401k Plan data: AGATE RESOURCES, INC. 401(K) PROFIT SHARING PLAN plan

AGATE RESOURCES, INC. 401(K) PROFIT SHARING PLAN 401k Plan overview

Plan Name	AGATE RESOURCES, INC. 401(K) PROFIT SHARING PLAN
Plan identification number	002

AGATE RESOURCES, INC. 401(K) PROFIT SHARING PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Profit-sharing
ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

401k Sponsoring company profile

AGATE RESOURCES, INC. has sponsored the creation of one or more 401k plans.

Company Name: AGATE RESOURCES, INC.

Employer identification number (EIN): 200483299

NAIC Classification: 621399
NAIC Description: Offices of All Other Miscellaneous Health Practitioners

Additional information about AGATE RESOURCES, INC.

Jurisdiction of Incorporation: Oregon Secretary of State Corporations Division

Incorporation Date: 2003-12-12

Company Identification Number: 18893099

Legal Registered Office Address: 780 COMMERCIAL ST SE STE 100

SALEM
United States of America (USA)
97301

More information about AGATE RESOURCES, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan AGATE RESOURCES, INC. 401(K) PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2016-01-01
002 2015-01-01
002 2015-01-01
002 2014-01-01 DAVID L COLE
002 2013-01-01 TERRY W. COPLIN 2014-07-24
002 2012-01-01 TERRY W. COPLIN
002 2011-01-01 SHANNON DOLAN
002 2010-01-01 DAVID L. COLE DAVID L. COLE 2011-10-10
002 2009-01-01 DAVID COLE
002 2009-01-01 DAVID COLE 2010-10-13

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
002	2016-01-01
002	2015-01-01
002	2015-01-01
002	2014-01-01	DAVID L COLE
002	2013-01-01	TERRY W. COPLIN	2014-07-24
002	2012-01-01	TERRY W. COPLIN
002	2011-01-01	SHANNON DOLAN
002	2010-01-01	DAVID L. COLE		DAVID L. COLE	2011-10-10
002	2009-01-01	DAVID COLE
002	2009-01-01			DAVID COLE	2010-10-13

Plan Statistics for AGATE RESOURCES, INC. 401(K) PROFIT SHARING PLAN

401k plan membership statisitcs for AGATE RESOURCES, INC. 401(K) PROFIT SHARING PLAN

Measure Date Value
2016: AGATE RESOURCES, INC. 401(K) PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 252
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 0
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 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 0
Number of participants with account balances 2016-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 0
2015: AGATE RESOURCES, INC. 401(K) PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 245
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 215
Number of retired or separated participants receiving benefits 2015-01-01 37
Number of other retired or separated participants entitled to future benefits 2015-01-01 0
Total of all active and inactive participants 2015-01-01 252
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 252
Number of participants with account balances 2015-01-01 204
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 11
2014: AGATE RESOURCES, INC. 401(K) PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 217
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 199
Number of retired or separated participants receiving benefits 2014-01-01 43
Number of other retired or separated participants entitled to future benefits 2014-01-01 4
Total of all active and inactive participants 2014-01-01 246
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 246
Number of participants with account balances 2014-01-01 203
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 12
2012: AGATE RESOURCES, INC. 401(K) PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 109
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 67
Number of retired or separated participants receiving benefits 2012-01-01 0
Number of other retired or separated participants entitled to future benefits 2012-01-01 27
Total of all active and inactive participants 2012-01-01 94
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 94
Number of participants with account balances 2012-01-01 94
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 2
2011: AGATE RESOURCES, INC. 401(K) PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 115
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 71
Number of retired or separated participants receiving benefits 2011-01-01 0
Number of other retired or separated participants entitled to future benefits 2011-01-01 38
Total of all active and inactive participants 2011-01-01 109
Total participants 2011-01-01 109
Number of participants with account balances 2011-01-01 109
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 3
2010: AGATE RESOURCES, INC. 401(K) PROFIT SHARING PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 102
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 74
Number of other retired or separated participants entitled to future benefits 2010-01-01 19
Total of all active and inactive participants 2010-01-01 93
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 93
Number of participants with account balances 2010-01-01 93
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 2
2009: AGATE RESOURCES, INC. 401(K) PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 136
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 126
Number of retired or separated participants receiving benefits 2009-01-01 0
Number of other retired or separated participants entitled to future benefits 2009-01-01 25
Total of all active and inactive participants 2009-01-01 151
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 151
Number of participants with account balances 2009-01-01 130

