401k Plan data: FM FACILITY MAINTENANCE 401(K) PLAN plan

FM FACILITY MAINTENANCE 401(K) PLAN 401k Plan overview

Plan Name	FM FACILITY MAINTENANCE 401(K) PLAN
Plan identification number	001

FM FACILITY MAINTENANCE 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.
Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

IPT, LLC FM FACILITY MAINTENANCE has sponsored the creation of one or more 401k plans.

Company Name: IPT, LLC FM FACILITY MAINTENANCE

Employer identification number (EIN): 341994464

NAIC Classification: 561210
NAIC Description: Facilities Support Services

Additional information about IPT, LLC FM FACILITY MAINTENANCE

Jurisdiction of Incorporation: New York Department of State

Incorporation Date: 1995-12-06

Company Identification Number: 1979209

Legal Registered Office Address: PO BOX 510261
340 12th street
Key Colony Beach
United States of America (USA)
33051

More information about IPT, LLC FM FACILITY MAINTENANCE

Form 5500 Filing Information

Submission information for form 5500 for 401k plan FM FACILITY MAINTENANCE 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2016-01-01 NATALIE DOPP 2016-10-14
001 2015-01-01 NATALIE DOPP
001 2014-01-01 STEPHEN PARK
001 2013-02-01 STEPHEN PARK

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
001	2016-01-01	NATALIE DOPP	2016-10-14
001	2015-01-01	NATALIE DOPP
001	2014-01-01	STEPHEN PARK
001	2013-02-01	STEPHEN PARK

Plan Statistics for FM FACILITY MAINTENANCE 401(K) PLAN

401k plan membership statisitcs for FM FACILITY MAINTENANCE 401(K) PLAN

Measure Date Value
2015: FM FACILITY MAINTENANCE 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 327
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 9
Number of retired or separated participants receiving benefits 2015-01-01 0
Number of other retired or separated participants entitled to future benefits 2015-01-01 4
Total of all active and inactive participants 2015-01-01 13
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 13
Number of participants with account balances 2015-01-01 13
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0
2014: FM FACILITY MAINTENANCE 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 335
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 277
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 50
Total of all active and inactive participants 2014-01-01 327
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 327
Number of participants with account balances 2014-01-01 185
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0
2013: FM FACILITY MAINTENANCE 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year 2013-02-01 0
Total number of active participants reported on line 7a of the Form 5500 2013-02-01 292
Number of retired or separated participants receiving benefits 2013-02-01 0
Number of other retired or separated participants entitled to future benefits 2013-02-01 43
Total of all active and inactive participants 2013-02-01 335
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-02-01 0
Total participants 2013-02-01 335
Number of participants with account balances 2013-02-01 193
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-02-01 0

Measure	Date	Value
2015: FM FACILITY MAINTENANCE 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	327
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	9
Number of retired or separated participants receiving benefits	2015-01-01	0
Number of other retired or separated participants entitled to future benefits	2015-01-01	4
Total of all active and inactive participants	2015-01-01	13
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	13
Number of participants with account balances	2015-01-01	13
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0
2014: FM FACILITY MAINTENANCE 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	335
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	277
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	50
Total of all active and inactive participants	2014-01-01	327
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	327
Number of participants with account balances	2014-01-01	185
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2013: FM FACILITY MAINTENANCE 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year	2013-02-01	0
Total number of active participants reported on line 7a of the Form 5500	2013-02-01	292
Number of retired or separated participants receiving benefits	2013-02-01	0
Number of other retired or separated participants entitled to future benefits	2013-02-01	43
Total of all active and inactive participants	2013-02-01	335
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-02-01	0
Total participants	2013-02-01	335
Number of participants with account balances	2013-02-01	193
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-02-01	0

