401k Plan data: ISLANDAIRE, INC. 401(K) PLAN plan

ISLANDAIRE, INC. 401(K) PLAN 401k Plan overview

Plan Name	ISLANDAIRE, INC. 401(K) PLAN
Plan identification number	001

ISLANDAIRE, INC. 401(K) 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

RE HANSEN IND., INC DBA ISLANDAIRE has sponsored the creation of one or more 401k plans.

Company Name: RE HANSEN IND., INC DBA ISLANDAIRE

Employer identification number (EIN): 261709702

NAIC Classification: 333900

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ISLANDAIRE, 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 ELIZABETH GREENHOUSE 2023-10-10 ELIZABETH GREENHOUSE 2023-10-10
001 2021-01-01 ELIZABETH GREENHOUSE 2022-10-12 ELIZABETH GREENHOUSE 2022-10-12
001 2020-01-01 ELIZABETH GREENHOUSE 2021-10-14 ELIZABETH GREENHOUSE 2021-10-14
001 2019-01-01 DONNA THOMPSON 2020-10-14 DONNA THOMPSON 2020-10-14
001 2018-01-01 DONNA THOMPSON 2019-10-15 DONNA THOMPSON 2019-10-15
001 2017-01-01 DONNA THOMPSON 2018-10-02 DONNA THOMPSON 2018-10-02
001 2016-01-01 DONNA THOMPSON 2017-06-21 DONNA THOMPSON 2017-06-21
001 2015-01-01 DONNA THOMPSON 2016-08-12 DONNA THOMPSON 2016-08-12
001 2014-01-01 DONNA THOMPSON 2015-06-12 DONNA THOMPSON 2015-06-12
001 2013-01-01 DONNA THOMPSON 2014-09-15 DONNA THOMPSON 2014-09-15
001 2012-01-01 DONNA THOMPSON 2013-09-04 DONNA THOMPSON 2013-09-04
001 2011-01-01 DONNA THOMPSON 2012-09-18 DONNA THOMPSON 2012-09-18
001 2010-01-01 DONNA THOMPSON 2011-09-20 DONNA THOMPSON 2011-09-20

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2022-01-01	ELIZABETH GREENHOUSE	2023-10-10	ELIZABETH GREENHOUSE	2023-10-10
001	2021-01-01	ELIZABETH GREENHOUSE	2022-10-12	ELIZABETH GREENHOUSE	2022-10-12
001	2020-01-01	ELIZABETH GREENHOUSE	2021-10-14	ELIZABETH GREENHOUSE	2021-10-14
001	2019-01-01	DONNA THOMPSON	2020-10-14	DONNA THOMPSON	2020-10-14
001	2018-01-01	DONNA THOMPSON	2019-10-15	DONNA THOMPSON	2019-10-15
001	2017-01-01	DONNA THOMPSON	2018-10-02	DONNA THOMPSON	2018-10-02
001	2016-01-01	DONNA THOMPSON	2017-06-21	DONNA THOMPSON	2017-06-21
001	2015-01-01	DONNA THOMPSON	2016-08-12	DONNA THOMPSON	2016-08-12
001	2014-01-01	DONNA THOMPSON	2015-06-12	DONNA THOMPSON	2015-06-12
001	2013-01-01	DONNA THOMPSON	2014-09-15	DONNA THOMPSON	2014-09-15
001	2012-01-01	DONNA THOMPSON	2013-09-04	DONNA THOMPSON	2013-09-04
001	2011-01-01	DONNA THOMPSON	2012-09-18	DONNA THOMPSON	2012-09-18
001	2010-01-01	DONNA THOMPSON	2011-09-20	DONNA THOMPSON	2011-09-20

Plan Statistics for ISLANDAIRE, INC. 401(K) PLAN

401k plan membership statisitcs for ISLANDAIRE, INC. 401(K) PLAN

Measure Date Value
2022: ISLANDAIRE, INC. 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 133
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 152
Number of retired or separated participants receiving benefits 2022-01-01 0
Number of other retired or separated participants entitled to future benefits 2022-01-01 33
Total of all active and inactive participants 2022-01-01 185
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 0
Total participants 2022-01-01 185
Number of participants with account balances 2022-01-01 168
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 3
2021: ISLANDAIRE, INC. 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 162
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 120
Number of retired or separated participants receiving benefits 2021-01-01 0
Number of other retired or separated participants entitled to future benefits 2021-01-01 37
Total of all active and inactive participants 2021-01-01 157
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 157
Number of participants with account balances 2021-01-01 145
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 7
2020: ISLANDAIRE, INC. 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 156
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 135
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 22
Total of all active and inactive participants 2020-01-01 157
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 157
Number of participants with account balances 2020-01-01 144
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 8
2019: ISLANDAIRE, INC. 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 132
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 129
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 14
Total of all active and inactive participants 2019-01-01 143
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 143
Number of participants with account balances 2019-01-01 130
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 1
2018: ISLANDAIRE, INC. 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 124
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 113
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 10
Total of all active and inactive participants 2018-01-01 123
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 123
Number of participants with account balances 2018-01-01 109
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 4

Measure	Date	Value
2022: ISLANDAIRE, INC. 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	133
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	152
Number of retired or separated participants receiving benefits	2022-01-01	0
Number of other retired or separated participants entitled to future benefits	2022-01-01	33
Total of all active and inactive participants	2022-01-01	185
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	0
Total participants	2022-01-01	185
Number of participants with account balances	2022-01-01	168
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	3
2021: ISLANDAIRE, INC. 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	162
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	120
Number of retired or separated participants receiving benefits	2021-01-01	0
Number of other retired or separated participants entitled to future benefits	2021-01-01	37
Total of all active and inactive participants	2021-01-01	157
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	157
Number of participants with account balances	2021-01-01	145
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	7
2020: ISLANDAIRE, INC. 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	156
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	135
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	22
Total of all active and inactive participants	2020-01-01	157
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	157
Number of participants with account balances	2020-01-01	144
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	8
2019: ISLANDAIRE, INC. 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	132
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	129
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	14
Total of all active and inactive participants	2019-01-01	143
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	143
Number of participants with account balances	2019-01-01	130
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	1
2018: ISLANDAIRE, INC. 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	124
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	113
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	10
Total of all active and inactive participants	2018-01-01	123
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	123
Number of participants with account balances	2018-01-01	109
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	4

