401k Plan data: COLLIFLOWER, INC. 401(K) PROFIT SHARING PLAN plan

COLLIFLOWER, INC. 401(K) PROFIT SHARING PLAN 401k Plan overview

Plan Name	COLLIFLOWER, INC. 401(K) PROFIT SHARING PLAN
Plan identification number	001

COLLIFLOWER, INC. 401(K) PROFIT SHARING 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

COLLIFLOWER, INC. has sponsored the creation of one or more 401k plans.

Company Name: COLLIFLOWER, INC.

Employer identification number (EIN): 520603335

NAIC Classification: 541990
NAIC Description: All Other Professional, Scientific, and Technical Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan COLLIFLOWER, INC. 401(K) PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2022-01-01 WILLIAM BURDYCK 2023-10-13
001 2021-01-01 WILLIAM BURDYCK 2022-08-29
001 2020-01-01 WILLIAM BURDYCK 2021-10-04
001 2019-01-01 WILLIAM BURDYCK 2020-03-29
001 2018-01-01 WILLIAM BURDYCK 2019-07-28
001 2017-01-01
001 2016-01-01 WILLIAM BURDYCK 2017-03-07
001 2015-01-01 WILLIAM BURDYCK 2016-04-15
001 2014-01-01 WILLIAM BURDYCK 2015-04-24
001 2013-01-01 WILLIAM BURDYCK 2014-03-13
001 2012-01-01 WILLIAM BURDYCK 2013-04-09
001 2011-01-01 WILLIAM BURDYCK 2012-03-30
001 2010-01-01 WILLIAM BURDYCK 2011-06-17

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
001	2022-01-01	WILLIAM BURDYCK	2023-10-13
001	2021-01-01	WILLIAM BURDYCK	2022-08-29
001	2020-01-01	WILLIAM BURDYCK	2021-10-04
001	2019-01-01	WILLIAM BURDYCK	2020-03-29
001	2018-01-01	WILLIAM BURDYCK	2019-07-28
001	2017-01-01
001	2016-01-01	WILLIAM BURDYCK	2017-03-07
001	2015-01-01	WILLIAM BURDYCK	2016-04-15
001	2014-01-01	WILLIAM BURDYCK	2015-04-24
001	2013-01-01	WILLIAM BURDYCK	2014-03-13
001	2012-01-01	WILLIAM BURDYCK	2013-04-09
001	2011-01-01	WILLIAM BURDYCK	2012-03-30
001	2010-01-01	WILLIAM BURDYCK	2011-06-17

Plan Statistics for COLLIFLOWER, INC. 401(K) PROFIT SHARING PLAN

401k plan membership statisitcs for COLLIFLOWER, INC. 401(K) PROFIT SHARING PLAN

Measure Date Value
2022: COLLIFLOWER, INC. 401(K) PROFIT SHARING PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 162
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 159
Number of retired or separated participants receiving benefits 2022-01-01 5
Number of other retired or separated participants entitled to future benefits 2022-01-01 13
Total of all active and inactive participants 2022-01-01 177
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 0
Total participants 2022-01-01 177
Number of participants with account balances 2022-01-01 131
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 11
2021: COLLIFLOWER, INC. 401(K) PROFIT SHARING PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 156
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 133
Number of retired or separated participants receiving benefits 2021-01-01 1
Number of other retired or separated participants entitled to future benefits 2021-01-01 16
Total of all active and inactive participants 2021-01-01 150
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 150
Number of participants with account balances 2021-01-01 125
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 16
2020: COLLIFLOWER, INC. 401(K) PROFIT SHARING PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 158
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 138
Number of retired or separated participants receiving benefits 2020-01-01 4
Number of other retired or separated participants entitled to future benefits 2020-01-01 13
Total of all active and inactive participants 2020-01-01 155
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 155
Number of participants with account balances 2020-01-01 124
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 11
2019: COLLIFLOWER, INC. 401(K) PROFIT SHARING PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 134
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 139
Number of retired or separated participants receiving benefits 2019-01-01 1
Number of other retired or separated participants entitled to future benefits 2019-01-01 14
Total of all active and inactive participants 2019-01-01 154
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 154
Number of participants with account balances 2019-01-01 125
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 15
2018: COLLIFLOWER, INC. 401(K) PROFIT SHARING PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 129
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 117
Number of retired or separated participants receiving benefits 2018-01-01 1
Number of other retired or separated participants entitled to future benefits 2018-01-01 12
Total of all active and inactive participants 2018-01-01 130
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 130
Number of participants with account balances 2018-01-01 110
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 19