Financial Data on FM FACILITY MAINTENANCE 401(K) PLAN

Measure	Date	Value
2015 : FM FACILITY MAINTENANCE 401(K) PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets	2015-12-31	$0
Total transfer of assets from this plan	2015-12-31	$4,450,058
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Total income from all sources (including contributions)	2015-12-31	$287,980
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$477,991
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$453,629
Value of total corrective distributions	2015-12-31	$22,990
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$171,104
Value of total assets at end of year	2015-12-31	$314,153
Value of total assets at beginning of year	2015-12-31	$4,954,222
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$1,372
Total interest from all sources	2015-12-31	$4,509
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$3,066
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2015-12-31	$3,066
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$500,000
If this is an individual account plan, was there a blackout period	2015-12-31	Yes
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2015-12-31	No
Contributions received from participants	2015-12-31	$171,104
Participant contributions at end of year	2015-12-31	$0
Participant contributions at beginning of year	2015-12-31	$63,248
Participant contributions at end of year	2015-12-31	$0
Participant contributions at beginning of year	2015-12-31	$32,343
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Value of net income/loss	2015-12-31	$-190,011
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$314,153
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$4,954,222
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2015-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2015-12-31	No
Were any leases to which the plan was party in default or uncollectible	2015-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2015-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-12-31	$4,479,827
Interest on participant loans	2015-12-31	$599
Interest earned on other investments	2015-12-31	$3,910
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-12-31	$314,153
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-12-31	$378,804
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2015-12-31	$109,301
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2015-12-31	No
Was there a failure to transmit to the plan any participant contributions	2015-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2015-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$453,629
Contract administrator fees	2015-12-31	$1,372
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2015-12-31	Yes
Did the plan have assets held for investment	2015-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2015-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2015-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2015-12-31	Disclaimer
Accountancy firm name	2015-12-31	BLUM SHAPIRO & CO. P.C.
Accountancy firm EIN	2015-12-31	061009205
2014 : FM FACILITY MAINTENANCE 401(K) PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets	2014-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Total income from all sources (including contributions)	2014-12-31	$1,179,203
Total loss/gain on sale of assets	2014-12-31	$0
Total of all expenses incurred	2014-12-31	$606,203
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$587,657
Value of total corrective distributions	2014-12-31	$14,479
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$926,256
Value of total assets at end of year	2014-12-31	$4,954,222
Value of total assets at beginning of year	2014-12-31	$4,381,222
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$4,067
Total interest from all sources	2014-12-31	$7,353
Total dividends received (eg from common stock, registered investment company shares)	2014-12-31	$289,425
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2014-12-31	$289,425
Was this plan covered by a fidelity bond	2014-12-31	Yes
Value of fidelity bond cover	2014-12-31	$500,000
If this is an individual account plan, was there a blackout period	2014-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2014-12-31	No
Contributions received from participants	2014-12-31	$840,407
Participant contributions at end of year	2014-12-31	$63,248
Participant contributions at beginning of year	2014-12-31	$65,130
Participant contributions at end of year	2014-12-31	$32,343
Participant contributions at beginning of year	2014-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2014-12-31	$85,849
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Value of net income/loss	2014-12-31	$573,000
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$4,954,222
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$4,381,222
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2014-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2014-12-31	No
Were any leases to which the plan was party in default or uncollectible	2014-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2014-12-31	$4,479,827
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-12-31	$4,023,623
Interest on participant loans	2014-12-31	$2,886
Interest earned on other investments	2014-12-31	$4,467
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-12-31	$378,804
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-12-31	$292,469
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2014-12-31	$-43,831
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2014-12-31	No
Was there a failure to transmit to the plan any participant contributions	2014-12-31	No
Has the plan failed to provide any benefit when due under the plan	2014-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$587,657
Contract administrator fees	2014-12-31	$4,067
Did the plan have assets held for investment	2014-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2014-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2014-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2014-12-31	Disclaimer
Accountancy firm name	2014-12-31	BLUM SHAPIRO & CO. P.C.
Accountancy firm EIN	2014-12-31	061009205
2013 : FM FACILITY MAINTENANCE 401(K) PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets	2013-12-31	$0
Total transfer of assets to this plan	2013-12-31	$3,704,913
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
Total income from all sources (including contributions)	2013-12-31	$1,464,054
Total loss/gain on sale of assets	2013-12-31	$0
Total of all expenses incurred	2013-12-31	$787,745
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$786,392
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$1,109,596
Value of total assets at end of year	2013-12-31	$4,381,222
Value of total assets at beginning of year	2013-12-31	$0
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$1,353
Total interest from all sources	2013-12-31	$3,930
Total dividends received (eg from common stock, registered investment company shares)	2013-12-31	$213,444
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2013-12-31	$213,444
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$500,000
If this is an individual account plan, was there a blackout period	2013-12-31	Yes
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2013-12-31	No
Contributions received from participants	2013-12-31	$814,098
Participant contributions at end of year	2013-12-31	$65,130
Participant contributions at beginning of year	2013-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2013-12-31	$295,498
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Value of net income/loss	2013-12-31	$676,309
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$4,381,222
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2013-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2013-12-31	No
Were any leases to which the plan was party in default or uncollectible	2013-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2013-12-31	$4,023,623
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2013-12-31	$0
Interest on participant loans	2013-12-31	$3,930
Interest earned on other investments	2013-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2013-12-31	$292,469
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2013-12-31	$137,084
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2013-12-31	No
Was there a failure to transmit to the plan any participant contributions	2013-12-31	No
Has the plan failed to provide any benefit when due under the plan	2013-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$786,392
Contract administrator fees	2013-12-31	$1,353
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2013-12-31	Yes
Did the plan have assets held for investment	2013-12-31	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	2013-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2013-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2013-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2013-12-31	Disclaimer
Accountancy firm name	2013-12-31	BLUM SHAPIRO & CO. P.C.
Accountancy firm EIN	2013-12-31	061009205

