401k Plan data: CEMEX SOUTHEAST, LLC GROUP WELFARE PLAN plan

CEMEX SOUTHEAST, LLC GROUP WELFARE PLAN 401k Plan overview

Plan Name	CEMEX SOUTHEAST, LLC GROUP WELFARE PLAN
Plan identification number	503

CEMEX SOUTHEAST, LLC GROUP WELFARE PLAN Benefits

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

401k Sponsoring company profile

CEMEX SOUTHEAST, LLC has sponsored the creation of one or more 401k plans.

Company Name: CEMEX SOUTHEAST, LLC

Employer identification number (EIN): 470954454

NAIC Classification: 327300

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CEMEX SOUTHEAST, LLC GROUP WELFARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
503 2012-01-01 SUSIE MEJIA SUSIE MEJIA 2013-08-01
503 2011-01-01 SUSIE MEJIA SUSIE MEJIA 2012-07-30
503 2010-01-01 GERARDO A. GUERRA GERARDO A. GUERRA 2011-07-29
503 2009-01-01 GERARDO A. GUERRA GERARDO A. GUERRA 2010-08-02
503 2008-01-01 DR. GERARDO A. GUERRA DR. GERARDO A. GUERRA 2010-08-02
503 2007-01-01 DR. GERARDO A. GUERRA DR. GERARDO A. GUERRA 2010-08-02
503 2006-01-01 DR. GERARDO A. GUERRA DR. GERARDO A. GUERRA 2010-08-02
503 2005-10-01 DR. GERARDO A. GUERRA DR. GERARDO A. GUERRA 2010-08-02

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
503	2012-01-01	SUSIE MEJIA	SUSIE MEJIA	2013-08-01
503	2011-01-01	SUSIE MEJIA	SUSIE MEJIA	2012-07-30
503	2010-01-01	GERARDO A. GUERRA	GERARDO A. GUERRA	2011-07-29
503	2009-01-01	GERARDO A. GUERRA	GERARDO A. GUERRA	2010-08-02
503	2008-01-01	DR. GERARDO A. GUERRA	DR. GERARDO A. GUERRA	2010-08-02
503	2007-01-01	DR. GERARDO A. GUERRA	DR. GERARDO A. GUERRA	2010-08-02
503	2006-01-01	DR. GERARDO A. GUERRA	DR. GERARDO A. GUERRA	2010-08-02
503	2005-10-01	DR. GERARDO A. GUERRA	DR. GERARDO A. GUERRA	2010-08-02

Plan Statistics for CEMEX SOUTHEAST, LLC GROUP WELFARE PLAN

401k plan membership statisitcs for CEMEX SOUTHEAST, LLC GROUP WELFARE PLAN

Measure Date Value
2012: CEMEX SOUTHEAST, LLC GROUP WELFARE PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 335
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 0
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 0
2011: CEMEX SOUTHEAST, LLC GROUP WELFARE PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 266
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 295
Number of retired or separated participants receiving benefits 2011-01-01 40
Total of all active and inactive participants 2011-01-01 335
2010: CEMEX SOUTHEAST, LLC GROUP WELFARE PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 261
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 253
Number of retired or separated participants receiving benefits 2010-01-01 13
Total of all active and inactive participants 2010-01-01 266
2009: CEMEX SOUTHEAST, LLC GROUP WELFARE PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 260
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 243
Number of retired or separated participants receiving benefits 2009-01-01 18
Number of other retired or separated participants entitled to future benefits 2009-01-01 0
Total of all active and inactive participants 2009-01-01 261
2008: CEMEX SOUTHEAST, LLC GROUP WELFARE PLAN 2008 401k membership
Total participants, beginning-of-year 2008-01-01 253
Total number of active participants reported on line 7a of the Form 5500 2008-01-01 260
Number of retired or separated participants receiving benefits 2008-01-01 0
Number of other retired or separated participants entitled to future benefits 2008-01-01 0
Total of all active and inactive participants 2008-01-01 260
2007: CEMEX SOUTHEAST, LLC GROUP WELFARE PLAN 2007 401k membership
Total participants, beginning-of-year 2007-01-01 272
Total number of active participants reported on line 7a of the Form 5500 2007-01-01 253
Number of retired or separated participants receiving benefits 2007-01-01 0
Number of other retired or separated participants entitled to future benefits 2007-01-01 0
Total of all active and inactive participants 2007-01-01 253
2006: CEMEX SOUTHEAST, LLC GROUP WELFARE PLAN 2006 401k membership
Total participants, beginning-of-year 2006-01-01 272
Total number of active participants reported on line 7a of the Form 5500 2006-01-01 272
Number of retired or separated participants receiving benefits 2006-01-01 0
Number of other retired or separated participants entitled to future benefits 2006-01-01 0
Total of all active and inactive participants 2006-01-01 272
2005: CEMEX SOUTHEAST, LLC GROUP WELFARE PLAN 2005 401k membership
Total participants, beginning-of-year 2005-10-01 257
Total number of active participants reported on line 7a of the Form 5500 2005-10-01 272
Number of retired or separated participants receiving benefits 2005-10-01 0
Number of other retired or separated participants entitled to future benefits 2005-10-01 0
Total of all active and inactive participants 2005-10-01 272

