401k Plan data: CMH SPACE FLOORING PRODUCTS, INC. EMPLOYEE BENEFITS PLAN plan

CMH SPACE FLOORING PRODUCTS, INC. EMPLOYEE BENEFITS PLAN 401k Plan overview

Plan Name	CMH SPACE FLOORING PRODUCTS, INC. EMPLOYEE BENEFITS PLAN
Plan identification number	501

CMH SPACE FLOORING PRODUCTS, INC. EMPLOYEE BENEFITS PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Dental Temporary disability (accident and sickness) Long-term disability cover Other welfare benefit cover Unfunded, fully insured, or combination unfunded/insured welfare plan that will not file a Form 5500 for next plan year pursuant to 29 CFR 2520.104-20.

401k Sponsoring company profile

CMH SPACE FLOORING INC. has sponsored the creation of one or more 401k plans.

Company Name: CMH SPACE FLOORING INC.

Employer identification number (EIN): 263513265

NAIC Classification: 442210
NAIC Description: Floor Covering Stores

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CMH SPACE FLOORING PRODUCTS, INC. EMPLOYEE BENEFITS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2014-01-01 JEREMY WILSON
501 2013-01-01 JEREMY WILSON
501 2012-01-01 JEREMY WILSON
501 2011-01-01 JEREMY WILSON
501 2010-01-01 JEREMY WILSON

Plan id#	Filing Submission Date	Name of Administrator
501	2014-01-01	JEREMY WILSON
501	2013-01-01	JEREMY WILSON
501	2012-01-01	JEREMY WILSON
501	2011-01-01	JEREMY WILSON
501	2010-01-01	JEREMY WILSON

Plan Statistics for CMH SPACE FLOORING PRODUCTS, INC. EMPLOYEE BENEFITS PLAN

401k plan membership statisitcs for CMH SPACE FLOORING PRODUCTS, INC. EMPLOYEE BENEFITS PLAN

Measure Date Value
2014: CMH SPACE FLOORING PRODUCTS, INC. EMPLOYEE BENEFITS PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 261
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 0
Number of retired or separated participants receiving benefits 2014-01-01 0
Number of other retired or separated participants entitled to future benefits 2014-01-01 0
Total of all active and inactive participants 2014-01-01 0
2013: CMH SPACE FLOORING PRODUCTS, INC. EMPLOYEE BENEFITS PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 340
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 365
Number of retired or separated participants receiving benefits 2013-01-01 0
Number of other retired or separated participants entitled to future benefits 2013-01-01 0
Total of all active and inactive participants 2013-01-01 365
2012: CMH SPACE FLOORING PRODUCTS, INC. EMPLOYEE BENEFITS PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 224
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 261
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 0
Total of all active and inactive participants 2012-01-01 261
2011: CMH SPACE FLOORING PRODUCTS, INC. EMPLOYEE BENEFITS PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 229
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 224
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 0
Total of all active and inactive participants 2011-01-01 224
2010: CMH SPACE FLOORING PRODUCTS, INC. EMPLOYEE BENEFITS PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 208
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 218
Number of retired or separated participants receiving benefits 2010-01-01 0
Number of other retired or separated participants entitled to future benefits 2010-01-01 0
Total of all active and inactive participants 2010-01-01 218

Measure	Date	Value
2014: CMH SPACE FLOORING PRODUCTS, INC. EMPLOYEE BENEFITS PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	261
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	0
Number of retired or separated participants receiving benefits	2014-01-01	0
Number of other retired or separated participants entitled to future benefits	2014-01-01	0
Total of all active and inactive participants	2014-01-01	0
2013: CMH SPACE FLOORING PRODUCTS, INC. EMPLOYEE BENEFITS PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	340
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	365
Number of retired or separated participants receiving benefits	2013-01-01	0
Number of other retired or separated participants entitled to future benefits	2013-01-01	0
Total of all active and inactive participants	2013-01-01	365
2012: CMH SPACE FLOORING PRODUCTS, INC. EMPLOYEE BENEFITS PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	224
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	261
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	0
Total of all active and inactive participants	2012-01-01	261
2011: CMH SPACE FLOORING PRODUCTS, INC. EMPLOYEE BENEFITS PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	229
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	224
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	0
Total of all active and inactive participants	2011-01-01	224
2010: CMH SPACE FLOORING PRODUCTS, INC. EMPLOYEE BENEFITS PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	208
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	218
Number of retired or separated participants receiving benefits	2010-01-01	0
Number of other retired or separated participants entitled to future benefits	2010-01-01	0
Total of all active and inactive participants	2010-01-01	218

Form 5500 Responses for CMH SPACE FLOORING PRODUCTS, INC. EMPLOYEE BENEFITS PLAN

2014: CMH SPACE FLOORING PRODUCTS, INC. EMPLOYEE BENEFITS 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	Yes
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 – General assets of the sponsor	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2013: CMH SPACE FLOORING PRODUCTS, INC. EMPLOYEE BENEFITS PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2012: CMH SPACE FLOORING PRODUCTS, INC. EMPLOYEE BENEFITS 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 – General assets of the sponsor	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2011: CMH SPACE FLOORING PRODUCTS, INC. EMPLOYEE BENEFITS 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 – General assets of the sponsor	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2010: CMH SPACE FLOORING PRODUCTS, INC. EMPLOYEE BENEFITS 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 – General assets of the sponsor	Yes
2010-01-01	Plan benefit arrangement – Insurance	Yes
2010-01-01	Plan benefit arrangement – General assets of the sponsor	Yes

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Company Name:	CMH SPACE FLOORING INC.
Employer identification number (EIN):	263513265
NAIC Classification:	442210
NAIC Description:	Floor Covering Stores