Financial Data on ISLANDAIRE, INC. 401(K) PLAN

Measure	Date	Value
2022 : ISLANDAIRE, INC. 401(K) PLAN 2022 401k financial data
Unrealized appreciation/depreciation of real estate assets	2022-12-31	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2022-12-31	$-702,913
Total unrealized appreciation/depreciation of assets	2022-12-31	$-702,913
Total transfer of assets to this plan	2022-12-31	$0
Total transfer of assets from this plan	2022-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$0
Expenses. Interest paid	2022-12-31	$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2022-12-31	$0
Total income from all sources (including contributions)	2022-12-31	$-1,352,026
Total loss/gain on sale of assets	2022-12-31	$-1,457,442
Total of all expenses incurred	2022-12-31	$2,324,408
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-31	$2,271,320
Expenses. Certain deemed distributions of participant loans	2022-12-31	$5,397
Value of total corrective distributions	2022-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-12-31	$794,137
Value of total assets at end of year	2022-12-31	$8,559,785
Value of total assets at beginning of year	2022-12-31	$12,236,219
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-12-31	$47,691
Total income from rents	2022-12-31	$0
Total interest from all sources	2022-12-31	$14,192
Total dividends received (eg from common stock, registered investment company shares)	2022-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2022-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2022-12-31	$0
Assets. Real estate other than employer real property at end of year	2022-12-31	$0
Assets. Real estate other than employer real property at beginning of year	2022-12-31	$0
Administrative expenses professional fees incurred	2022-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at end of year	2022-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year	2022-12-31	$0
Was this plan covered by a fidelity bond	2022-12-31	Yes
Value of fidelity bond cover	2022-12-31	$500,000
If this is an individual account plan, was there a blackout period	2022-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2022-12-31	No
Contributions received from participants	2022-12-31	$557,136
Participant contributions at end of year	2022-12-31	$284,634
Participant contributions at beginning of year	2022-12-31	$302,456
Participant contributions at end of year	2022-12-31	$0
Participant contributions at beginning of year	2022-12-31	$0
Assets. Other investments not covered elsewhere at end of year	2022-12-31	$0
Assets. Other investments not covered elsewhere at beginning of year	2022-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2022-12-31	$104,737
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2022-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2022-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2022-12-31	$0
Assets. Loans (other than to participants) at end of year	2022-12-31	$0
Assets. Loans (other than to participants) at beginning of year	2022-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2022-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2022-12-31	$0
Other income not declared elsewhere	2022-12-31	$0
Administrative expenses (other) incurred	2022-12-31	$47,691
Liabilities. Value of operating payables at end of year	2022-12-31	$0
Liabilities. Value of operating payables at beginning of year	2022-12-31	$0
Total non interest bearing cash at end of year	2022-12-31	$0
Total non interest bearing cash at beginning of year	2022-12-31	$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	2022-12-31	No
Income. Non cash contributions	2022-12-31	$0
Value of net income/loss	2022-12-31	$-3,676,434
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$8,559,785
Value of net assets at beginning of year (total assets less liabilities)	2022-12-31	$12,236,219
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2022-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2022-12-31	No
Were any leases to which the plan was party in default or uncollectible	2022-12-31	No
Assets. partnership/joint venture interests at end of year	2022-12-31	$0
Assets. partnership/joint venture interests at beginning of year	2022-12-31	$0
Investment advisory and management fees	2022-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2022-12-31	$7,731,730
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2022-12-31	$11,429,159
Value of interest in pooled separate accounts at end of year	2022-12-31	$0
Value of interest in pooled separate accounts at beginning of year	2022-12-31	$0
Interest on participant loans	2022-12-31	$14,192
Income. Interest from loans (other than to participants)	2022-12-31	$0
Interest earned on other investments	2022-12-31	$0
Income. Interest from US Government securities	2022-12-31	$0
Income. Interest from corporate debt instruments	2022-12-31	$0
Value of interest in master investment trust accounts at end of year	2022-12-31	$0
Value of interest in master investment trust accounts at beginning of year	2022-12-31	$0
Value of interest in common/collective trusts at end of year	2022-12-31	$0
Value of interest in common/collective trusts at beginning of year	2022-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2022-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2022-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2022-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2022-12-31	$0
Assets. Value of investments in 103.12 investment entities at end of year	2022-12-31	$0
Assets. Value of investments in 103.12 investment entities at beginning of year	2022-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2022-12-31	$543,421
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2022-12-31	$504,604
Expenses. Payments to insurance carriers foe the provision of benefits	2022-12-31	$0
Asset value of US Government securities at end of year	2022-12-31	$0
Asset value of US Government securities at beginning of year	2022-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2022-12-31	$0
Net investment gain/loss from pooled separate accounts	2022-12-31	$0
Net investment gain or loss from common/collective trusts	2022-12-31	$0
Net gain/loss from 103.12 investment entities	2022-12-31	$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2022-12-31	No
Was there a failure to transmit to the plan any participant contributions	2022-12-31	No
Has the plan failed to provide any benefit when due under the plan	2022-12-31	No
Assets. Invements in employer securities at end of year	2022-12-31	$0
Assets. Invements in employer securities at beginning of year	2022-12-31	$0
Assets. Value of employer real property at end of year	2022-12-31	$0
Assets. Value of employer real property at beginning of year	2022-12-31	$0
Contributions received in cash from employer	2022-12-31	$132,264
Employer contributions (assets) at end of year	2022-12-31	$0
Employer contributions (assets) at beginning of year	2022-12-31	$0
Income. Dividends from preferred stock	2022-12-31	$0
Income. Dividends from common stock	2022-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-12-31	$2,271,320
Asset. Corporate debt instrument preferred debt at end of year	2022-12-31	$0
Asset. Corporate debt instrument preferred debt at beginning of year	2022-12-31	$0
Asset. Corporate debt instrument debt (other) at end of year	2022-12-31	$0
Asset. Corporate debt instrument debt (other) at beginning of year	2022-12-31	$0
Contract administrator fees	2022-12-31	$0
Assets. Corporate common stocks other than exployer securities at end of year	2022-12-31	$0
Assets. Corporate common stocks other than exployer securities at beginning of year	2022-12-31	$0
Liabilities. Value of benefit claims payable at end of year	2022-12-31	$0
Liabilities. Value of benefit claims payable at beginning of year	2022-12-31	$0
Assets. Value of buildings and other operty used in plan operation at end of year	2022-12-31	$0
Assets. Value of buildings and other operty used in plan operation at beginning of year	2022-12-31	$0
Did the plan have assets held for investment	2022-12-31	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	2022-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2022-12-31	No