Measure	Date	Value
2022: COLLIFLOWER, INC. 401(K) PROFIT SHARING PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	162
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	159
Number of retired or separated participants receiving benefits	2022-01-01	5
Number of other retired or separated participants entitled to future benefits	2022-01-01	13
Total of all active and inactive participants	2022-01-01	177
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	0
Total participants	2022-01-01	177
Number of participants with account balances	2022-01-01	131
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	11
2021: COLLIFLOWER, INC. 401(K) PROFIT SHARING PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	156
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	133
Number of retired or separated participants receiving benefits	2021-01-01	1
Number of other retired or separated participants entitled to future benefits	2021-01-01	16
Total of all active and inactive participants	2021-01-01	150
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	150
Number of participants with account balances	2021-01-01	125
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	16
2020: COLLIFLOWER, INC. 401(K) PROFIT SHARING PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	158
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	138
Number of retired or separated participants receiving benefits	2020-01-01	4
Number of other retired or separated participants entitled to future benefits	2020-01-01	13
Total of all active and inactive participants	2020-01-01	155
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	155
Number of participants with account balances	2020-01-01	124
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	11
2019: COLLIFLOWER, INC. 401(K) PROFIT SHARING PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	134
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	139
Number of retired or separated participants receiving benefits	2019-01-01	1
Number of other retired or separated participants entitled to future benefits	2019-01-01	14
Total of all active and inactive participants	2019-01-01	154
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	154
Number of participants with account balances	2019-01-01	125
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	15
2018: COLLIFLOWER, INC. 401(K) PROFIT SHARING PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	129
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	117
Number of retired or separated participants receiving benefits	2018-01-01	1
Number of other retired or separated participants entitled to future benefits	2018-01-01	12
Total of all active and inactive participants	2018-01-01	130
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	130
Number of participants with account balances	2018-01-01	110
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	19

