administrator fees	2013-12-31	$11,149
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	2013-12-31	Yes
Assets. Corporate common stocks other than exployer securities at beginning of year	2013-12-31	$0
Did the plan have assets held for investment	2013-12-31	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	2013-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2013-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2013-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2013-12-31	Disclaimer
Accountancy firm name	2013-12-31	BONADIO & CO., LLP
Accountancy firm EIN	2013-12-31	161131146
2012 : NORTHERN SAFETY SAVINGS & RETIREMENT 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
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	$1,479,943
Total loss/gain on sale of assets	2012-12-31	$0
Total of all expenses incurred	2012-12-31	$94,643
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$91,780
Expenses. Certain deemed distributions of participant loans	2012-12-31	$1,463
Value of total corrective distributions	2012-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$824,268
Value of total assets at end of year	2012-12-31	$6,175,350
Value of total assets at beginning of year	2012-12-31	$4,790,050
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$1,400
Total income from rents	2012-12-31	$0
Total interest from all sources	2012-12-31	$10,978
Total dividends received (eg from common stock, registered investment company shares)	2012-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-12-31	No
Assets. Real estate other than employer real property at end of year	2012-12-31	$0
Assets. Real estate other than employer real property at beginning of year	2012-12-31	$0
Administrative expenses professional fees incurred	2012-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at end of year	2012-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year	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	No
Were there any nonexempt tranactions with any party-in-interest	2012-12-31	No
Contributions received from participants	2012-12-31	$600,583
Participant contributions at end of year	2012-12-31	$220,805
Participant contributions at beginning of year	2012-12-31	$164,001
Participant contributions at end of year	2012-12-31	$11,214
Participant contributions at beginning of year	2012-12-31	$9,074
Assets. Other investments not covered elsewhere at end of year	2012-12-31	$0
Assets. Other investments not covered elsewhere at beginning of year	2012-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2012-12-31	$109,034
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	$1,829
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2012-12-31	$1,584
Assets. Loans (other than to participants) at end of year	2012-12-31	$0
Assets. Loans (other than to participants) 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
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	$1,385,300
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$6,175,350
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$4,790,050
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
Were any leases to which the plan was party in default or uncollectible	2012-12-31	No
Assets. partnership/joint venture interests at end of year	2012-12-31	$0
Assets. partnership/joint venture interests at beginning of 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	$0
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	$5,887,233
Value of interest in pooled separate accounts at beginning of year	2012-12-31	$4,562,591
Interest on participant loans	2012-12-31	$9,781
Income. Interest from loans (other than to participants)	2012-12-31	$0
Interest earned on other investments	2012-12-31	$0
Income. Interest from US Government securities	2012-12-31	$0
Income. Interest from corporate debt instruments	2012-12-31	$0
Value of interest in master investment trust accounts at end of year	2012-12-31	$0
Value of interest in master investment trust accounts at beginning of year	2012-12-31	$0
Value of interest in common/collective trusts at end of year	2012-12-31	$0
Value of interest in common/collective trusts at beginning of year	2012-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2012-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2012-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) 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	$1,197
Assets. Value of investments in 103.12 investment entities at end of year	2012-12-31	$0
Assets. Value of investments in 103.12 investment entities at beginning of year	2012-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-12-31	$52,105
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-12-31	$50,934
Expenses. Payments to insurance carriers foe the provision of benefits	2012-12-31	$0
Asset value of US Government securities at end of year	2012-12-31	$0
Asset value of US Government securities at beginning of year	2012-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2012-12-31	$0
Net investment gain/loss from pooled separate accounts	2012-12-31	$644,697
Net investment gain or loss from common/collective trusts	2012-12-31	$0
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	No
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	$114,651