Measure	Date	Value
2016: AGATE RESOURCES, INC. 401(K) PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	252
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	0
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	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	0
Number of participants with account balances	2016-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	0
2015: AGATE RESOURCES, INC. 401(K) PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	245
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	215
Number of retired or separated participants receiving benefits	2015-01-01	37
Number of other retired or separated participants entitled to future benefits	2015-01-01	0
Total of all active and inactive participants	2015-01-01	252
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	252
Number of participants with account balances	2015-01-01	204
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	11
2014: AGATE RESOURCES, INC. 401(K) PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	217
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	199
Number of retired or separated participants receiving benefits	2014-01-01	43
Number of other retired or separated participants entitled to future benefits	2014-01-01	4
Total of all active and inactive participants	2014-01-01	246
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	246
Number of participants with account balances	2014-01-01	203
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	12
2012: AGATE RESOURCES, INC. 401(K) PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	109
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	67
Number of retired or separated participants receiving benefits	2012-01-01	0
Number of other retired or separated participants entitled to future benefits	2012-01-01	27
Total of all active and inactive participants	2012-01-01	94
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	94
Number of participants with account balances	2012-01-01	94
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	2
2011: AGATE RESOURCES, INC. 401(K) PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	115
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	71
Number of retired or separated participants receiving benefits	2011-01-01	0
Number of other retired or separated participants entitled to future benefits	2011-01-01	38
Total of all active and inactive participants	2011-01-01	109
Total participants	2011-01-01	109
Number of participants with account balances	2011-01-01	109
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	3
2010: AGATE RESOURCES, INC. 401(K) PROFIT SHARING PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	102
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	74
Number of other retired or separated participants entitled to future benefits	2010-01-01	19
Total of all active and inactive participants	2010-01-01	93
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	93
Number of participants with account balances	2010-01-01	93
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	2
2009: AGATE RESOURCES, INC. 401(K) PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	136
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	126
Number of retired or separated participants receiving benefits	2009-01-01	0
Number of other retired or separated participants entitled to future benefits	2009-01-01	25
Total of all active and inactive participants	2009-01-01	151
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	151
Number of participants with account balances	2009-01-01	130

