401k Plan data: KG OFFSHORE EMPLOYEE RETIREMENT PLAN plan

KG OFFSHORE EMPLOYEE RETIREMENT PLAN 401k Plan overview

Plan Name	KG OFFSHORE EMPLOYEE RETIREMENT PLAN
Plan identification number	001

KG OFFSHORE EMPLOYEE RETIREMENT 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.
Plan covering Self-Employed individuals.
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

KEVIN GROS OFFSHORE, LLC. has sponsored the creation of one or more 401k plans.

Company Name: KEVIN GROS OFFSHORE, LLC.

Employer identification number (EIN): 481295691

NAIC Classification: 488990

Form 5500 Filing Information

Submission information for form 5500 for 401k plan KG OFFSHORE EMPLOYEE RETIREMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2019-01-01
001 2018-01-01
001 2017-01-01
001 2016-01-01
001 2016-01-01 CHANTISE GROS 2017-10-13
001 2015-01-01 STEPHANIE CHERAMIE
001 2015-01-01 STEPHANIE CHERAMIE
001 2015-01-01
001 2014-01-01 STEPHANIE CHERAMIE
001 2013-01-01 JAMIE TROSCLAIR
001 2012-01-01 JAMIE TROSCLAIR
001 2011-01-01 JAMIE TROSCLAIR
001 2010-01-01 JAMIE TROSCLAIR
001 2009-01-01 CHERYL OPPERMAN

Plan Statistics for KG OFFSHORE EMPLOYEE RETIREMENT PLAN

401k plan membership statisitcs for KG OFFSHORE EMPLOYEE RETIREMENT PLAN

Measure Date Value
2016: KG OFFSHORE EMPLOYEE RETIREMENT PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 109
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 51
Number of retired or separated participants receiving benefits 2016-01-01 0
Number of other retired or separated participants entitled to future benefits 2016-01-01 26
Total of all active and inactive participants 2016-01-01 77
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 77
Number of participants with account balances 2016-01-01 48
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 1
2015: KG OFFSHORE EMPLOYEE RETIREMENT PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 133
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 71
Number of retired or separated participants receiving benefits 2015-01-01 1
Number of other retired or separated participants entitled to future benefits 2015-01-01 37
Total of all active and inactive participants 2015-01-01 109
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 109
Number of participants with account balances 2015-01-01 109
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 68
2014: KG OFFSHORE EMPLOYEE RETIREMENT PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 171
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 100
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 33
Total of all active and inactive participants 2014-01-01 133
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 133
Number of participants with account balances 2014-01-01 84
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 3
2013: KG OFFSHORE EMPLOYEE RETIREMENT PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 154
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 142
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 25
Total of all active and inactive participants 2013-01-01 167
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 167
Number of participants with account balances 2013-01-01 75
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 4
2012: KG OFFSHORE EMPLOYEE RETIREMENT PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 140
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 127
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 25
Total of all active and inactive participants 2012-01-01 152
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 152
Number of participants with account balances 2012-01-01 78
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 6
2011: KG OFFSHORE EMPLOYEE RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 198
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 171
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 18
Total of all active and inactive participants 2011-01-01 189
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 189
Number of participants with account balances 2011-01-01 66
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 7
2010: KG OFFSHORE EMPLOYEE RETIREMENT PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 205
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 167
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 19
Total of all active and inactive participants 2010-01-01 186
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 186
Number of participants with account balances 2010-01-01 73
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 10
2009: KG OFFSHORE EMPLOYEE RETIREMENT PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 206
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 188
Number of retired or separated participants receiving benefits 2009-01-01 0
Number of other retired or separated participants entitled to future benefits 2009-01-01 12
Total of all active and inactive participants 2009-01-01 200
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 200
Number of participants with account balances 2009-01-01 75
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 7