Financial Data on COLLIFLOWER, INC. 401(K) PROFIT SHARING PLAN

Measure	Date	Value
2022 : COLLIFLOWER, INC. 401(K) PROFIT SHARING PLAN 2022 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$667
Total income from all sources (including contributions)	2022-12-31	$-1,268,860
Total of all expenses incurred	2022-12-31	$1,488,726
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-31	$1,399,073
Value of total corrective distributions	2022-12-31	$28,566
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-12-31	$1,207,620
Value of total assets at end of year	2022-12-31	$9,544,061
Value of total assets at beginning of year	2022-12-31	$12,302,314
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-12-31	$61,087
Total interest from all sources	2022-12-31	$12,047
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2022-12-31	No
Administrative expenses professional fees incurred	2022-12-31	$27,319
Was this plan covered by a fidelity bond	2022-12-31	Yes
Value of fidelity bond cover	2022-12-31	$500,000
If this is an individual account plan, was there a blackout period	2022-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2022-12-31	No
Contributions received from participants	2022-12-31	$739,413
Participant contributions at end of year	2022-12-31	$271,818
Participant contributions at beginning of year	2022-12-31	$227,140
Participant contributions at end of year	2022-12-31	$319
Income. Received or receivable in cash from other sources (including rollovers)	2022-12-31	$134,374
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2022-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2022-12-31	$667
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-12-31	No
Value of net income/loss	2022-12-31	$-2,757,586
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$9,544,061
Value of net assets at beginning of year (total assets less liabilities)	2022-12-31	$12,301,647
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2022-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2022-12-31	No
Were any leases to which the plan was party in default or uncollectible	2022-12-31	No
Investment advisory and management fees	2022-12-31	$28,193
Value of interest in registered invesment companies (eg mutual funds) at end of year	2022-12-31	$9,217,884
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2022-12-31	$12,054,608
Interest on participant loans	2022-12-31	$12,047
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2022-12-31	$38,839
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2022-12-31	$20,566
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2022-12-31	$-2,488,527
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2022-12-31	No
Was there a failure to transmit to the plan any participant contributions	2022-12-31	No
Has the plan failed to provide any benefit when due under the plan	2022-12-31	No
Contributions received in cash from employer	2022-12-31	$333,833
Employer contributions (assets) at end of year	2022-12-31	$15,201
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-12-31	$1,399,073
Contract administrator fees	2022-12-31	$5,575
Did the plan have assets held for investment	2022-12-31	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	2022-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2022-12-31	No
Opinion of an independent qualified public accountant for this plan	2022-12-31	Unqualified
Accountancy firm name	2022-12-31	ELLEN & TUCKER CHARTERS
Accountancy firm EIN	2022-12-31	520959934
2021 : COLLIFLOWER, INC. 401(K) PROFIT SHARING PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets	2021-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$667
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$0
Total income from all sources (including contributions)	2021-12-31	$2,526,002
Total loss/gain on sale of assets	2021-12-31	$0
Total of all expenses incurred	2021-12-31	$1,495,057
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$1,373,375
Value of total corrective distributions	2021-12-31	$54,933
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$1,003,512
Value of total assets at end of year	2021-12-31	$12,302,314
Value of total assets at beginning of year	2021-12-31	$11,270,702
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$66,749
Total interest from all sources	2021-12-31	$10,315
Total dividends received (eg from common stock, registered investment company shares)	2021-12-31	$0
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	$5,550
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
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2021-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2021-12-31	No
Contributions received from participants	2021-12-31	$612,732
Participant contributions at end of year	2021-12-31	$227,140
Participant contributions at beginning of year	2021-12-31	$219,395
Income. Received or receivable in cash from other sources (including rollovers)	2021-12-31	$156,115
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2021-12-31	$717
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2021-12-31	$667
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	$1,030,945
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$12,301,647
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$11,270,702
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
Investment advisory and management fees	2021-12-31	$21,096
Value of interest in registered invesment companies (eg mutual funds) at end of year	2021-12-31	$12,054,608
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-12-31	$11,029,704
Interest on participant loans	2021-12-31	$10,315
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2021-12-31	$20,566
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2021-12-31	$19,247
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2021-12-31	$1,512,175
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	$234,665
Employer contributions (assets) at beginning of year	2021-12-31	$1,639
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$1,373,375
Contract administrator fees	2021-12-31	$40,103
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	ELLEN & TUCKER CHARTERS
Accountancy firm EIN	2021-12-31	520959934
2020 : COLLIFLOWER, INC. 401(K) PROFIT SHARING PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets	2020-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total income from all sources (including contributions)	2020-12-31	$2,632,452
Total loss/gain on sale of assets	2020-12-31	$0
Total of all expenses incurred	2020-12-31	$1,123,022
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$1,046,308
Value of total corrective distributions	2020-12-31	$22,239
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$875,845
Value of total assets at end of year	2020-12-31	$11,270,702
Value of total assets at beginning of year	2020-12-31	$9,761,272
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$54,475
Total interest from all sources	2020-12-31	$9,454
Total dividends received (eg from common stock, registered investment company shares)	2020-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2020-12-31	No
Administrative expenses professional fees incurred	2020-12-31	$4,000
Was this plan covered by a fidelity bond	2020-12-31	Yes
Value of fidelity bond cover	2020-12-31	$500,000
If this is an individual account plan, was there a blackout period	2020-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2020-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2020-12-31	No
Contributions received from participants	2020-12-31	$619,835
Participant contributions at end of year	2020-12-31	$219,395
Participant contributions at beginning of year	2020-12-31	$176,445
Income. Received or receivable in cash from other sources (including rollovers)	2020-12-31	$11,380
Value of other receiveables (less allowance for doubtful accounts) at end of year	2020-12-31	$717
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Value of net income/loss	2020-12-31	$1,509,430
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$11,270,702
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$9,761,272
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2020-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2020-12-31	No
Were any leases to which the plan was party in default or uncollectible	2020-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2020-12-31	$11,029,704
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-12-31	$9,566,433
Income. Interest from loans (other than to participants)	2020-12-31	$9,454
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2020-12-31	$19,247
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2020-12-31	$16,711
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2020-12-31	$1,747,153
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2020-12-31	No
Was there a failure to transmit to the plan any participant contributions	2020-12-31	No
Has the plan failed to provide any benefit when due under the plan	2020-12-31	No
Contributions received in cash from employer	2020-12-31	$244,630
Employer contributions (assets) at end of year	2020-12-31	$1,639
Employer contributions (assets) at beginning of year	2020-12-31	$1,683