Aggregate proceeds on sale of assets	2022-12-31	$-1,457,442
Aggregate carrying amount (costs) on sale of assets	2022-12-31	$0
Liabilities. Value of acquisition indebtedness at end of year	2022-12-31	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2022-12-31	$0
Opinion of an independent qualified public accountant for this plan	2022-12-31	Unqualified
Accountancy firm name	2022-12-31	SAMUEL GOLDSTEIN & CO PC
Accountancy firm EIN	2022-12-31	112478817
2021 : ISLANDAIRE, INC. 401(K) PLAN 2021 401k financial data
Unrealized appreciation/depreciation of real estate assets	2021-12-31	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2021-12-31	$308,605
Total unrealized appreciation/depreciation of assets	2021-12-31	$308,605
Total transfer of assets to this plan	2021-12-31	$0
Total transfer of assets from this plan	2021-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$0
Expenses. Interest paid	2021-12-31	$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2021-12-31	$0
Total income from all sources (including contributions)	2021-12-31	$1,746,330
Total loss/gain on sale of assets	2021-12-31	$796,172
Total of all expenses incurred	2021-12-31	$531,183
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$501,782
Expenses. Certain deemed distributions of participant loans	2021-12-31	$5,058
Value of total corrective distributions	2021-12-31	$6,641
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$620,291
Value of total assets at end of year	2021-12-31	$12,236,219
Value of total assets at beginning of year	2021-12-31	$11,021,072
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$17,702
Total income from rents	2021-12-31	$0
Total interest from all sources	2021-12-31	$21,262
Total dividends received (eg from common stock, registered investment company shares)	2021-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2021-12-31	No
Assets. Real estate other than employer real property at end of year	2021-12-31	$0
Assets. Real estate other than employer real property at beginning of year	2021-12-31	$0
Administrative expenses professional fees incurred	2021-12-31	$17,702
Assets. Corporate prefeered stocks other than exployer securities at end of year	2021-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year	2021-12-31	$0
Was this plan covered by a fidelity bond	2021-12-31	Yes
Value of fidelity bond cover	2021-12-31	$500,000
If this is an individual account plan, was there a blackout period	2021-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2021-12-31	No
Contributions received from participants	2021-12-31	$494,292
Participant contributions at end of year	2021-12-31	$302,456
Participant contributions at beginning of year	2021-12-31	$316,107
Participant contributions at end of year	2021-12-31	$0
Participant contributions at beginning of year	2021-12-31	$0
Assets. Other investments not covered elsewhere at end of year	2021-12-31	$0
Assets. Other investments not covered elsewhere at beginning of year	2021-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2021-12-31	$16,339
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2021-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2021-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2021-12-31	$0
Assets. Loans (other than to participants) at end of year	2021-12-31	$0
Assets. Loans (other than to participants) at beginning of year	2021-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2021-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2021-12-31	$0
Other income not declared elsewhere	2021-12-31	$0
Administrative expenses (other) incurred	2021-12-31	$0
Liabilities. Value of operating payables at end of year	2021-12-31	$0
Liabilities. Value of operating payables at beginning of year	2021-12-31	$0
Total non interest bearing cash at end of year	2021-12-31	$0
Total non interest bearing cash at beginning of year	2021-12-31	$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	2021-12-31	No
Income. Non cash contributions	2021-12-31	$0
Value of net income/loss	2021-12-31	$1,215,147
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$12,236,219
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$11,021,072
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2021-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2021-12-31	No
Were any leases to which the plan was party in default or uncollectible	2021-12-31	No
Assets. partnership/joint venture interests at end of year	2021-12-31	$0
Assets. partnership/joint venture interests at beginning of year	2021-12-31	$0
Investment advisory and management fees	2021-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2021-12-31	$11,429,159
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-12-31	$10,351,490
Value of interest in pooled separate accounts at end of year	2021-12-31	$0
Value of interest in pooled separate accounts at beginning of year	2021-12-31	$0
Interest on participant loans	2021-12-31	$16,296
Income. Interest from loans (other than to participants)	2021-12-31	$0
Interest earned on other investments	2021-12-31	$4,966
Income. Interest from US Government securities	2021-12-31	$0
Income. Interest from corporate debt instruments	2021-12-31	$0
Value of interest in master investment trust accounts at end of year	2021-12-31	$0
Value of interest in master investment trust accounts at beginning of year	2021-12-31	$0
Value of interest in common/collective trusts at end of year	2021-12-31	$0
Value of interest in common/collective trusts at beginning of year	2021-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2021-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2021-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2021-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2021-12-31	$0
Assets. Value of investments in 103.12 investment entities at end of year	2021-12-31	$0
Assets. Value of investments in 103.12 investment entities at beginning of year	2021-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2021-12-31	$504,604
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2021-12-31	$335,965
Expenses. Payments to insurance carriers foe the provision of benefits	2021-12-31	$0
Asset value of US Government securities at end of year	2021-12-31	$0
Asset value of US Government securities at beginning of year	2021-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2021-12-31	$0
Net investment gain/loss from pooled separate accounts	2021-12-31	$0
Net investment gain or loss from common/collective trusts	2021-12-31	$0
Net gain/loss from 103.12 investment entities	2021-12-31	$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2021-12-31	No
Was there a failure to transmit to the plan any participant contributions	2021-12-31	No
Has the plan failed to provide any benefit when due under the plan	2021-12-31	No
Assets. Invements in employer securities at end of year	2021-12-31	$0
Assets. Invements in employer securities at beginning of year	2021-12-31	$0
Assets. Value of employer real property at end of year	2021-12-31	$0
Assets. Value of employer real property at beginning of year	2021-12-31	$0
Contributions received in cash from employer	2021-12-31	$109,660
Employer contributions (assets) at end of year	2021-12-31	$0
Employer contributions (assets) at beginning of year	2021-12-31	$17,510
Income. Dividends from preferred stock	2021-12-31	$0
Income. Dividends from common stock	2021-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$501,782
Asset. Corporate debt instrument preferred debt at end of year	2021-12-31	$0
Asset. Corporate debt instrument preferred debt at beginning of year	2021-12-31	$0
Asset. Corporate debt instrument debt (other) at end of year	2021-12-31	$0
Asset. Corporate debt instrument debt (other) at beginning of year	2021-12-31	$0
Contract administrator fees	2021-12-31	$0
Assets. Corporate common stocks other than exployer securities at end of year	2021-12-31	$0
Assets. Corporate common stocks other than exployer securities at beginning of year	2021-12-31	$0
Liabilities. Value of benefit claims payable at end of year	2021-12-31	$0