Measure	Date	Value
2016: KG OFFSHORE EMPLOYEE RETIREMENT PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	109
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	51
Number of retired or separated participants receiving benefits	2016-01-01	0
Number of other retired or separated participants entitled to future benefits	2016-01-01	26
Total of all active and inactive participants	2016-01-01	77
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	77
Number of participants with account balances	2016-01-01	48
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	1
2015: KG OFFSHORE EMPLOYEE RETIREMENT PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	133
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	71
Number of retired or separated participants receiving benefits	2015-01-01	1
Number of other retired or separated participants entitled to future benefits	2015-01-01	37
Total of all active and inactive participants	2015-01-01	109
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	109
Number of participants with account balances	2015-01-01	109
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	68
2014: KG OFFSHORE EMPLOYEE RETIREMENT PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	171
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	100
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	33
Total of all active and inactive participants	2014-01-01	133
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	133
Number of participants with account balances	2014-01-01	84
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	3
2013: KG OFFSHORE EMPLOYEE RETIREMENT PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	154
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	142
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	25
Total of all active and inactive participants	2013-01-01	167
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	167
Number of participants with account balances	2013-01-01	75
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	4
2012: KG OFFSHORE EMPLOYEE RETIREMENT PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	140
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	127
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	25
Total of all active and inactive participants	2012-01-01	152
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	152
Number of participants with account balances	2012-01-01	78
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	6
2011: KG OFFSHORE EMPLOYEE RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	198
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	171
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	18
Total of all active and inactive participants	2011-01-01	189
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	189
Number of participants with account balances	2011-01-01	66
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	7
2010: KG OFFSHORE EMPLOYEE RETIREMENT PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	205
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	167
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	19
Total of all active and inactive participants	2010-01-01	186
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	186
Number of participants with account balances	2010-01-01	73
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	10
2009: KG OFFSHORE EMPLOYEE RETIREMENT PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	206
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	188
Number of retired or separated participants receiving benefits	2009-01-01	0
Number of other retired or separated participants entitled to future benefits	2009-01-01	12
Total of all active and inactive participants	2009-01-01	200
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	200
Number of participants with account balances	2009-01-01	75
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	7