Employer contributions (assets) at end of year	2012-12-31	$2,164
Employer contributions (assets) at beginning of year	2012-12-31	$1,866
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	$91,780
Asset. Corporate debt instrument preferred debt at end of year	2012-12-31	$0
Asset. Corporate debt instrument preferred debt at beginning of year	2012-12-31	$0
Asset. Corporate debt instrument debt (other) at end of year	2012-12-31	$0
Asset. Corporate debt instrument debt (other) at beginning of year	2012-12-31	$0
Contract administrator fees	2012-12-31	$1,400
Assets. Corporate common stocks other than exployer securities at end of year	2012-12-31	$0
Assets. Corporate common stocks other than exployer securities 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
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	BONADIO & CO., LLP
Accountancy firm EIN	2012-12-31	161131146
2011 : NORTHERN SAFETY SAVINGS & RETIREMENT PLAN 2011 401k financial data
Unrealized appreciation/depreciation of real estate assets	2011-12-31	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2011-12-31	$0
Total unrealized appreciation/depreciation of assets	2011-12-31	$0
Total transfer of assets to this plan	2011-12-31	$0
Total transfer of assets from this plan	2011-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$0
Expenses. Interest paid	2011-12-31	$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2011-12-31	$0
Total income from all sources (including contributions)	2011-12-31	$983,779
Total loss/gain on sale of assets	2011-12-31	$0
Total of all expenses incurred	2011-12-31	$122,480
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$118,462
Expenses. Certain deemed distributions of participant loans	2011-12-31	$2,968
Value of total corrective distributions	2011-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$1,168,264
Value of total assets at end of year	2011-12-31	$4,790,050
Value of total assets at beginning of year	2011-12-31	$3,928,751
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$1,050
Total income from rents	2011-12-31	$0
Total interest from all sources	2011-12-31	$9,477
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
Total dividends received from registered investment company shares (eg mutual funds)	2011-12-31	$0
Assets. Real estate other than employer real property at end of year	2011-12-31	$0
Assets. Real estate other than employer real property at beginning of year	2011-12-31	$0
Administrative expenses professional fees incurred	2011-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at end of year	2011-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year	2011-12-31	$0
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
Were there any nonexempt tranactions with any party-in-interest	2011-12-31	No
Contributions received from participants	2011-12-31	$452,592
Participant contributions at end of year	2011-12-31	$164,001
Participant contributions at beginning of year	2011-12-31	$126,542
Participant contributions at end of year	2011-12-31	$9,074
Participant contributions at beginning of year	2011-12-31	$6,193
Assets. Other investments not covered elsewhere at end of year	2011-12-31	$0
Assets. Other investments not covered elsewhere at beginning of year	2011-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2011-12-31	$636,292
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2011-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2011-12-31	$1,584
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2011-12-31	$1,218
Assets. Loans (other than to participants) at end of year	2011-12-31	$0
Assets. Loans (other than to participants) at beginning of year	2011-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2011-12-31	$0
Other income not declared elsewhere	2011-12-31	$26
Administrative expenses (other) incurred	2011-12-31	$0
Liabilities. Value of operating payables at beginning of year	2011-12-31	$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	2011-12-31	No
Value of net income/loss	2011-12-31	$861,299
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$4,790,050
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$3,928,751
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
Assets. partnership/joint venture interests at end of year	2011-12-31	$0
Assets. partnership/joint venture interests at beginning of year	2011-12-31	$0
Investment advisory and management fees	2011-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2011-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-12-31	$0
Value of interest in pooled separate accounts at end of year	2011-12-31	$4,562,591
Value of interest in pooled separate accounts at beginning of year	2011-12-31	$3,747,067
Interest on participant loans	2011-12-31	$8,393
Income. Interest from loans (other than to participants)	2011-12-31	$0
Interest earned on other investments	2011-12-31	$0
Income. Interest from US Government securities	2011-12-31	$0
Income. Interest from corporate debt instruments	2011-12-31	$0
Value of interest in master investment trust accounts at end of year	2011-12-31	$0
Value of interest in master investment trust accounts at beginning of year	2011-12-31	$0
Value of interest in common/collective trusts at end of year	2011-12-31	$0