Measure	Date	Value
2012: CEMEX SOUTHEAST, LLC GROUP WELFARE PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	335
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	0
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	0
2011: CEMEX SOUTHEAST, LLC GROUP WELFARE PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	266
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	295
Number of retired or separated participants receiving benefits	2011-01-01	40
Total of all active and inactive participants	2011-01-01	335
2010: CEMEX SOUTHEAST, LLC GROUP WELFARE PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	261
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	253
Number of retired or separated participants receiving benefits	2010-01-01	13
Total of all active and inactive participants	2010-01-01	266
2009: CEMEX SOUTHEAST, LLC GROUP WELFARE PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	260
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	243
Number of retired or separated participants receiving benefits	2009-01-01	18
Number of other retired or separated participants entitled to future benefits	2009-01-01	0
Total of all active and inactive participants	2009-01-01	261
2008: CEMEX SOUTHEAST, LLC GROUP WELFARE PLAN 2008 401k membership
Total participants, beginning-of-year	2008-01-01	253
Total number of active participants reported on line 7a of the Form 5500	2008-01-01	260
Number of retired or separated participants receiving benefits	2008-01-01	0
Number of other retired or separated participants entitled to future benefits	2008-01-01	0
Total of all active and inactive participants	2008-01-01	260
2007: CEMEX SOUTHEAST, LLC GROUP WELFARE PLAN 2007 401k membership
Total participants, beginning-of-year	2007-01-01	272
Total number of active participants reported on line 7a of the Form 5500	2007-01-01	253
Number of retired or separated participants receiving benefits	2007-01-01	0
Number of other retired or separated participants entitled to future benefits	2007-01-01	0
Total of all active and inactive participants	2007-01-01	253
2006: CEMEX SOUTHEAST, LLC GROUP WELFARE PLAN 2006 401k membership
Total participants, beginning-of-year	2006-01-01	272
Total number of active participants reported on line 7a of the Form 5500	2006-01-01	272
Number of retired or separated participants receiving benefits	2006-01-01	0
Number of other retired or separated participants entitled to future benefits	2006-01-01	0
Total of all active and inactive participants	2006-01-01	272
2005: CEMEX SOUTHEAST, LLC GROUP WELFARE PLAN 2005 401k membership
Total participants, beginning-of-year	2005-10-01	257
Total number of active participants reported on line 7a of the Form 5500	2005-10-01	272
Number of retired or separated participants receiving benefits	2005-10-01	0
Number of other retired or separated participants entitled to future benefits	2005-10-01	0
Total of all active and inactive participants	2005-10-01	272

Form 5500 Responses for CEMEX SOUTHEAST, LLC GROUP WELFARE PLAN

2012: CEMEX SOUTHEAST, LLC GROUP WELFARE 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	Yes
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: CEMEX SOUTHEAST, LLC GROUP WELFARE 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: CEMEX SOUTHEAST, LLC GROUP WELFARE 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 – General assets of the sponsor	Yes
2010-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2009: CEMEX SOUTHEAST, LLC GROUP WELFARE PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	No
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	No
2009-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2009-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2008: CEMEX SOUTHEAST, LLC GROUP WELFARE PLAN 2008 form 5500 responses
2008-01-01	Type of plan entity	Single employer plan
2008-01-01	Submission has been amended	No
2008-01-01	This submission is the final filing	No
2008-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2008-01-01	Plan is a collectively bargained plan	No
2008-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2008-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2007: CEMEX SOUTHEAST, LLC GROUP WELFARE PLAN 2007 form 5500 responses
2007-01-01	Type of plan entity	Single employer plan
2007-01-01	Submission has been amended	No
2007-01-01	This submission is the final filing	No
2007-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2007-01-01	Plan is a collectively bargained plan	No
2007-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2007-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2006: CEMEX SOUTHEAST, LLC GROUP WELFARE PLAN 2006 form 5500 responses
2006-01-01	Type of plan entity	Single employer plan
2006-01-01	Submission has been amended	No
2006-01-01	This submission is the final filing	No
2006-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2006-01-01	Plan is a collectively bargained plan	No
2006-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2006-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2005: CEMEX SOUTHEAST, LLC GROUP WELFARE PLAN 2005 form 5500 responses
2005-10-01	Type of plan entity	Single employer plan
2005-10-01	First time form 5500 has been submitted	Yes
2005-10-01	Submission has been amended	No
2005-10-01	This submission is the final filing	No
2005-10-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2005-10-01	Plan is a collectively bargained plan	No
2005-10-01	Plan funding arrangement – General assets of the sponsor	Yes
2005-10-01	Plan benefit arrangement – General assets of the sponsor	Yes

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Company Name:	CEMEX SOUTHEAST, LLC
Employer identification number (EIN):	470954454
NAIC Classification:	327300