401k Plan data: CAPITOL CONCRETE CONTRACTORS, INC. 401(K) PLAN plan

CAPITOL CONCRETE CONTRACTORS, INC. 401(K) PLAN 401k Plan overview

Plan Name	CAPITOL CONCRETE CONTRACTORS, INC. 401(K) PLAN
Plan identification number	001

CAPITOL CONCRETE CONTRACTORS, INC. 401(K) 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.
Participant-directed brokerage accounts provided as an investment option under the plan.
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

CAPITOL CONCRETE CONTRACTORS, INC. has sponsored the creation of one or more 401k plans.

Company Name: CAPITOL CONCRETE CONTRACTORS, INC.

Employer identification number (EIN): 200362187

NAIC Classification: 236200

Additional information about CAPITOL CONCRETE CONTRACTORS, INC.

Jurisdiction of Incorporation: Texas Secretary of State

Incorporation Date: 2003-10-31

Company Identification Number: 0800264282

Legal Registered Office Address: 4260 COUNTY ROAD 236

LIBERTY HILL
United States of America (USA)
78642

More information about CAPITOL CONCRETE CONTRACTORS, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CAPITOL CONCRETE CONTRACTORS, INC. 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2022-01-01 JORDAN MOORE 2023-10-12
001 2021-01-01
001 2020-01-01
001 2019-01-01 JORDAN MOORE 2020-10-15
001 2018-01-01 SANDRA MOORE 2019-10-15

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
001	2022-01-01	JORDAN MOORE	2023-10-12
001	2021-01-01
001	2020-01-01
001	2019-01-01	JORDAN MOORE	2020-10-15
001	2018-01-01	SANDRA MOORE	2019-10-15

Plan Statistics for CAPITOL CONCRETE CONTRACTORS, INC. 401(K) PLAN

401k plan membership statisitcs for CAPITOL CONCRETE CONTRACTORS, INC. 401(K) PLAN

Measure Date Value
2020: CAPITOL CONCRETE CONTRACTORS, INC. 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 157
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 158
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 0
Total of all active and inactive participants 2020-01-01 158
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 158
Number of participants with account balances 2020-01-01 12
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 0
2019: CAPITOL CONCRETE CONTRACTORS, INC. 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 177
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 140
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 0
Total of all active and inactive participants 2019-01-01 140
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 140
Number of participants with account balances 2019-01-01 11
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 0
2018: CAPITOL CONCRETE CONTRACTORS, INC. 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 139
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 176
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 0
Total of all active and inactive participants 2018-01-01 176
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 176
Number of participants with account balances 2018-01-01 5
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 0

Measure	Date	Value
2020: CAPITOL CONCRETE CONTRACTORS, INC. 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	157
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	158
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	0
Total of all active and inactive participants	2020-01-01	158
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	158
Number of participants with account balances	2020-01-01	12
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	0
2019: CAPITOL CONCRETE CONTRACTORS, INC. 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	177
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	140
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	0
Total of all active and inactive participants	2019-01-01	140
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	140
Number of participants with account balances	2019-01-01	11
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	0
2018: CAPITOL CONCRETE CONTRACTORS, INC. 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	139
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	176
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	0
Total of all active and inactive participants	2018-01-01	176
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	176
Number of participants with account balances	2018-01-01	5
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	0