Liabilities. Value of benefit claims payable at beginning of year	2021-12-31	$0
Assets. Value of buildings and other operty used in plan operation at end of year	2021-12-31	$0
Assets. Value of buildings and other operty used in plan operation at beginning of year	2021-12-31	$0
Did the plan have assets held for investment	2021-12-31	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	2021-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2021-12-31	No
Aggregate proceeds on sale of assets	2021-12-31	$796,172
Aggregate carrying amount (costs) on sale of assets	2021-12-31	$0
Liabilities. Value of acquisition indebtedness at end of year	2021-12-31	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2021-12-31	$0
Opinion of an independent qualified public accountant for this plan	2021-12-31	Disclaimer
Accountancy firm name	2021-12-31	SAMUEL GOLDSTEIN & CO PC
Accountancy firm EIN	2021-12-31	112478817
2020 : ISLANDAIRE, INC. 401(K) PLAN 2020 401k financial data
Unrealized appreciation/depreciation of real estate assets	2020-12-31	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2020-12-31	$1,105,416
Total unrealized appreciation/depreciation of assets	2020-12-31	$1,105,416
Total transfer of assets to this plan	2020-12-31	$0
Total transfer of assets from this plan	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
Expenses. Interest paid	2020-12-31	$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2020-12-31	$0
Total income from all sources (including contributions)	2020-12-31	$2,168,515
Total loss/gain on sale of assets	2020-12-31	$0
Total of all expenses incurred	2020-12-31	$142,608
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$120,580
Expenses. Certain deemed distributions of participant loans	2020-12-31	$13,971
Value of total corrective distributions	2020-12-31	$5,232
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$611,277
Value of total assets at end of year	2020-12-31	$11,021,072
Value of total assets at beginning of year	2020-12-31	$8,995,165
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$2,825
Total income from rents	2020-12-31	$0
Total interest from all sources	2020-12-31	$21,487
Total dividends received (eg from common stock, registered investment company shares)	2020-12-31	$430,335
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2020-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2020-12-31	$430,335
Assets. Real estate other than employer real property at end of year	2020-12-31	$0
Assets. Real estate other than employer real property at beginning of year	2020-12-31	$0
Administrative expenses professional fees incurred	2020-12-31	$2,825
Assets. Corporate prefeered stocks other than exployer securities at end of year	2020-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year	2020-12-31	$0
Was this plan covered by a fidelity bond	2020-12-31	Yes
Value of fidelity bond cover	2020-12-31	$500,000
If this is an individual account plan, was there a blackout period	2020-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2020-12-31	No
Contributions received from participants	2020-12-31	$482,795
Participant contributions at end of year	2020-12-31	$316,107
Participant contributions at beginning of year	2020-12-31	$329,059
Participant contributions at end of year	2020-12-31	$0
Participant contributions at beginning of year	2020-12-31	$0
Assets. Other investments not covered elsewhere at end of year	2020-12-31	$0
Assets. Other investments not covered elsewhere at beginning of year	2020-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2020-12-31	$0
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2020-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2020-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2020-12-31	$0
Assets. Loans (other than to participants) at end of year	2020-12-31	$0
Assets. Loans (other than to participants) at beginning of year	2020-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2020-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2020-12-31	$0
Other income not declared elsewhere	2020-12-31	$0
Administrative expenses (other) incurred	2020-12-31	$0
Liabilities. Value of operating payables at end of year	2020-12-31	$0
Liabilities. Value of operating payables at beginning of year	2020-12-31	$0
Total non interest bearing cash at end of year	2020-12-31	$0
Total non interest bearing cash at beginning of year	2020-12-31	$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	2020-12-31	No
Income. Non cash contributions	2020-12-31	$0
Value of net income/loss	2020-12-31	$2,025,907
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$11,021,072
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$8,995,165
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
Assets. partnership/joint venture interests at end of year	2020-12-31	$0
Assets. partnership/joint venture interests at beginning of year	2020-12-31	$0
Investment advisory and management fees	2020-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2020-12-31	$10,351,490
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-12-31	$8,322,631
Value of interest in pooled separate accounts at end of year	2020-12-31	$0
Value of interest in pooled separate accounts at beginning of year	2020-12-31	$0
Interest on participant loans	2020-12-31	$17,139
Income. Interest from loans (other than to participants)	2020-12-31	$0
Interest earned on other investments	2020-12-31	$4,348
Income. Interest from US Government securities	2020-12-31	$0
Income. Interest from corporate debt instruments	2020-12-31	$0
Value of interest in master investment trust accounts at end of year	2020-12-31	$0
Value of interest in master investment trust accounts at beginning of year	2020-12-31	$0
Value of interest in common/collective trusts at end of year	2020-12-31	$0
Value of interest in common/collective trusts at beginning of year	2020-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2020-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2020-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2020-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2020-12-31	$0
Assets. Value of investments in 103.12 investment entities at end of year	2020-12-31	$0
Assets. Value of investments in 103.12 investment entities at beginning of year	2020-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2020-12-31	$335,965
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2020-12-31	$330,340
Expenses. Payments to insurance carriers foe the provision of benefits	2020-12-31	$0
Asset value of US Government securities at end of year	2020-12-31	$0
Asset value of US Government securities at beginning of year	2020-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2020-12-31	$0
Net investment gain/loss from pooled separate accounts	2020-12-31	$0
Net investment gain or loss from common/collective trusts	2020-12-31	$0
Net gain/loss from 103.12 investment entities	2020-12-31	$0
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
Assets. Invements in employer securities at end of year	2020-12-31	$0
Assets. Invements in employer securities at beginning of year	2020-12-31	$0
Assets. Value of employer real property at end of year	2020-12-31	$0
Assets. Value of employer real property at beginning of year	2020-12-31	$0
Contributions received in cash from employer	2020-12-31	$128,482
Employer contributions (assets) at end of year	2020-12-31	$17,510
Employer contributions (assets) at beginning of year	2020-12-31	$13,135
Income. Dividends from preferred stock	2020-12-31	$0
Income. Dividends from common stock	2020-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$120,580
Asset. Corporate debt instrument preferred debt at end of year	2020-12-31	$0
Asset. Corporate debt instrument preferred debt at beginning of year	2020-12-31	$0
Asset. Corporate debt instrument debt (other) at end of year	2020-12-31	$0
Asset. Corporate debt instrument debt (other) at beginning of year	2020-12-31	$0
Contract administrator fees	2020-12-31	$0
Assets. Corporate common stocks other than exployer securities at end of year	2020-12-31	$0
Assets. Corporate common stocks other than exployer securities at beginning of year	2020-12-31	$0