Financial Data on AGATE RESOURCES, INC. 401(K) PROFIT SHARING PLAN

Measure	Date	Value
2016 : AGATE RESOURCES, INC. 401(K) PROFIT SHARING PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets	2016-12-31	$0
Total transfer of assets from this plan	2016-12-31	$8,201,478
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$16,769
Total income from all sources (including contributions)	2016-12-31	$2,520
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$475,892
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$475,892
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$0
Value of total assets at end of year	2016-12-31	$0
Value of total assets at beginning of year	2016-12-31	$8,691,619
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$0
Total interest from all sources	2016-12-31	$2,520
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-12-31	No
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$500,000
If this is an individual account plan, was there a blackout period	2016-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Participant contributions at end of year	2016-12-31	$0
Participant contributions at beginning of year	2016-12-31	$347,274
Participant contributions at end of year	2016-12-31	$0
Participant contributions at beginning of year	2016-12-31	$13,238
Assets. Other investments not covered elsewhere at end of year	2016-12-31	$0
Assets. Other investments not covered elsewhere at beginning of year	2016-12-31	$7,358,759
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2016-12-31	$475,892
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	$3,240
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2016-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2016-12-31	$16,769
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	$-473,372
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$0
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$8,674,850
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
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2016-12-31	$2,520
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	$947,639
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	Yes
Has the plan failed to provide any benefit when due under the plan	2016-12-31	No
Employer contributions (assets) at end of year	2016-12-31	$0
Employer contributions (assets) at beginning of year	2016-12-31	$21,469
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	No
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	BROWN SMITH WALLACE LLP
Accountancy firm EIN	2016-12-31	431001367
2015 : AGATE RESOURCES, INC. 401(K) PROFIT SHARING PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets	2015-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Total income from all sources (including contributions)	2015-12-31	$1,235,461
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$503,504
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$441,673
Value of total corrective distributions	2015-12-31	$5,227
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$1,293,598
Value of total assets at end of year	2015-12-31	$8,218,274
Value of total assets at beginning of year	2015-12-31	$7,486,317
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$56,604
Total interest from all sources	2015-12-31	$25,613
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$250,148
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-12-31	No
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	Yes
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2015-12-31	No
Contributions received from participants	2015-12-31	$481,209
Participant contributions at end of year	2015-12-31	$347,274
Participant contributions at beginning of year	2015-12-31	$404,885
Participant contributions at end of year	2015-12-31	$13,238
Participant contributions at beginning of year	2015-12-31	$0
Assets. Other investments not covered elsewhere at end of year	2015-12-31	$7,359,682
Assets. Other investments not covered elsewhere at beginning of year	2015-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2015-12-31	$173,103
Value of other receiveables (less allowance for doubtful accounts) at end of year	2015-12-31	$3,240
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2015-12-31	$1,064
Other income not declared elsewhere	2015-12-31	$9,159
Administrative expenses (other) incurred	2015-12-31	$6,410
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Value of net income/loss	2015-12-31	$731,957
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$8,218,274
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$7,486,317
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	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-12-31	$6,686,384
Interest on participant loans	2015-12-31	$20,649
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2015-12-31	$4,964
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-12-31	$473,371
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-12-31	$392,458
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2015-12-31	$-343,057
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	Yes
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	$639,286
Employer contributions (assets) at end of year	2015-12-31	$21,469
Employer contributions (assets) at beginning of year	2015-12-31	$1,526
Income. Dividends from common stock	2015-12-31	$250,148
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$441,673
Contract administrator fees	2015-12-31	$50,194
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	2015-12-31	Yes
Did the plan have assets held for investment	2015-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2015-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2015-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2015-12-31	Disclaimer
Accountancy firm name	2015-12-31	DOWSETT FOGG & DOLER, P.C.
Accountancy firm EIN	2015-12-31	931045126
2014 : AGATE RESOURCES, INC. 401(K) PROFIT SHARING PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets	2014-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$3,865
Total income from all sources (including contributions)	2014-12-31	$1,746,059
Total loss/gain on sale of assets	2014-12-31	$0
Total of all expenses incurred	2014-12-31	$1,512,207
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$1,485,945
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$1,132,973
Value of total assets at end of year	2014-12-31	$7,486,317
Value of total assets at beginning of year	2014-12-31	$7,256,330
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$26,262
Total interest from all sources	2014-12-31	$58,494
Total dividends received (eg from common stock, registered investment company shares)	2014-12-31	$181,836
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-12-31	No
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	Yes
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2014-12-31	No
Contributions received from participants	2014-12-31	$459,279
Participant contributions at end of year	2014-12-31	$404,885
Participant contributions at beginning of year	2014-12-31	$366,004
Participant contributions at end of year	2014-12-31	$0
Participant contributions at beginning of year	2014-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2014-12-31	$103,275
Value of other receiveables (less allowance for doubtful accounts) at end of year	2014-12-31	$1,064
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2014-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2014-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2014-12-31	$3,865
Other income not declared elsewhere	2014-12-31	$7,514
Administrative expenses (other) incurred	2014-12-31	$26,262
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	$233,852
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$7,486,317
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$7,252,465
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	$6,686,384
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-12-31	$0
Value of interest in pooled separate accounts at end of year	2014-12-31	$0
Value of interest in pooled separate accounts at beginning of year	2014-12-31	$5,865,000
Interest on participant loans	2014-12-31	$19,568
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2014-12-31	$38,926
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-12-31	$392,458
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-12-31	$1,025,326
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2014-12-31	$393,537
Net investment gain/loss from pooled separate accounts	2014-12-31	$-28,295
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	$570,419
Employer contributions (assets) at end of year	2014-12-31	$1,526
Employer contributions (assets) at beginning of year	2014-12-31	$0
Income. Dividends from common stock	2014-12-31	$181,836
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$1,485,945
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	2014-12-31	Yes
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	DOWSETT FOGG & DOLER, P.C.
Accountancy firm EIN	2014-12-31	931045126
2012 : AGATE RESOURCES, INC. 401(K) PROFIT SHARING PLAN 2012 401k financial data
Total unrealized appreciation/depreciation of assets	2012-12-31	$0
Total transfer of assets to this plan	2012-12-31	$2
Total transfer of assets from this plan	2012-12-31	$3,759
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$9,506
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$0
Total income from all sources (including contributions)	2012-12-31	$1,063,204