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$1,046,308
Contract administrator fees	2020-12-31	$50,475
Did the plan have assets held for investment	2020-12-31	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	2020-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2020-12-31	No
Opinion of an independent qualified public accountant for this plan	2020-12-31	Disclaimer
Accountancy firm name	2020-12-31	ELLEN & TUCKER CHARTERED
Accountancy firm EIN	2020-12-31	520959934
2019 : COLLIFLOWER, INC. 401(K) PROFIT SHARING PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets	2019-12-31	$0
Total unrealized appreciation/depreciation of assets	2019-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total income from all sources (including contributions)	2019-12-31	$2,669,677
Total income from all sources (including contributions)	2019-12-31	$2,669,677
Total loss/gain on sale of assets	2019-12-31	$0
Total loss/gain on sale of assets	2019-12-31	$0
Total of all expenses incurred	2019-12-31	$263,688
Total of all expenses incurred	2019-12-31	$263,688
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$245,634
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$245,634
Value of total corrective distributions	2019-12-31	$3,635
Value of total corrective distributions	2019-12-31	$3,635
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$826,038
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$826,038
Value of total assets at end of year	2019-12-31	$9,761,272
Value of total assets at end of year	2019-12-31	$9,761,272
Value of total assets at beginning of year	2019-12-31	$7,355,283
Value of total assets at beginning of year	2019-12-31	$7,355,283
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$14,419
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$14,419
Total interest from all sources	2019-12-31	$11,260
Total interest from all sources	2019-12-31	$11,260
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
Administrative expenses professional fees incurred	2019-12-31	$5,232
Administrative expenses professional fees incurred	2019-12-31	$5,232
Was this plan covered by a fidelity bond	2019-12-31	Yes
Was this plan covered by a fidelity bond	2019-12-31	Yes
Value of fidelity bond cover	2019-12-31	$500,000
Value of fidelity bond cover	2019-12-31	$500,000
If this is an individual account plan, was there a blackout period	2019-12-31	No
If this is an individual account plan, was there a blackout period	2019-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2019-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Contributions received from participants	2019-12-31	$592,450
Contributions received from participants	2019-12-31	$592,450
Participant contributions at end of year	2019-12-31	$176,445
Participant contributions at end of year	2019-12-31	$176,445
Participant contributions at beginning of year	2019-12-31	$176,516
Participant contributions at beginning of year	2019-12-31	$176,516
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Value of net income/loss	2019-12-31	$2,405,989
Value of net income/loss	2019-12-31	$2,405,989
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$9,761,272
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$9,761,272
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$7,355,283
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$7,355,283
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-12-31	No
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$9,566,433
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$9,566,433
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$7,163,251
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$7,163,251
Interest on participant loans	2019-12-31	$11,260
Interest on participant loans	2019-12-31	$11,260
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$16,711
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$16,711
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$12,709
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$12,709
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$1,832,379
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$1,832,379
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-12-31	No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-12-31	No
Was there a failure to transmit to the plan any participant contributions	2019-12-31	No
Was there a failure to transmit to the plan any participant contributions	2019-12-31	No
Has the plan failed to provide any benefit when due under the plan	2019-12-31	No
Has the plan failed to provide any benefit when due under the plan	2019-12-31	No
Contributions received in cash from employer	2019-12-31	$233,588
Contributions received in cash from employer	2019-12-31	$233,588
Employer contributions (assets) at end of year	2019-12-31	$1,683
Employer contributions (assets) at end of year	2019-12-31	$1,683
Employer contributions (assets) at beginning of year	2019-12-31	$2,807
Employer contributions (assets) at beginning of year	2019-12-31	$2,807
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$245,634
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$245,634
Contract administrator fees	2019-12-31	$9,187
Contract administrator fees	2019-12-31	$9,187
Did the plan have assets held for investment	2019-12-31	Yes
Did the plan have assets held for investment	2019-12-31	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	2019-12-31	No
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	2019-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-12-31	Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2019-12-31	Disclaimer
Opinion of an independent qualified public accountant for this plan	2019-12-31	Disclaimer
Accountancy firm name	2019-12-31	ELLEN & TUCKER CHARTERED
Accountancy firm name	2019-12-31	ELLEN & TUCKER CHARTERED
Accountancy firm EIN	2019-12-31	520959934
Accountancy firm EIN	2019-12-31	520959934
2018 : COLLIFLOWER, INC. 401(K) PROFIT SHARING PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets	2018-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$0
Total income from all sources (including contributions)	2018-12-31	$243,850
Total loss/gain on sale of assets	2018-12-31	$0
Total of all expenses incurred	2018-12-31	$742,942
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$736,836
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$798,573
Value of total assets at end of year	2018-12-31	$7,355,283
Value of total assets at beginning of year	2018-12-31	$7,854,375
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$6,106
Total interest from all sources	2018-12-31	$9,718
Total dividends received (eg from common stock, registered investment company shares)	2018-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-12-31	No
Administrative expenses professional fees incurred	2018-12-31	$5,590
Was this plan covered by a fidelity bond	2018-12-31	Yes
Value of fidelity bond cover	2018-12-31	$500,000
If this is an individual account plan, was there a blackout period	2018-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2018-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2018-12-31	No
Contributions received from participants	2018-12-31	$541,358
Participant contributions at end of year	2018-12-31	$176,516
Participant contributions at beginning of year	2018-12-31	$154,777
Income. Received or receivable in cash from other sources (including rollovers)	2018-12-31	$51,023
Total non interest bearing cash at beginning of year	2018-12-31	$22
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Value of net income/loss	2018-12-31	$-499,092
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$7,355,283
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$7,854,375
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2018-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2018-12-31	No
Were any leases to which the plan was party in default or uncollectible	2018-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2018-12-31	$7,163,251
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-12-31	$7,689,728
Interest on participant loans	2018-12-31	$9,718
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2018-12-31	$12,709
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2018-12-31	$9,848
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2018-12-31	$-564,441
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2018-12-31	No
Was there a failure to transmit to the plan any participant contributions	2018-12-31	No
Has the plan failed to provide any benefit when due under the plan	2018-12-31	No
Contributions received in cash from employer	2018-12-31	$206,192
Employer contributions (assets) at end of year	2018-12-31	$2,807
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$736,836
Contract administrator fees	2018-12-31	$516
Did the plan have assets held for investment	2018-12-31	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	2018-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2018-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2018-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2018-12-31	Disclaimer
Accountancy firm name	2018-12-31	ELLIN & TUCKER CHARTERED
Accountancy firm EIN	2018-12-31	520959934