Liabilities. Value of benefit claims payable at end of year	2020-12-31	$0
Liabilities. Value of benefit claims payable at beginning of year	2020-12-31	$0
Assets. Value of buildings and other operty used in plan operation at end of year	2020-12-31	$0
Assets. Value of buildings and other operty used in plan operation at beginning of year	2020-12-31	$0
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
Aggregate proceeds on sale of assets	2020-12-31	$0
Aggregate carrying amount (costs) on sale of assets	2020-12-31	$0
Liabilities. Value of acquisition indebtedness at end of year	2020-12-31	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2020-12-31	$0
Opinion of an independent qualified public accountant for this plan	2020-12-31	Disclaimer
Accountancy firm name	2020-12-31	SAMUEL GOLDSTEIN & CO PC
Accountancy firm EIN	2020-12-31	112478817
2019 : ISLANDAIRE, INC. 401(K) PLAN 2019 401k financial data
Unrealized appreciation/depreciation of real estate assets	2019-12-31	$0
Unrealized appreciation/depreciation of real estate assets	2019-12-31	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2019-12-31	$1,161,861
Unrealized appreciation/depreciation of other (non real estate) assets	2019-12-31	$1,161,861
Total unrealized appreciation/depreciation of assets	2019-12-31	$1,161,861
Total unrealized appreciation/depreciation of assets	2019-12-31	$1,161,861
Total transfer of assets to this plan	2019-12-31	$0
Total transfer of assets to this plan	2019-12-31	$0
Total transfer of assets from this plan	2019-12-31	$0
Total transfer of assets from this plan	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 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 liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Expenses. Interest paid	2019-12-31	$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2019-12-31	$0
Expenses. Interest paid	2019-12-31	$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2019-12-31	$0
Total income from all sources (including contributions)	2019-12-31	$2,202,727
Total income from all sources (including contributions)	2019-12-31	$2,202,727
Total loss/gain on sale of assets	2019-12-31	$0
Total loss/gain on sale of assets	2019-12-31	$0
Total of all expenses incurred	2019-12-31	$140,723
Total of all expenses incurred	2019-12-31	$140,723
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$129,928
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$129,928
Expenses. Certain deemed distributions of participant loans	2019-12-31	$0
Expenses. Certain deemed distributions of participant loans	2019-12-31	$0
Value of total corrective distributions	2019-12-31	$7,657
Value of total corrective distributions	2019-12-31	$7,657
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$628,259
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$628,259
Value of total assets at end of year	2019-12-31	$8,995,165
Value of total assets at end of year	2019-12-31	$8,995,165
Value of total assets at beginning of year	2019-12-31	$6,933,161
Value of total assets at beginning of year	2019-12-31	$6,933,161
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$3,138
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$3,138
Total interest from all sources	2019-12-31	$21,946
Total interest from all sources	2019-12-31	$21,946
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$390,661
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$390,661
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2019-12-31	$390,661
Total dividends received from registered investment company shares (eg mutual funds)	2019-12-31	$390,661
Assets. Real estate other than employer real property at end of year	2019-12-31	$0
Assets. Real estate other than employer real property at end of year	2019-12-31	$0
Assets. Real estate other than employer real property at beginning of year	2019-12-31	$0
Assets. Real estate other than employer real property at beginning of year	2019-12-31	$0
Administrative expenses professional fees incurred	2019-12-31	$3,138
Administrative expenses professional fees incurred	2019-12-31	$3,138
Assets. Corporate prefeered stocks other than exployer securities at end of year	2019-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at end of year	2019-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year	2019-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year	2019-12-31	$0
Was this plan covered by a fidelity bond	2019-12-31	Yes
Was this plan covered by a fidelity bond	2019-12-31	Yes
Value of fidelity bond cover	2019-12-31	$500,000
Value of fidelity bond cover	2019-12-31	$500,000
If this is an individual account plan, was there a blackout period	2019-12-31	No
If this is an individual account plan, was there a blackout period	2019-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Contributions received from participants	2019-12-31	$500,482
Contributions received from participants	2019-12-31	$500,482
Participant contributions at end of year	2019-12-31	$329,059
Participant contributions at end of year	2019-12-31	$329,059
Participant contributions at beginning of year	2019-12-31	$298,432
Participant contributions at beginning of year	2019-12-31	$298,432
Participant contributions at end of year	2019-12-31	$0
Participant contributions at end of year	2019-12-31	$0
Participant contributions at beginning of year	2019-12-31	$0
Participant contributions at beginning of year	2019-12-31	$0
Assets. Other investments not covered elsewhere at end of year	2019-12-31	$0
Assets. Other investments not covered elsewhere at end of year	2019-12-31	$0
Assets. Other investments not covered elsewhere at beginning of year	2019-12-31	$0
Assets. Other investments not covered elsewhere at beginning of year	2019-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$2,312
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$2,312
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2019-12-31	$0
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2019-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2019-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2019-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2019-12-31	$0
Assets. Loans (other than to participants) at end of year	2019-12-31	$0
Assets. Loans (other than to participants) at end of year	2019-12-31	$0
Assets. Loans (other than to participants) at beginning of year	2019-12-31	$0
Assets. Loans (other than to participants) at beginning of year	2019-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2019-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2019-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2019-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2019-12-31	$0
Other income not declared elsewhere	2019-12-31	$0
Other income not declared elsewhere	2019-12-31	$0
Administrative expenses (other) incurred	2019-12-31	$0
Administrative expenses (other) incurred	2019-12-31	$0
Liabilities. Value of operating payables at end of year	2019-12-31	$0
Liabilities. Value of operating payables at end of year	2019-12-31	$0
Liabilities. Value of operating payables at beginning of year	2019-12-31	$0
Liabilities. Value of operating payables at beginning of year	2019-12-31	$0
Total non interest bearing cash at end of year	2019-12-31	$0
Total non interest bearing cash at end of year	2019-12-31	$0
Total non interest bearing cash at beginning of year	2019-12-31	$0
Total non interest bearing cash at beginning of year	2019-12-31	$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	2019-12-31	No
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
Income. Non cash contributions	2019-12-31	$0
Income. Non cash contributions	2019-12-31	$0
Value of net income/loss	2019-12-31	$2,062,004
Value of net income/loss	2019-12-31	$2,062,004
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$8,995,165
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$8,995,165
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$6,933,161
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$6,933,161
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
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 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