Total loss/gain on sale of assets	2012-12-31	$0
Total of all expenses incurred	2012-12-31	$303,405
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$265,867
Expenses. Certain deemed distributions of participant loans	2012-12-31	$26,117
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$494,704
Value of total assets at end of year	2012-12-31	$5,336,417
Value of total assets at beginning of year	2012-12-31	$4,570,869
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$11,421
Total interest from all sources	2012-12-31	$14,194
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
Administrative expenses professional fees incurred	2012-12-31	$11,421
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
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2012-12-31	No
Contributions received from participants	2012-12-31	$138,600
Participant contributions at end of year	2012-12-31	$263,870
Participant contributions at beginning of year	2012-12-31	$263,355
Participant contributions at end of year	2012-12-31	$0
Participant contributions at beginning of year	2012-12-31	$113
Income. Received or receivable in cash from other sources (including rollovers)	2012-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2012-12-31	$9,506
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2012-12-31	$0
Other income not declared elsewhere	2012-12-31	$34
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
Value of net income/loss	2012-12-31	$759,799
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$5,326,911
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$4,570,869
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
Value of interest in pooled separate accounts at end of year	2012-12-31	$4,250,274
Value of interest in pooled separate accounts at beginning of year	2012-12-31	$3,526,881
Interest on participant loans	2012-12-31	$14,194
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-12-31	$822,247
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-12-31	$779,329
Net investment gain/loss from pooled separate accounts	2012-12-31	$554,272
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	$356,104
Employer contributions (assets) at end of year	2012-12-31	$26
Employer contributions (assets) at beginning of year	2012-12-31	$1,191
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$265,867
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
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	DOWSETT FOGG & DOLER, P.C.
Accountancy firm EIN	2012-12-31	931045126
2011 : AGATE RESOURCES, INC. 401(K) PROFIT SHARING PLAN 2011 401k financial data
Total transfer of assets from this plan	2011-12-31	$110
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$10,599
Total income from all sources (including contributions)	2011-12-31	$371,234
Total of all expenses incurred	2011-12-31	$331,052
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$310,323
Expenses. Certain deemed distributions of participant loans	2011-12-31	$18,339
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$515,084
Value of total assets at end of year	2011-12-31	$4,570,869
Value of total assets at beginning of year	2011-12-31	$4,541,396
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$2,390
Total interest from all sources	2011-12-31	$28,227
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-12-31	No
Administrative expenses professional fees incurred	2011-12-31	$2,390
Was this plan covered by a fidelity bond	2011-12-31	Yes
Value of fidelity bond cover	2011-12-31	$500,000
If this is an individual account plan, was there a blackout period	2011-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2011-12-31	No
Contributions received from participants	2011-12-31	$126,057
Participant contributions at end of year	2011-12-31	$263,355
Participant contributions at beginning of year	2011-12-31	$234,336
Participant contributions at end of year	2011-12-31	$113
Participant contributions at beginning of year	2011-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2011-12-31	$425
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2011-12-31	$-9,820
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2011-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2011-12-31	$10,599
Other income not declared elsewhere	2011-12-31	$0
Administrative expenses (other) incurred	2011-12-31	$0
Total non interest bearing cash at end of year	2011-12-31	$0
Total non interest bearing cash 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	$40,182
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$4,570,869
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$4,530,797
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2011-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2011-12-31	No
Were any leases to which the plan was party in default or uncollectible	2011-12-31	No
Value of interest in pooled separate accounts at end of year	2011-12-31	$3,526,881
Value of interest in pooled separate accounts at beginning of year	2011-12-31	$3,860,780
Interest on participant loans	2011-12-31	$11,811
Interest earned on other investments	2011-12-31	$16,416
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2011-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-12-31	$779,329
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-12-31	$446,280
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2011-12-31	$324
Net investment gain/loss from pooled separate accounts	2011-12-31	$-172,401
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
Contributions received in cash from employer	2011-12-31	$388,602
Employer contributions (assets) at end of year	2011-12-31	$1,191
Employer contributions (assets) at beginning of year	2011-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$320,143
Contract administrator fees	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
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	DOWSETT FOGG & DOLER, P.C.
Accountancy firm EIN	2011-12-31	931045126
2010 : AGATE RESOURCES, INC. 401(K) PROFIT SHARING PLAN 2010 401k financial data
Total unrealized appreciation/depreciation of assets	2010-12-31	$0
Total transfer of assets from this plan	2010-12-31	$85,348
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$10,599
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$426
Total income from all sources (including contributions)	2010-12-31	$1,079,670
Total loss/gain on sale of assets	2010-12-31	$0
Total of all expenses incurred	2010-12-31	$73,842
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$71,207
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$575,837
Value of total assets at end of year	2010-12-31	$4,541,396
Value of total assets at beginning of year	2010-12-31	$3,610,743
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$2,635
Total interest from all sources	2010-12-31	$457,072
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
Administrative expenses professional fees incurred	2010-12-31	$2,635
Was this plan covered by a fidelity bond	2010-12-31	Yes
Value of fidelity bond cover	2010-12-31	$500,000
If this is an individual account plan, was there a blackout period	2010-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2010-12-31	No
Contributions received from participants	2010-12-31	$128,818
Participant contributions at end of year	2010-12-31	$234,336
Participant contributions at beginning of year	2010-12-31	$184,044
Income. Received or receivable in cash from other sources (including rollovers)	2010-12-31	$18
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2010-12-31	$10,599
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2010-12-31	$426
Total non interest bearing cash at end of year	2010-12-31	$0
Total non interest bearing cash at beginning of year	2010-12-31	$407
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Value of net income/loss	2010-12-31	$1,005,828
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$4,530,797
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$3,610,317
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2010-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2010-12-31	No
Were any leases to which the plan was party in default or uncollectible	2010-12-31	No
Value of interest in pooled separate accounts at end of year	2010-12-31	$3,860,780
Value of interest in pooled separate accounts at beginning of year	2010-12-31	$3,060,418
Interest on participant loans	2010-12-31	$10,792
Interest earned on other investments	2010-12-31	$446,280
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2010-12-31	$446,280
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2010-12-31	$357,324
Net investment gain/loss from pooled separate accounts	2010-12-31	$46,761
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
Contributions received in cash from employer	2010-12-31	$447,001
Employer contributions (assets) at end of year	2010-12-31	$0
Employer contributions (assets) at beginning of year	2010-12-31	$8,550
Income. Dividends from preferred stock	2010-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$71,207
Did the plan have assets held for investment	2010-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2010-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2010-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2010-12-31	Disclaimer
Accountancy firm name	2010-12-31	DOWSETT FOGG & DOLER, P.C.
Accountancy firm EIN	2010-12-31	931045126
2009 : AGATE RESOURCES, INC. 401(K) PROFIT SHARING PLAN 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2009-12-31	$0