Form 5500 Responses for COLLIFLOWER, INC. 401(K) PROFIT SHARING PLAN

2022: COLLIFLOWER, INC. 401(K) PROFIT SHARING PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Plan funding arrangement – Insurance	Yes
2022-01-01	Plan funding arrangement – Trust	Yes
2022-01-01	Plan benefit arrangement – Insurance	Yes
2022-01-01	Plan benefit arrangement - Trust	Yes
2021: COLLIFLOWER, INC. 401(K) PROFIT SHARING PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Submission has been amended	No
2021-01-01	This submission is the final filing	No
2021-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-01-01	Plan is a collectively bargained plan	No
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
2020: COLLIFLOWER, INC. 401(K) PROFIT SHARING PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Submission has been amended	No
2020-01-01	This submission is the final filing	No
2020-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-01-01	Plan is a collectively bargained plan	No
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan funding arrangement – Trust	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement - Trust	Yes
2019: COLLIFLOWER, INC. 401(K) PROFIT SHARING PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Submission has been amended	No
2019-01-01	This submission is the final filing	No
2019-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-01-01	Plan is a collectively bargained plan	No
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan funding arrangement – Trust	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement - Trust	Yes
2018: COLLIFLOWER, INC. 401(K) PROFIT SHARING PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Submission has been amended	No
2018-01-01	This submission is the final filing	No
2018-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-01-01	Plan is a collectively bargained plan	No
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan funding arrangement – Trust	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2018-01-01	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

125839

Policy instance

Insurance contract or identification number	125839
Number of Individuals Covered	135
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $5,473
Total amount of fees paid to insurance company	USD $5,575
Amount paid for insurance broker fees	4400
Insurance broker organization code?	5
Commission paid to Insurance Broker	USD $3,990

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

Policy contract number

71662

Policy instance

Insurance contract or identification number	71662
Number of Individuals Covered	130
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $18,318
Total amount of fees paid to insurance company	USD $5,550
Are there contracts with allocated funds for individual policies?	0
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?	Yes
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 $12,492
Insurance broker organization code?	3
Amount paid for insurance broker fees	5550
Additional information about fees paid to insurance broker	TPA FEES

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

Policy contract number

71662

Policy instance

Insurance contract or identification number	71662
Number of Individuals Covered	125
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $29,594
Total amount of fees paid to insurance company	USD $4,000
Are there contracts with allocated funds for individual policies?	0
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?	Yes
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 $24,893
Insurance broker organization code?	3
Amount paid for insurance broker fees	4000
Additional information about fees paid to insurance broker	TPA FEES

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

Policy contract number

71662

Policy instance

Insurance contract or identification number	71662
Number of Individuals Covered	128
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $26,804
Total amount of fees paid to insurance company	USD $5,232
Are there contracts with allocated funds for individual policies?	0
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?	Yes
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 $22,532
Insurance broker organization code?	3
Amount paid for insurance broker fees	5232
Additional information about fees paid to insurance broker	TPA FEES

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

Policy contract number

71662

Policy instance

Insurance contract or identification number	71662
Number of Individuals Covered	114
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $26,094
Total amount of fees paid to insurance company	USD $5,590
Are there contracts with allocated funds for individual policies?	0
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?	Yes
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 $21,214
Insurance broker organization code?	3
Amount paid for insurance broker fees	5590
Additional information about fees paid to insurance broker	TPA FEES

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Company Name:	COLLIFLOWER, INC.
Employer identification number (EIN):	520603335
NAIC Classification:	541990
NAIC Description:	All Other Professional, Scientific, and Technical Services