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Assets. partnership/joint venture interests at end of year	2019-12-31	$0
Assets. partnership/joint venture interests at end of year	2019-12-31	$0
Assets. partnership/joint venture interests at beginning of year	2019-12-31	$0
Assets. partnership/joint venture interests at beginning of year	2019-12-31	$0
Investment advisory and management fees	2019-12-31	$0
Investment advisory and management fees	2019-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$8,322,631
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$8,322,631
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$6,315,250
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$6,315,250
Value of interest in pooled separate accounts at end of year	2019-12-31	$0
Value of interest in pooled separate accounts at end of year	2019-12-31	$0
Value of interest in pooled separate accounts at beginning of year	2019-12-31	$0
Value of interest in pooled separate accounts at beginning of year	2019-12-31	$0
Interest on participant loans	2019-12-31	$18,140
Interest on participant loans	2019-12-31	$18,140
Income. Interest from loans (other than to participants)	2019-12-31	$0
Income. Interest from loans (other than to participants)	2019-12-31	$0
Interest earned on other investments	2019-12-31	$3,806
Interest earned on other investments	2019-12-31	$3,806
Income. Interest from US Government securities	2019-12-31	$0
Income. Interest from US Government securities	2019-12-31	$0
Income. Interest from corporate debt instruments	2019-12-31	$0
Income. Interest from corporate debt instruments	2019-12-31	$0
Value of interest in master investment trust accounts at end of year	2019-12-31	$0
Value of interest in master investment trust accounts at end of year	2019-12-31	$0
Value of interest in master investment trust accounts at beginning of year	2019-12-31	$0
Value of interest in master investment trust accounts at beginning of year	2019-12-31	$0
Value of interest in common/collective trusts at end of year	2019-12-31	$0
Value of interest in common/collective trusts at end of year	2019-12-31	$0
Value of interest in common/collective trusts at beginning of year	2019-12-31	$0
Value of interest in common/collective trusts at beginning of year	2019-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2019-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2019-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2019-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2019-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2019-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2019-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2019-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2019-12-31	$0
Assets. Value of investments in 103.12 investment entities at end of year	2019-12-31	$0
Assets. Value of investments in 103.12 investment entities at end of year	2019-12-31	$0
Assets. Value of investments in 103.12 investment entities at beginning of year	2019-12-31	$0
Assets. Value of investments in 103.12 investment entities at beginning of year	2019-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$330,340
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$330,340
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$315,990
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$315,990
Expenses. Payments to insurance carriers foe the provision of benefits	2019-12-31	$0
Expenses. Payments to insurance carriers foe the provision of benefits	2019-12-31	$0
Asset value of US Government securities at end of year	2019-12-31	$0
Asset value of US Government securities at end of year	2019-12-31	$0
Asset value of US Government securities at beginning of year	2019-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$0
Net investment gain/loss from pooled separate accounts	2019-12-31	$0
Net investment gain/loss from pooled separate accounts	2019-12-31	$0
Net investment gain or loss from common/collective trusts	2019-12-31	$0
Net investment gain or loss from common/collective trusts	2019-12-31	$0
Net gain/loss from 103.12 investment entities	2019-12-31	$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-12-31	No
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
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
Has the plan failed to provide any benefit when due under the plan	2019-12-31	No
Assets. Invements in employer securities at end of year	2019-12-31	$0
Assets. Invements in employer securities at end of year	2019-12-31	$0
Assets. Invements in employer securities at beginning of year	2019-12-31	$0
Assets. Invements in employer securities at beginning of year	2019-12-31	$0
Assets. Value of employer real property at end of year	2019-12-31	$0
Assets. Value of employer real property at end of year	2019-12-31	$0
Assets. Value of employer real property at beginning of year	2019-12-31	$0
Assets. Value of employer real property at beginning of year	2019-12-31	$0
Contributions received in cash from employer	2019-12-31	$125,465
Contributions received in cash from employer	2019-12-31	$125,465
Employer contributions (assets) at end of year	2019-12-31	$13,135
Employer contributions (assets) at end of year	2019-12-31	$13,135
Employer contributions (assets) at beginning of year	2019-12-31	$3,489
Employer contributions (assets) at beginning of year	2019-12-31	$3,489
Income. Dividends from preferred stock	2019-12-31	$0
Income. Dividends from preferred stock	2019-12-31	$0
Income. Dividends from common stock	2019-12-31	$0
Income. Dividends from common stock	2019-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$129,928
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$129,928
Asset. Corporate debt instrument preferred debt at end of year	2019-12-31	$0
Asset. Corporate debt instrument preferred debt at end of year	2019-12-31	$0
Asset. Corporate debt instrument preferred debt at beginning of year	2019-12-31	$0
Asset. Corporate debt instrument preferred debt at beginning of year	2019-12-31	$0
Asset. Corporate debt instrument debt (other) at end of year	2019-12-31	$0
Asset. Corporate debt instrument debt (other) at end of year	2019-12-31	$0
Asset. Corporate debt instrument debt (other) at beginning of year	2019-12-31	$0
Asset. Corporate debt instrument debt (other) at beginning of year	2019-12-31	$0
Contract administrator fees	2019-12-31	$0
Contract administrator fees	2019-12-31	$0
Assets. Corporate common stocks other than exployer securities at end of year	2019-12-31	$0
Assets. Corporate common stocks other than exployer securities at end of year	2019-12-31	$0
Assets. Corporate common stocks other than exployer securities at beginning of year	2019-12-31	$0
Assets. Corporate common stocks other than exployer securities at beginning of year	2019-12-31	$0
Liabilities. Value of benefit claims payable at end of year	2019-12-31	$0
Liabilities. Value of benefit claims payable at end of year	2019-12-31	$0
Liabilities. Value of benefit claims payable at beginning of year	2019-12-31	$0
Liabilities. Value of benefit claims payable at beginning of year	2019-12-31	$0
Assets. Value of buildings and other operty used in plan operation at end of year	2019-12-31	$0
Assets. Value of buildings and other operty used in plan operation at end of year	2019-12-31	$0
Assets. Value of buildings and other operty used in plan operation at beginning of year	2019-12-31	$0
Assets. Value of buildings and other operty used in plan operation at beginning of year	2019-12-31	$0
Did the plan have assets held for investment	2019-12-31	Yes
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
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
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
Liabilities. Value of acquisition indebtedness at end of year	2019-12-31	$0
Liabilities. Value of acquisition indebtedness at end of year	2019-12-31	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2019-12-31	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2019-12-31	$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-12-31	Yes
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