Value of interest in common/collective trusts at beginning of year	2011-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2011-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2011-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2011-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2011-12-31	$1,084
Assets. Value of investments in 103.12 investment entities at end of year	2011-12-31	$0
Assets. Value of investments in 103.12 investment entities at beginning of year	2011-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-12-31	$50,934
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-12-31	$46,486
Expenses. Payments to insurance carriers foe the provision of benefits	2011-12-31	$0
Asset value of US Government securities at end of year	2011-12-31	$0
Asset value of US Government securities at beginning of year	2011-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2011-12-31	$0
Net investment gain/loss from pooled separate accounts	2011-12-31	$-193,988
Net investment gain or loss from common/collective trusts	2011-12-31	$0
Net gain/loss from 103.12 investment entities	2011-12-31	$0
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	No
Has the plan failed to provide any benefit when due under the plan	2011-12-31	No
Assets. Invements in employer securities at beginning of year	2011-12-31	$0
Assets. Value of employer real property at beginning of year	2011-12-31	$0
Contributions received in cash from employer	2011-12-31	$79,380
Employer contributions (assets) at end of year	2011-12-31	$1,866
Employer contributions (assets) at beginning of year	2011-12-31	$1,245
Income. Dividends from preferred stock	2011-12-31	$0
Income. Dividends from common stock	2011-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$118,462
Asset. Corporate debt instrument preferred debt at end of year	2011-12-31	$0
Asset. Corporate debt instrument preferred debt at beginning of year	2011-12-31	$0
Asset. Corporate debt instrument debt (other) at end of year	2011-12-31	$0
Asset. Corporate debt instrument debt (other) at beginning of year	2011-12-31	$0
Contract administrator fees	2011-12-31	$1,050
Assets. Corporate common stocks other than exployer securities at end of year	2011-12-31	$0
Assets. Corporate common stocks other than exployer securities at beginning of year	2011-12-31	$0
Liabilities. Value of benefit claims payable at beginning of year	2011-12-31	$0
Assets. Value of buildings and other operty used in plan operation at beginning of year	2011-12-31	$0
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
Aggregate proceeds on sale of assets	2011-12-31	$0
Aggregate carrying amount (costs) on sale of assets	2011-12-31	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2011-12-31	$0
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	BONADIO & CO., LLP
Accountancy firm EIN	2011-12-31	161131146
2010 : NORTHERN SAFETY SAVINGS & RETIREMENT PLAN 2010 401k financial data
Unrealized appreciation/depreciation of real estate assets	2010-12-31	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2010-12-31	$0
Total unrealized appreciation/depreciation of assets	2010-12-31	$0
Total transfer of assets to this plan	2010-12-31	$0
Total transfer of assets from this plan	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
Expenses. Interest paid	2010-12-31	$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2010-12-31	$0
Total income from all sources (including contributions)	2010-12-31	$876,600
Total loss/gain on sale of assets	2010-12-31	$0
Total of all expenses incurred	2010-12-31	$321,909
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$310,113
Expenses. Certain deemed distributions of participant loans	2010-12-31	$10,646
Value of total corrective distributions	2010-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$421,702
Value of total assets at end of year	2010-12-31	$3,928,751
Value of total assets at beginning of year	2010-12-31	$3,374,060
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$1,150
Total income from rents	2010-12-31	$0
Total interest from all sources	2010-12-31	$11,747
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
Total dividends received from registered investment company shares (eg mutual funds)	2010-12-31	$0
Assets. Real estate other than employer real property at end of year	2010-12-31	$0
Assets. Real estate other than employer real property at beginning of year	2010-12-31	$0
Administrative expenses professional fees incurred	2010-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at end of year	2010-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year	2010-12-31	$0
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
Were there any nonexempt tranactions with any party-in-interest	2010-12-31	No
Contributions received from participants	2010-12-31	$356,812
Participant contributions at end of year	2010-12-31	$126,542
Participant contributions at beginning of year	2010-12-31	$169,225
Participant contributions at end of year	2010-12-31	$6,193
Participant contributions at beginning of year	2010-12-31	$5,743
Assets. Other investments not covered elsewhere at end of year	2010-12-31	$0
Assets. Other investments not covered elsewhere at beginning of year	2010-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2010-12-31	$0
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2010-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2010-12-31	$1,218