Form 5500 Responses for FM FACILITY MAINTENANCE 401(K) PLAN

2015: FM FACILITY MAINTENANCE 401(K) PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: FM FACILITY MAINTENANCE 401(K) PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: FM FACILITY MAINTENANCE 401(K) PLAN 2013 form 5500 responses
2013-02-01	Type of plan entity	Single employer plan
2013-02-01	First time form 5500 has been submitted	Yes
2013-02-01	Submission has been amended	No
2013-02-01	This submission is the final filing	No
2013-02-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2013-02-01	Plan is a collectively bargained plan	No
2013-02-01	Plan funding arrangement – Insurance	Yes
2013-02-01	Plan funding arrangement – Trust	Yes
2013-02-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

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

Policy contract number

335456-01

Policy instance

Insurance contract or identification number	335456-01
Number of Individuals Covered	13
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $6,244
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $6,244
Insurance broker organization code?	3
Insurance broker name	CETERA ADVISOR NETWORKS LLC

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

Policy contract number

335456-01

Policy instance

Insurance contract or identification number	335456-01
Number of Individuals Covered	21
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $1,263
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,263
Insurance broker organization code?	3
Insurance broker name	CETERA ADVISOR NETWORKS LLC

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

Policy contract number

335456-01

Policy instance

Insurance contract or identification number	335456-01
Number of Individuals Covered	18
Insurance policy start date	2013-02-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $648
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $399
Insurance broker organization code?	3
Insurance broker name	CETERA ADVISOR NETWORKS LLC

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Company Name:	IPT, LLC FM FACILITY MAINTENANCE
Employer identification number (EIN):	341994464
NAIC Classification:	561210
NAIC Description:	Facilities Support Services

Jurisdiction of Incorporation:	New York Department of State
Incorporation Date:	1995-12-06
Company Identification Number:	1979209
Legal Registered Office Address:	PO BOX 510261 340 12th street Key Colony Beach United States of America (USA) 33051