Opinion of an independent qualified public accountant for this plan	2019-12-31	Disclaimer
Accountancy firm name	2019-12-31	SAMUEL GOLDSTEIN & CO PC
Accountancy firm name	2019-12-31	SAMUEL GOLDSTEIN & CO PC
Accountancy firm EIN	2019-12-31	112478817
Accountancy firm EIN	2019-12-31	112478817
2018 : ISLANDAIRE, INC. 401(K) PLAN 2018 401k financial data
Unrealized appreciation/depreciation of real estate assets	2018-12-31	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2018-12-31	$-1,106,728
Total unrealized appreciation/depreciation of assets	2018-12-31	$-1,106,728
Total transfer of assets to this plan	2018-12-31	$0
Total transfer of assets from this plan	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
Expenses. Interest paid	2018-12-31	$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2018-12-31	$0
Total income from all sources (including contributions)	2018-12-31	$-74,696
Total loss/gain on sale of assets	2018-12-31	$0
Total of all expenses incurred	2018-12-31	$250,196
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$239,053
Expenses. Certain deemed distributions of participant loans	2018-12-31	$0
Value of total corrective distributions	2018-12-31	$7,768
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$549,803
Value of total assets at end of year	2018-12-31	$6,933,161
Value of total assets at beginning of year	2018-12-31	$7,258,053
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$3,375
Total income from rents	2018-12-31	$0
Total interest from all sources	2018-12-31	$14,787
Total dividends received (eg from common stock, registered investment company shares)	2018-12-31	$461,173
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2018-12-31	$461,173
Assets. Real estate other than employer real property at end of year	2018-12-31	$0
Assets. Real estate other than employer real property at beginning of year	2018-12-31	$0
Administrative expenses professional fees incurred	2018-12-31	$3,375
Assets. Corporate prefeered stocks other than exployer securities at end of year	2018-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year	2018-12-31	$0
Was this plan covered by a fidelity bond	2018-12-31	Yes
Value of fidelity bond cover	2018-12-31	$500,000
If this is an individual account plan, was there a blackout period	2018-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2018-12-31	No
Contributions received from participants	2018-12-31	$442,302
Participant contributions at end of year	2018-12-31	$298,432
Participant contributions at beginning of year	2018-12-31	$218,585
Participant contributions at end of year	2018-12-31	$0
Participant contributions at beginning of year	2018-12-31	$0
Assets. Other investments not covered elsewhere at end of year	2018-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2018-12-31	$4,717
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2018-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2018-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2018-12-31	$0
Assets. Loans (other than to participants) at end of year	2018-12-31	$0
Assets. Loans (other than to participants) at beginning of year	2018-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2018-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2018-12-31	$0
Other income not declared elsewhere	2018-12-31	$0
Administrative expenses (other) incurred	2018-12-31	$0
Liabilities. Value of operating payables at end of year	2018-12-31	$0
Liabilities. Value of operating payables at beginning of year	2018-12-31	$0
Total non interest bearing cash at end of year	2018-12-31	$0
Total non interest bearing cash at beginning of year	2018-12-31	$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	2018-12-31	No
Income. Non cash contributions	2018-12-31	$0
Value of net income/loss	2018-12-31	$-324,892
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$6,933,161
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$7,258,053
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
Assets. partnership/joint venture interests at end of year	2018-12-31	$0
Assets. partnership/joint venture interests at beginning of year	2018-12-31	$0
Investment advisory and management fees	2018-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2018-12-31	$6,315,250
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-12-31	$6,733,982
Value of interest in pooled separate accounts at end of year	2018-12-31	$0
Value of interest in pooled separate accounts at beginning of year	2018-12-31	$0
Interest on participant loans	2018-12-31	$11,577
Income. Interest from loans (other than to participants)	2018-12-31	$0
Interest earned on other investments	2018-12-31	$3,210
Income. Interest from US Government securities	2018-12-31	$0
Income. Interest from corporate debt instruments	2018-12-31	$0
Value of interest in master investment trust accounts at end of year	2018-12-31	$0
Value of interest in master investment trust accounts at beginning of year	2018-12-31	$0
Value of interest in common/collective trusts at end of year	2018-12-31	$0
Value of interest in common/collective trusts at beginning of year	2018-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2018-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2018-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2018-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2018-12-31	$0
Assets. Value of investments in 103.12 investment entities at end of year	2018-12-31	$0
Assets. Value of investments in 103.12 investment entities at beginning of year	2018-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2018-12-31	$315,990
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2018-12-31	$305,486
Expenses. Payments to insurance carriers foe the provision of benefits	2018-12-31	$0
Asset value of US Government securities at end of year	2018-12-31	$0
Asset value of US Government securities at beginning of year	2018-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2018-12-31	$6,269
Net investment gain/loss from pooled separate accounts	2018-12-31	$0
Net investment gain or loss from common/collective trusts	2018-12-31	$0
Net gain/loss from 103.12 investment entities	2018-12-31	$0
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
Assets. Invements in employer securities at end of year	2018-12-31	$0
Assets. Invements in employer securities at beginning of year	2018-12-31	$0
Assets. Value of employer real property at end of year	2018-12-31	$0
Assets. Value of employer real property at beginning of year	2018-12-31	$0
Contributions received in cash from employer	2018-12-31	$102,784
Employer contributions (assets) at end of year	2018-12-31	$3,489
Employer contributions (assets) at beginning of year	2018-12-31	$0
Income. Dividends from preferred stock	2018-12-31	$0
Income. Dividends from common stock	2018-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$239,053
Asset. Corporate debt instrument preferred debt at end of year	2018-12-31	$0
Asset. Corporate debt instrument preferred debt at beginning of year	2018-12-31	$0
Asset. Corporate debt instrument debt (other) at end of year	2018-12-31	$0
Asset. Corporate debt instrument debt (other) at beginning of year	2018-12-31	$0
Contract administrator fees	2018-12-31	$0
Assets. Corporate common stocks other than exployer securities at end of year	2018-12-31	$0
Assets. Corporate common stocks other than exployer securities at beginning of year	2018-12-31	$0
Liabilities. Value of benefit claims payable at end of year	2018-12-31	$0
Liabilities. Value of benefit claims payable at beginning of year	2018-12-31	$0
Assets. Value of buildings and other operty used in plan operation at end of year	2018-12-31	$0
Assets. Value of buildings and other operty used in plan operation at beginning of year	2018-12-31	$0
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
Aggregate proceeds on sale of assets	2018-12-31	$0
Aggregate carrying amount (costs) on sale of assets	2018-12-31	$0
Liabilities. Value of acquisition indebtedness at end of year	2018-12-31	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2018-12-31	$0
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	SAMUEL GOLDSTEIN & CO PC
Accountancy firm EIN	2018-12-31	112478817