Financial Data on KG OFFSHORE EMPLOYEE RETIREMENT PLAN

Measure	Date	Value
2016 : KG OFFSHORE EMPLOYEE RETIREMENT PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets	2016-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total income from all sources (including contributions)	2016-12-31	$88,264
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$838,734
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$812,078
Value of total corrective distributions	2016-12-31	$21,810
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$42,503
Value of total assets at end of year	2016-12-31	$983,259
Value of total assets at beginning of year	2016-12-31	$1,733,729
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$4,846
Total interest from all sources	2016-12-31	$6,577
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-12-31	No
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$250,000
If this is an individual account plan, was there a blackout period	2016-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Contributions received from participants	2016-12-31	$42,503
Participant contributions at end of year	2016-12-31	$64,529
Participant contributions at beginning of year	2016-12-31	$157,786
Participant contributions at beginning of year	2016-12-31	$4,917
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Value of net income/loss	2016-12-31	$-750,470
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$983,259
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$1,733,729
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2016-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2016-12-31	No
Were any leases to which the plan was party in default or uncollectible	2016-12-31	No
Value of interest in pooled separate accounts at end of year	2016-12-31	$450,809
Value of interest in pooled separate accounts at beginning of year	2016-12-31	$896,337
Interest on participant loans	2016-12-31	$3,451
Interest earned on other investments	2016-12-31	$3,126
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-12-31	$467,921
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-12-31	$674,689
Net investment gain/loss from pooled separate accounts	2016-12-31	$39,184
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2016-12-31	No
Was there a failure to transmit to the plan any participant contributions	2016-12-31	No
Has the plan failed to provide any benefit when due under the plan	2016-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$812,078
Contract administrator fees	2016-12-31	$4,846
Did the plan have assets held for investment	2016-12-31	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	2016-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2016-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2016-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2016-12-31	Disclaimer
Accountancy firm name	2016-12-31	ERICKSEN, KRENTEL & LAPORTE
Accountancy firm EIN	2016-12-31	720549733
2015 : KG OFFSHORE EMPLOYEE RETIREMENT PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets	2015-12-31	$0
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	$187,353
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$673,954
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$665,907
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$217,189
Value of total assets at end of year	2015-12-31	$1,733,729
Value of total assets at beginning of year	2015-12-31	$2,220,330
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$8,047
Total interest from all sources	2015-12-31	$7,024
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-12-31	No
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$250,000
If this is an individual account plan, was there a blackout period	2015-12-31	No
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	$144,977
Participant contributions at end of year	2015-12-31	$157,786
Participant contributions at beginning of year	2015-12-31	$121,202
Participant contributions at end of year	2015-12-31	$4,917
Income. Received or receivable in cash from other sources (including rollovers)	2015-12-31	$72,212
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	$-486,601
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$1,733,729
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$2,220,330
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 pooled separate accounts at end of year	2015-12-31	$896,337
Value of interest in pooled separate accounts at beginning of year	2015-12-31	$1,393,342
Interest on participant loans	2015-12-31	$2,857
Interest earned on other investments	2015-12-31	$4,167
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-12-31	$674,689
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-12-31	$705,786
Net investment gain/loss from pooled separate accounts	2015-12-31	$-36,860
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	$665,907
Contract administrator fees	2015-12-31	$8,047
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	ERICKSEN, KRENTEL & LAPORTE
Accountancy firm EIN	2015-12-31	720549733
2014 : KG OFFSHORE EMPLOYEE RETIREMENT 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	$448,959
Total loss/gain on sale of assets	2014-12-31	$0
Total of all expenses incurred	2014-12-31	$184,307
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$180,027
Expenses. Certain deemed distributions of participant loans	2014-12-31	$-2,771
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$345,316
Value of total assets at end of year	2014-12-31	$2,220,330
Value of total assets at beginning of year	2014-12-31	$1,955,678
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$7,051
Total interest from all sources	2014-12-31	$10,223
Total dividends received (eg from common stock, registered investment company shares)	2014-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-12-31	No
Was this plan covered by a fidelity bond	2014-12-31	Yes
Value of fidelity bond cover	2014-12-31	$250,000
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	$328,699
Participant contributions at end of year	2014-12-31	$121,202
Participant contributions at beginning of year	2014-12-31	$131,914
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	$264,652
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$2,220,330
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$1,955,678
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 pooled separate accounts at end of year	2014-12-31	$1,393,342
Value of interest in pooled separate accounts at beginning of year	2014-12-31	$1,334,724
Interest on participant loans	2014-12-31	$3,583
Interest earned on other investments	2014-12-31	$6,640
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-12-31	$705,786
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-12-31	$489,040
Net investment gain/loss from pooled separate accounts	2014-12-31	$93,420
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	Yes
Has the plan failed to provide any benefit when due under the plan	2014-12-31	No
Contributions received in cash from employer	2014-12-31	$16,617
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$180,027
Contract administrator fees	2014-12-31	$7,051
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	ERICKSEN, KRENTEL & LAPORTE
Accountancy firm EIN	2014-12-31	720549733
2013 : KG OFFSHORE EMPLOYEE RETIREMENT PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets	2013-12-31	$0
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	$583,353
Total loss/gain on sale of assets	2013-12-31	$0
Total of all expenses incurred	2013-12-31	$347,183
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$337,886
Expenses. Certain deemed distributions of participant loans	2013-12-31	$2,771
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$262,571
Value of total assets at end of year	2013-12-31	$1,955,678
Value of total assets at beginning of year	2013-12-31	$1,719,508
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$6,526
Total interest from all sources	2013-12-31	$10,177
Total dividends received (eg from common stock, registered investment company shares)	2013-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-12-31	No
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$250,000
If this is an individual account plan, was there a blackout period	2013-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2013-12-31	No
Contributions received from participants	2013-12-31	$261,436
Participant contributions at end of year	2013-12-31	$131,914
Participant contributions at beginning of year	2013-12-31	$145,454
Income. Received or receivable in cash from other sources (including rollovers)	2013-12-31	$1,135
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	$236,170
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$1,955,678
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$1,719,508
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 pooled separate accounts at end of year	2013-12-31	$1,334,724
Value of interest in pooled separate accounts at beginning of year	2013-12-31	$1,028,561
Interest on participant loans	2013-12-31	$4,724
Interest earned on other investments	2013-12-31	$5,453
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2013-12-31	$489,040
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-12-31	$545,493
