401k Plan data: NORTHERN CONCRETE CONSTRUCTION 401(K) PLAN plan

NORTHERN CONCRETE CONSTRUCTION 401(K) PLAN 401k Plan overview

Plan Name	NORTHERN CONCRETE CONSTRUCTION 401(K) PLAN
Plan identification number	001

NORTHERN CONCRETE CONSTRUCTION 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.
Plan provides for automatic enrollment in plan that has employee contributions deducted from payroll.
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

NORTHERN CONCRETE CONSTRUCTION, LLC has sponsored the creation of one or more 401k plans.

Company Name: NORTHERN CONCRETE CONSTRUCTION, LLC

Employer identification number (EIN): 391846836

NAIC Classification: 562000

Form 5500 Filing Information

Submission information for form 5500 for 401k plan NORTHERN CONCRETE CONSTRUCTION 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2021-01-01 BRYAN LEMMENS 2022-10-03

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2021-01-01	BRYAN LEMMENS	2022-10-03

Plan Statistics for NORTHERN CONCRETE CONSTRUCTION 401(K) PLAN

401k plan membership statisitcs for NORTHERN CONCRETE CONSTRUCTION 401(K) PLAN

Measure Date Value
2021: NORTHERN CONCRETE CONSTRUCTION 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 138
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 88
Number of retired or separated participants receiving benefits 2021-01-01 37
Total of all active and inactive participants 2021-01-01 125
Total participants 2021-01-01 125
Number of participants with account balances 2021-01-01 114
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 6

Measure	Date	Value
2021: NORTHERN CONCRETE CONSTRUCTION 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	138
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	88
Number of retired or separated participants receiving benefits	2021-01-01	37
Total of all active and inactive participants	2021-01-01	125
Total participants	2021-01-01	125
Number of participants with account balances	2021-01-01	114
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	6

Financial Data on NORTHERN CONCRETE CONSTRUCTION 401(K) PLAN

Measure	Date	Value
2021 : NORTHERN CONCRETE CONSTRUCTION 401(K) PLAN 2021 401k financial data
Total income from all sources (including contributions)	2021-12-31	$1,250,399
Total of all expenses incurred	2021-12-31	$619,930
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$571,063
Expenses. Certain deemed distributions of participant loans	2021-12-31	$4,152
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$558,740
Value of total assets at end of year	2021-12-31	$4,995,223
Value of total assets at beginning of year	2021-12-31	$4,364,754
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$44,715
Total interest from all sources	2021-12-31	$5,671
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2021-12-31	No
Administrative expenses professional fees incurred	2021-12-31	$14,924
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	$356,903
Participant contributions at end of year	2021-12-31	$135,853
Participant contributions at beginning of year	2021-12-31	$45,822
Participant contributions at beginning of year	2021-12-31	$5,962
Income. Received or receivable in cash from other sources (including rollovers)	2021-12-31	$1,109
Total non interest bearing cash at end of year	2021-12-31	$29,820
Total non interest bearing cash at beginning of year	2021-12-31	$20,698
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
Value of net income/loss	2021-12-31	$630,469
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$4,995,223
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$4,364,754
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
Value of interest in pooled separate accounts at end of year	2021-12-31	$4,829,550
Value of interest in pooled separate accounts at beginning of year	2021-12-31	$4,288,597
Interest on participant loans	2021-12-31	$5,671
Net investment gain/loss from pooled separate accounts	2021-12-31	$685,988
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
Contributions received in cash from employer	2021-12-31	$200,728
Employer contributions (assets) at beginning of year	2021-12-31	$3,675
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$571,063
Contract administrator fees	2021-12-31	$29,791
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
Opinion of an independent qualified public accountant for this plan	2021-12-31	Unqualified
Accountancy firm name	2021-12-31	VRAKAS S.C.
Accountancy firm EIN	2021-12-31	391453055

Form 5500 Responses for NORTHERN CONCRETE CONSTRUCTION 401(K) PLAN

2021: NORTHERN CONCRETE CONSTRUCTION 401(K) PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
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

Insurance Providers Used on plan

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

128385

Policy instance

Insurance contract or identification number	128385
Total amount of fees paid to insurance company	USD $12,250
Amount paid for insurance broker fees	12250
Insurance broker organization code?	5

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Company Name:	NORTHERN CONCRETE CONSTRUCTION, LLC
Employer identification number (EIN):	391846836
NAIC Classification:	562000