Form 5500 Responses for ISLANDAIRE, INC. 401(K) PLAN

2022: ISLANDAIRE, INC. 401(K) PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Submission has been amended	No
2022-01-01	This submission is the final filing	No
2022-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2022-01-01	Plan is a collectively bargained plan	No
2022-01-01	Plan funding arrangement – Insurance	Yes
2022-01-01	Plan funding arrangement – Trust	Yes
2022-01-01	Plan benefit arrangement – Insurance	Yes
2022-01-01	Plan benefit arrangement - Trust	Yes
2021: ISLANDAIRE, INC. 401(K) PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Submission has been amended	No
2021-01-01	This submission is the final filing	No
2021-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-01-01	Plan is a collectively bargained plan	No
2021-01-01	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan funding arrangement – Trust	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes
2021-01-01	Plan benefit arrangement - Trust	Yes
2020: ISLANDAIRE, 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: ISLANDAIRE, 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: ISLANDAIRE, INC. 401(K) PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
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

FIRST GREAT WEST LIFE INSURANCE & ANNUITY CO (National Association of Insurance Commissioners NAIC id number: 60214 )

Policy contract number

386290-01

Policy instance

Insurance contract or identification number	386290-01
Number of Individuals Covered	30
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $1,264
Total amount of fees paid to insurance company	USD $0
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Commission paid to Insurance Broker	USD $1,264
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

FIRST GREAT WEST LIFE INSURANCE & ANNUITY CO (National Association of Insurance Commissioners NAIC id number: 60214 )

Policy contract number

386290-01

Policy instance

Insurance contract or identification number	386290-01
Number of Individuals Covered	32
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $0
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
Insurance broker organization code?	3

FIRST GREAT WEST LIFE INSURANCE & ANNUITY CO (National Association of Insurance Commissioners NAIC id number: 60214 )

Policy contract number

386290-01

Policy instance

Insurance contract or identification number	386290-01
Number of Individuals Covered	27
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $820
Total amount of fees paid to insurance company	USD $0
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Commission paid to Insurance Broker	USD $820
Insurance broker organization code?	3

FIRST GREAT WEST LIFE INSURANCE & ANNUITY CO (National Association of Insurance Commissioners NAIC id number: 60214 )

Policy contract number

386290-01

Policy instance

Insurance contract or identification number	386290-01
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $872
Total amount of fees paid to insurance company	USD $0
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Commission paid to Insurance Broker	USD $872
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

FIRST GREAT WEST LIFE INSURANCE & ANNUITY CO (National Association of Insurance Commissioners NAIC id number: 60214 )

Policy contract number

386290-01

Policy instance

Insurance contract or identification number	386290-01
Number of Individuals Covered	28
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $1,040
Total amount of fees paid to insurance company	USD $0
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Commission paid to Insurance Broker	USD $1,040
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

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Company Name:	RE HANSEN IND., INC DBA ISLANDAIRE
Employer identification number (EIN):	261709702
NAIC Classification:	333900