Net investment gain/loss from pooled separate accounts	2013-12-31	$310,605
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	Yes
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	$337,886
Contract administrator fees	2013-12-31	$6,526
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	ERICKSEN, KRENTEL & LAPORTE, LLP
Accountancy firm EIN	2013-12-31	720549733
2012 : KG OFFSHORE EMPLOYEE RETIREMENT PLAN 2012 401k financial data
Total unrealized appreciation/depreciation of assets	2012-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$0
Total income from all sources (including contributions)	2012-12-31	$391,448
Total loss/gain on sale of assets	2012-12-31	$0
Total of all expenses incurred	2012-12-31	$206,194
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$200,126
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$229,639
Value of total assets at end of year	2012-12-31	$1,719,508
Value of total assets at beginning of year	2012-12-31	$1,534,254
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$6,068
Total interest from all sources	2012-12-31	$12,090
Total dividends received (eg from common stock, registered investment company shares)	2012-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-12-31	No
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$250,000
If this is an individual account plan, was there a blackout period	2012-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2012-12-31	No
Contributions received from participants	2012-12-31	$219,037
Participant contributions at end of year	2012-12-31	$145,454
Participant contributions at beginning of year	2012-12-31	$156,038
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Value of net income/loss	2012-12-31	$185,254
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$1,719,508
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$1,534,254
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-12-31	No
Were any leases to which the plan was party in default or uncollectible	2012-12-31	No
Value of interest in pooled separate accounts at end of year	2012-12-31	$1,028,561
Value of interest in pooled separate accounts at beginning of year	2012-12-31	$1,084,284
Interest on participant loans	2012-12-31	$4,787
Interest earned on other investments	2012-12-31	$7,303
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-12-31	$545,493
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-12-31	$293,932
Net investment gain/loss from pooled separate accounts	2012-12-31	$149,719
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-12-31	No
Was there a failure to transmit to the plan any participant contributions	2012-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2012-12-31	No
Contributions received in cash from employer	2012-12-31	$10,602
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$200,126
Contract administrator fees	2012-12-31	$6,068
Did the plan have assets held for investment	2012-12-31	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	2012-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2012-12-31	Disclaimer
Accountancy firm name	2012-12-31	ERICKSEN, KRENTEL & LAPORTE, LLP
Accountancy firm EIN	2012-12-31	720549733
2011 : KG OFFSHORE EMPLOYEE RETIREMENT PLAN 2011 401k financial data
Total unrealized appreciation/depreciation of assets	2011-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$0
Total income from all sources (including contributions)	2011-12-31	$202,660
Total loss/gain on sale of assets	2011-12-31	$0
Total of all expenses incurred	2011-12-31	$455,560
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$449,561
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$233,618
Value of total assets at end of year	2011-12-31	$1,534,254
Value of total assets at beginning of year	2011-12-31	$1,787,154
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$5,999
Total interest from all sources	2011-12-31	$9,519
Total dividends received (eg from common stock, registered investment company shares)	2011-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-12-31	No
Was this plan covered by a fidelity bond	2011-12-31	Yes
Value of fidelity bond cover	2011-12-31	$250,000
If this is an individual account plan, was there a blackout period	2011-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2011-12-31	No
Contributions received from participants	2011-12-31	$204,291
Participant contributions at end of year	2011-12-31	$156,038
Participant contributions at beginning of year	2011-12-31	$165,407
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Value of net income/loss	2011-12-31	$-252,900
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$1,534,254
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$1,787,154
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2011-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2011-12-31	No
Were any leases to which the plan was party in default or uncollectible	2011-12-31	No
Value of interest in pooled separate accounts at end of year	2011-12-31	$1,084,284
Value of interest in pooled separate accounts at beginning of year	2011-12-31	$1,319,419
Interest on participant loans	2011-12-31	$4,274
Interest earned on other investments	2011-12-31	$5,245
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-12-31	$293,932
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-12-31	$302,328
Net investment gain/loss from pooled separate accounts	2011-12-31	$-40,477
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-12-31	No
Was there a failure to transmit to the plan any participant contributions	2011-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2011-12-31	No
Contributions received in cash from employer	2011-12-31	$29,327
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$449,561
Contract administrator fees	2011-12-31	$5,999
Did the plan have assets held for investment	2011-12-31	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	2011-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2011-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2011-12-31	Disclaimer
Accountancy firm name	2011-12-31	ERICKSEN, KRENTEL & LAPORTE, LLP
Accountancy firm EIN	2011-12-31	720549733
2010 : KG OFFSHORE EMPLOYEE RETIREMENT PLAN 2010 401k financial data
Total unrealized appreciation/depreciation of assets	2010-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$0
Total income from all sources (including contributions)	2010-12-31	$564,027
Total loss/gain on sale of assets	2010-12-31	$0
Total of all expenses incurred	2010-12-31	$287,657
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$280,328
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$356,056
Value of total assets at end of year	2010-12-31	$1,787,154
Value of total assets at beginning of year	2010-12-31	$1,510,784
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$7,329
Total interest from all sources	2010-12-31	$8,388
Total dividends received (eg from common stock, registered investment company shares)	2010-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2010-12-31	No
Was this plan covered by a fidelity bond	2010-12-31	Yes
Value of fidelity bond cover	2010-12-31	$250,000
If this is an individual account plan, was there a blackout period	2010-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2010-12-31	No
Contributions received from participants	2010-12-31	$289,132
Participant contributions at end of year	2010-12-31	$165,407
Participant contributions at beginning of year	2010-12-31	$125,989
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Value of net income/loss	2010-12-31	$276,370
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$1,787,154
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$1,510,784
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2010-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2010-12-31	No
Were any leases to which the plan was party in default or uncollectible	2010-12-31	No
Value of interest in pooled separate accounts at end of year	2010-12-31	$1,319,419
Value of interest in pooled separate accounts at beginning of year	2010-12-31	$1,109,536
Interest on participant loans	2010-12-31	$3,145
Interest earned on other investments	2010-12-31	$5,243
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2010-12-31	$302,328
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2010-12-31	$275,259
Net investment gain/loss from pooled separate accounts	2010-12-31	$199,583
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2010-12-31	No
Was there a failure to transmit to the plan any participant contributions	2010-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2010-12-31	No
Contributions received in cash from employer	2010-12-31	$66,924
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$280,328
Contract administrator fees	2010-12-31	$7,329
Did the plan have assets held for investment	2010-12-31	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	2010-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2010-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2010-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2010-12-31	Disclaimer
Accountancy firm name	2010-12-31	ERICKSEN, KRENTEL & LAPORTE, LLP
Accountancy firm EIN	2010-12-31	720549733
2009 : KG OFFSHORE EMPLOYEE RETIREMENT PLAN 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2009-12-31	$0