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2010-12-31	$0
Assets. Loans (other than to participants) at end of year	2010-12-31	$0
Assets. Loans (other than to participants) at beginning of year	2010-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2010-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2010-12-31	$0
Other income not declared elsewhere	2010-12-31	$2,465
Administrative expenses (other) incurred	2010-12-31	$1,150
Liabilities. Value of operating payables at end of year	2010-12-31	$0
Liabilities. Value of operating payables at beginning of year	2010-12-31	$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	2010-12-31	No
Income. Non cash contributions	2010-12-31	$0
Value of net income/loss	2010-12-31	$554,691
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$3,928,751
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$3,374,060
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
Assets. partnership/joint venture interests at end of year	2010-12-31	$0
Assets. partnership/joint venture interests at beginning of year	2010-12-31	$0
Investment advisory and management fees	2010-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2010-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2010-12-31	$0
Value of interest in pooled separate accounts at end of year	2010-12-31	$3,747,067
Value of interest in pooled separate accounts at beginning of year	2010-12-31	$3,092,271
Interest on participant loans	2010-12-31	$10,071
Income. Interest from loans (other than to participants)	2010-12-31	$0
Interest earned on other investments	2010-12-31	$0
Income. Interest from US Government securities	2010-12-31	$0
Income. Interest from corporate debt instruments	2010-12-31	$0
Value of interest in master investment trust accounts at end of year	2010-12-31	$0
Value of interest in master investment trust accounts at beginning of year	2010-12-31	$0
Value of interest in common/collective trusts at end of year	2010-12-31	$0
Value of interest in common/collective trusts at beginning of year	2010-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2010-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2010-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2010-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2010-12-31	$1,676
Assets. Value of investments in 103.12 investment entities at end of year	2010-12-31	$0
Assets. Value of investments in 103.12 investment entities at beginning of year	2010-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2010-12-31	$46,486
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2010-12-31	$107,182
Expenses. Payments to insurance carriers foe the provision of benefits	2010-12-31	$0
Asset value of US Government securities at end of year	2010-12-31	$0
Asset value of US Government securities at beginning of year	2010-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2010-12-31	$0
Net investment gain/loss from pooled separate accounts	2010-12-31	$440,686
Net investment gain or loss from common/collective trusts	2010-12-31	$0
Net gain/loss from 103.12 investment entities	2010-12-31	$0
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	No
Has the plan failed to provide any benefit when due under the plan	2010-12-31	No
Assets. Invements in employer securities at end of year	2010-12-31	$0
Assets. Invements in employer securities at beginning of year	2010-12-31	$0
Assets. Value of employer real property at end of year	2010-12-31	$0
Assets. Value of employer real property at beginning of year	2010-12-31	$0
Contributions received in cash from employer	2010-12-31	$64,890
Employer contributions (assets) at end of year	2010-12-31	$1,245
Employer contributions (assets) at beginning of year	2010-12-31	$-361
Income. Dividends from preferred stock	2010-12-31	$0
Income. Dividends from common stock	2010-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$310,113
Asset. Corporate debt instrument preferred debt at end of year	2010-12-31	$0
Asset. Corporate debt instrument preferred debt at beginning of year	2010-12-31	$0
Asset. Corporate debt instrument debt (other) at end of year	2010-12-31	$0
Asset. Corporate debt instrument debt (other) at beginning of year	2010-12-31	$0
Contract administrator fees	2010-12-31	$0
Assets. Corporate common stocks other than exployer securities at end of year	2010-12-31	$0
Assets. Corporate common stocks other than exployer securities at beginning of year	2010-12-31	$0
Liabilities. Value of benefit claims payable at end of year	2010-12-31	$0
Liabilities. Value of benefit claims payable at beginning of year	2010-12-31	$0
Assets. Value of buildings and other operty used in plan operation at end of year	2010-12-31	$0
Assets. Value of buildings and other operty used in plan operation at beginning of year	2010-12-31	$0
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
Aggregate proceeds on sale of assets	2010-12-31	$0
Aggregate carrying amount (costs) on sale of assets	2010-12-31	$0
Liabilities. Value of acquisition indebtedness at end of year	2010-12-31	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2010-12-31	$0
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	BONADIO & CO., LLP
Accountancy firm EIN	2010-12-31	161131146