Form 5500 Responses for AGATE RESOURCES, INC. 401(K) PROFIT SHARING PLAN

2016: AGATE RESOURCES, INC. 401(K) PROFIT SHARING PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	Yes
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: AGATE RESOURCES, INC. 401(K) PROFIT SHARING PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	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: AGATE RESOURCES, INC. 401(K) PROFIT SHARING 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
2012: AGATE RESOURCES, INC. 401(K) PROFIT SHARING 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: AGATE RESOURCES, INC. 401(K) PROFIT SHARING 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: AGATE RESOURCES, INC. 401(K) PROFIT SHARING 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: AGATE RESOURCES, INC. 401(K) PROFIT SHARING 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

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

336790-01

Policy instance

Insurance contract or identification number	336790-01
Number of Individuals Covered	1
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

336790-01

Policy instance

Insurance contract or identification number	336790-01
Number of Individuals Covered	18
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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

Policy contract number

PH9780

Policy instance

Insurance contract or identification number	PH9780
Number of Individuals Covered	0
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $2,009
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	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 $2,009
Insurance broker organization code?	3
Insurance broker name	C.E.S. INSURANCE AGENCY, INC

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

Policy contract number

GH5523

Policy instance

Insurance contract or identification number	GH5523
Number of Individuals Covered	0
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $288
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	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 $288
Insurance broker organization code?	3
Insurance broker name	C.E.S. INSURANCE AGENCY, INC.

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

Policy contract number

PH9780

Policy instance

Insurance contract or identification number	PH9780
Number of Individuals Covered	114
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $18,544
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $16,878
Insurance broker organization code?	3
Insurance broker name	C.E.S., INSURANCE AGENCY, INC.

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

Policy contract number

PH9780

Policy instance

Insurance contract or identification number	PH9780
Number of Individuals Covered	113
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $17,572
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

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

Policy contract number

PH9780

Policy instance

Insurance contract or identification number	PH9780
Number of Individuals Covered	93
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $14,738
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

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Company Name:	AGATE RESOURCES, INC.
Employer identification number (EIN):	200483299
NAIC Classification:	621399
NAIC Description:	Offices of All Other Miscellaneous Health Practitioners

Jurisdiction of Incorporation:	Oregon Secretary of State Corporations Division
Incorporation Date:	2003-12-12
Company Identification Number:	18893099
Legal Registered Office Address:	780 COMMERCIAL ST SE STE 100 SALEM United States of America (USA) 97301