Form 5500 Responses for KG OFFSHORE EMPLOYEE RETIREMENT PLAN

2016: KG OFFSHORE EMPLOYEE RETIREMENT PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: KG OFFSHORE EMPLOYEE RETIREMENT PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	Yes
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: KG OFFSHORE EMPLOYEE RETIREMENT 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: KG OFFSHORE EMPLOYEE RETIREMENT 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 – Trust	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: KG OFFSHORE EMPLOYEE RETIREMENT 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 – Trust	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: KG OFFSHORE EMPLOYEE RETIREMENT 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 – Trust	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2010: KG OFFSHORE EMPLOYEE RETIREMENT 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 – Trust	Yes
2010-01-01	Plan benefit arrangement – Insurance	Yes
2010-01-01	Plan benefit arrangement - Trust	Yes
2009: KG OFFSHORE EMPLOYEE RETIREMENT 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 – Insurance	Yes
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

802636

Policy instance

Insurance contract or identification number	802636
Number of Individuals Covered	109
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $9,068
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	1
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?	No
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

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

802636

Policy instance

Insurance contract or identification number	802636
Number of Individuals Covered	133
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $9,879
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	1
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?	No
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 $9,879
Insurance broker organization code?	3
Insurance broker name	SIGNATOR INSURANCE AGENCY INC.

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

802636

Policy instance

Insurance contract or identification number	802636
Number of Individuals Covered	167
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $8,440
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	1
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?	No
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 $4,350
Insurance broker organization code?	3
Insurance broker name	MUTUAL SERVICE CORPORATION

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

802636

Policy instance

Insurance contract or identification number	802636
Number of Individuals Covered	152
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $7,159
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	1
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?	No
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 $7,159
Insurance broker organization code?	3
Insurance broker name	MUTUAL SERVICE CORPORATION

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

802636

Policy instance

Insurance contract or identification number	802636
Number of Individuals Covered	189
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $7,242
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	1
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?	No
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

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

802636

Policy instance

Insurance contract or identification number	802636
Number of Individuals Covered	186
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $7,366
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	1
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?	No
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

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Company Name:	KEVIN GROS OFFSHORE, LLC.
Employer identification number (EIN):	481295691
NAIC Classification:	488990

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
001	2019-01-01
001	2018-01-01
001	2017-01-01
001	2016-01-01
001	2016-01-01	CHANTISE GROS	2017-10-13
001	2015-01-01	STEPHANIE CHERAMIE
001	2015-01-01	STEPHANIE CHERAMIE
001	2015-01-01
001	2014-01-01	STEPHANIE CHERAMIE
001	2013-01-01	JAMIE TROSCLAIR
001	2012-01-01	JAMIE TROSCLAIR
001	2011-01-01	JAMIE TROSCLAIR
001	2010-01-01	JAMIE TROSCLAIR
001	2009-01-01	CHERYL OPPERMAN