Form 5500 Responses for NORTHERN SAFETY SAVINGS & RETIREMENT PLAN

2016: NORTHERN SAFETY SAVINGS & RETIREMENT PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: NORTHERN SAFETY SAVINGS & RETIREMENT PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: NORTHERN SAFETY SAVINGS & RETIREMENT PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
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
2013: NORTHERN SAFETY SAVINGS & RETIREMENT PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: NORTHERN SAFETY SAVINGS & RETIREMENT PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	No
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: NORTHERN SAFETY SAVINGS & RETIREMENT 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
2010: NORTHERN SAFETY SAVINGS & RETIREMENT 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 – Insurance	Yes
2010-01-01	Plan funding arrangement – Trust	Yes
2010-01-01	Plan benefit arrangement – Insurance	Yes
2010-01-01	Plan benefit arrangement - Trust	Yes
2009: NORTHERN SAFETY SAVINGS & RETIREMENT 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

714209

Policy instance

Insurance contract or identification number	714209
Number of Individuals Covered	406
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $27,277
Total amount of fees paid to insurance company	USD $2,728
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $27,277
Insurance broker organization code?	3
Amount paid for insurance broker fees	2728
Additional information about fees paid to insurance broker	REFERRAL/SERVICE FEE
Insurance broker name	SECURITY ADMINISTRATORS, INC.

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )

Policy contract number

613953

Policy instance

Insurance contract or identification number	613953
Number of Individuals Covered	406
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $1,967
Total amount of fees paid to insurance company	USD $197
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,967
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Additional information about fees paid to insurance broker	REFERRAL/SERVICE FEE
Insurance broker name	SECURITY ADMINISTRATORS, INC.

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )

Policy contract number

714209

Policy instance

Insurance contract or identification number	714209
Number of Individuals Covered	411
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $24,000
Total amount of fees paid to insurance company	USD $2,400
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $24,000
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Additional information about fees paid to insurance broker	SERVICE FEE
Insurance broker name	SECURITY ADMINISTRATORS, INC.

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )

Policy contract number

613953

Policy instance

Insurance contract or identification number	613953
Number of Individuals Covered	411
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $1,601
Total amount of fees paid to insurance company	USD $160
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,601
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Additional information about fees paid to insurance broker	SERVICE FEE
Insurance broker name	SECURITY ADMINISTRATORS, INC.

VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )

Policy contract number

878801

Policy instance

Insurance contract or identification number	878801
Number of Individuals Covered	0
Insurance policy start date	2013-01-01
Insurance policy end date	2013-08-06
Total amount of commissions paid to insurance broker	USD $330
Total amount of fees paid to insurance company	USD $0
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $330
Insurance broker organization code?	3
Insurance broker name	ROYAL ALLIANCE ASSOC.

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )

Policy contract number

613953

Policy instance

Insurance contract or identification number	613953
Number of Individuals Covered	391
Insurance policy start date	2013-08-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $4,614
Total amount of fees paid to insurance company	USD $4,983
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,614
Amount paid for insurance broker fees	1553
Additional information about fees paid to insurance broker	REFERRAL/SERVICE FEE
Insurance broker organization code?	3
Insurance broker name	SECURITY ADMINISTRATORS, INC.

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )

Policy contract number

714209

Policy instance

Insurance contract or identification number	714209
Number of Individuals Covered	391
Insurance policy start date	2013-08-01
Insurance policy end date	2013-12-31
Total amount of fees paid to insurance company	USD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )

Policy contract number

878801

Policy instance

Insurance contract or identification number	878801
Number of Individuals Covered	215
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $32,028
Total amount of fees paid to insurance company	USD $0
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Commission paid to Insurance Broker	USD $32,028
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Insurance broker name	ROYAL ALLIANCE ASSOC.

VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )

Policy contract number

878801

Policy instance

Insurance contract or identification number	878801
Number of Individuals Covered	208
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $24,200
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes

VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )

Policy contract number

878801

Policy instance

Insurance contract or identification number	878801
Number of Individuals Covered	151
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $19,627
Total amount of fees paid to insurance company	USD $0
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Commission paid to Insurance Broker	USD $19,627
Insurance broker organization code?	3
Insurance broker name	ROYAL ALLIANCE ASSOCIATES, INC.

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Company Name:	NORTHERN SAFETY CO., INC.
Employer identification number (EIN):	161214814
NAIC Classification:	423990
NAIC Description:	Other Miscellaneous Durable Goods Merchant Wholesalers

Jurisdiction of Incorporation:	New York Department of State
Incorporation Date:	1983-10-27
Company Identification Number:	877215
Legal Registered Office Address:	80 STATE STREET Herkimer ALBANY United States of America (USA) 12207