Financial Data on CAPITOL CONCRETE CONTRACTORS, INC. 401(K) PLAN

Measure	Date	Value
2020 : CAPITOL CONCRETE CONTRACTORS, INC. 401(K) 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	$124,212
Total loss/gain on sale of assets	2020-12-31	$0
Total of all expenses incurred	2020-12-31	$1,942
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$95,851
Value of total assets at end of year	2020-12-31	$185,415
Value of total assets at beginning of year	2020-12-31	$63,145
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$1,942
Total interest from all sources	2020-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2020-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2020-12-31	No
Was this plan covered by a fidelity bond	2020-12-31	No
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	$61,754
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	$122,270
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$185,415
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$63,145
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
Investment advisory and management fees	2020-12-31	$607
Value of interest in registered invesment companies (eg mutual funds) at end of year	2020-12-31	$185,415
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-12-31	$63,145
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2020-12-31	$28,361
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	$34,097
Contract administrator fees	2020-12-31	$1,335
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	MORRISON, FRIEDRICH AND SPINN, CPA
Accountancy firm EIN	2020-12-31	453276056
2019 : CAPITOL CONCRETE CONTRACTORS, INC. 401(K) 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	$63,183
Total loss/gain on sale of assets	2019-12-31	$0
Total of all expenses incurred	2019-12-31	$555
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$58,386
Value of total assets at end of year	2019-12-31	$63,145
Value of total assets at beginning of year	2019-12-31	$517
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$555
Total interest from all sources	2019-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
Was this plan covered by a fidelity bond	2019-12-31	No
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	$30,464
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$10,884
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	$62,628
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$63,145
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$517
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
Investment advisory and management fees	2019-12-31	$145
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$63,145
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$517
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$4,797
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	$17,038
Contract administrator fees	2019-12-31	$410
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	MORRISON, FRIEDRICH AND SPINN, CPA
Accountancy firm EIN	2019-12-31	453276056
2018 : CAPITOL CONCRETE CONTRACTORS, INC. 401(K) PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets	2018-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$0
Total income from all sources (including contributions)	2018-12-31	$517
Total loss/gain on sale of assets	2018-12-31	$0
Total of all expenses incurred	2018-12-31	$0
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$527
Value of total assets at end of year	2018-12-31	$517
Value of total assets at beginning of year	2018-12-31	$0
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$0
Total interest from all sources	2018-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2018-12-31	$0
Was this plan covered by a fidelity bond	2018-12-31	No
If this is an individual account plan, was there a blackout period	2018-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2018-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2018-12-31	No
Contributions received from participants	2018-12-31	$527
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Value of net income/loss	2018-12-31	$517
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$517
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2018-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2018-12-31	No
Were any leases to which the plan was party in default or uncollectible	2018-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2018-12-31	$517
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2018-12-31	$-10
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2018-12-31	No
Was there a failure to transmit to the plan any participant contributions	2018-12-31	No
Has the plan failed to provide any benefit when due under the plan	2018-12-31	No
Did the plan have assets held for investment	2018-12-31	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	2018-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2018-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2018-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2018-12-31	Disclaimer
Accountancy firm name	2018-12-31	MORRISON, FRIEDRICH AND SPINN, CPA
Accountancy firm EIN	2018-12-31	453276056

Form 5500 Responses for CAPITOL CONCRETE CONTRACTORS, INC. 401(K) PLAN

2020: CAPITOL CONCRETE CONTRACTORS, INC. 401(K) 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 – Insurance	Yes
2020-01-01	Plan funding arrangement – Trust	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement - Trust	Yes
2019: CAPITOL CONCRETE CONTRACTORS, INC. 401(K) 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 – Insurance	Yes
2019-01-01	Plan funding arrangement – Trust	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement - Trust	Yes
2018: CAPITOL CONCRETE CONTRACTORS, INC. 401(K) PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	First time form 5500 has been submitted	Yes
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 – Insurance	Yes
2018-01-01	Plan funding arrangement – Trust	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2018-01-01	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

136801

Policy instance

Insurance contract or identification number	136801
Number of Individuals Covered	12
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $53
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $53
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	OTHER ALLOWANCES
Insurance broker organization code?	5

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

136801

Policy instance

Insurance contract or identification number	136801
Number of Individuals Covered	11
Insurance policy start date	2019-11-19
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $23
Total amount of fees paid to insurance company	USD $380
Are there contracts with allocated funds for individual policies?	0
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $23
Amount paid for insurance broker fees	380
Additional information about fees paid to insurance broker	OTHER ALLOWANCES
Insurance broker organization code?	5

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

136801

Policy instance

Insurance contract or identification number	136801
Number of Individuals Covered	6
Insurance policy start date	2018-11-19
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $2
Total amount of fees paid to insurance company	USD $34
Are there contracts with allocated funds for individual policies?	0
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2
Amount paid for insurance broker fees	34
Additional information about fees paid to insurance broker	OTHER ALLOWANCES
Insurance broker organization code?	5

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Company Name:	CAPITOL CONCRETE CONTRACTORS, INC.
Employer identification number (EIN):	200362187
NAIC Classification:	236200

Jurisdiction of Incorporation:	Texas Secretary of State
Incorporation Date:	2003-10-31
Company Identification Number:	0800264282
Legal Registered Office Address:	4260 COUNTY ROAD 236 LIBERTY HILL United States of America (USA) 78642