401k Plan data: NORTHERN EAGLE BEVERAGE COMPANY, INC. plan

NORTHERN EAGLE BEVERAGE COMPANY, INC. 401k Plan overview

Plan Name	NORTHERN EAGLE BEVERAGE COMPANY, INC.
Plan identification number	501

NORTHERN EAGLE BEVERAGE COMPANY, INC. Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Dental Vision Long-term disability cover Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

NORTHERN EAGLE BEVERAGE COMPANY has sponsored the creation of one or more 401k plans.

Company Name: NORTHERN EAGLE BEVERAGE COMPANY

Employer identification number (EIN): 223232686

NAIC Classification: 424800

Form 5500 Filing Information

Submission information for form 5500 for 401k plan NORTHERN EAGLE BEVERAGE COMPANY, INC.

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2020-01-01 CHRISTOPHER QUINN 2021-02-12 CHRISTOPHER QUINN 2021-02-12

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
501	2020-01-01	CHRISTOPHER QUINN	2021-02-12	CHRISTOPHER QUINN	2021-02-12

Plan Statistics for NORTHERN EAGLE BEVERAGE COMPANY, INC.

401k plan membership statisitcs for NORTHERN EAGLE BEVERAGE COMPANY, INC.

Measure Date Value
2020: NORTHERN EAGLE BEVERAGE COMPANY, INC. 2020 401k membership
Total participants, beginning-of-year 2020-01-01 91
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 100
Total of all active and inactive participants 2020-01-01 100

Measure	Date	Value
2020: NORTHERN EAGLE BEVERAGE COMPANY, INC. 2020 401k membership
Total participants, beginning-of-year	2020-01-01	91
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	100
Total of all active and inactive participants	2020-01-01	100

Form 5500 Responses for NORTHERN EAGLE BEVERAGE COMPANY, INC.

2020: NORTHERN EAGLE BEVERAGE COMPANY, INC. 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	First time form 5500 has been submitted	Yes
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

00473750

Policy instance

Insurance contract or identification number	00473750
Number of Individuals Covered	100
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $11,315
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $53,232
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $11,315
Insurance broker organization code?	3

Potentially related plans

NORTHERN EAGLE BEVERAGES, INC. 401(K) PLAN [EIN = 150525837]

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Company Name:	NORTHERN EAGLE BEVERAGE COMPANY
Employer identification number (EIN):	223232686
NAIC Classification:	424800