401k Plan data: M. LUIS CONSTRUCTION COMPANY, INC. 401(K) PROFIT SHARING PLAN AND TRUST plan

M. LUIS CONSTRUCTION COMPANY, INC. 401(K) PROFIT SHARING PLAN AND TRUST 401k Plan overview

Plan Name	M. LUIS CONSTRUCTION COMPANY, INC. 401(K) PROFIT SHARING PLAN AND TRUST
Plan identification number	001

M. LUIS CONSTRUCTION COMPANY, INC. 401(K) PROFIT SHARING PLAN AND TRUST Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Age/Service Weighted or new comparability or similar plan - Age/Service Weighted Plan: Allocations are based on age, service, or age and service. New comparability or similar plan: Allocations are based on participant classifications and a classification(s) consists entirely or predominantly of highly compensated employees; or the plan provides an additional allocation rate on compensation above a specified threshold, and the theshold or additional rate exceeds the maximum threshold or rate allowed under the permitted disparity rules of section 401(l).
Profit-sharing
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.
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

M. LUIS CONSTRUCTION COMPANY, INC. has sponsored the creation of one or more 401k plans.

Company Name: M. LUIS CONSTRUCTION COMPANY, INC.

Employer identification number (EIN): 521418763

NAIC Classification: 238900

Form 5500 Filing Information

Submission information for form 5500 for 401k plan M. LUIS CONSTRUCTION COMPANY, INC. 401(K) PROFIT SHARING PLAN AND TRUST

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2013-01-01 CIDALIA AKBAR 2014-06-25
001 2012-01-01 CIDALIA AKBAR
001 2011-04-01 CIDALIA AKBAR
001 2010-04-01 CIDALIA AKBAR

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
001	2013-01-01	CIDALIA AKBAR	2014-06-25
001	2012-01-01	CIDALIA AKBAR
001	2011-04-01	CIDALIA AKBAR
001	2010-04-01	CIDALIA AKBAR

Plan Statistics for M. LUIS CONSTRUCTION COMPANY, INC. 401(K) PROFIT SHARING PLAN AND TRUST

401k plan membership statisitcs for M. LUIS CONSTRUCTION COMPANY, INC. 401(K) PROFIT SHARING PLAN AND TRUST

Measure Date Value
2012: M. LUIS CONSTRUCTION COMPANY, INC. 401(K) PROFIT SHARING PLAN AND TRUST 2012 401k membership
Total participants, beginning-of-year 2012-01-01 158
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 0
Number of retired or separated participants receiving benefits 2012-01-01 0
Number of other retired or separated participants entitled to future benefits 2012-01-01 0
Total of all active and inactive participants 2012-01-01 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 0
Number of participants with account balances 2012-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: M. LUIS CONSTRUCTION COMPANY, INC. 401(K) PROFIT SHARING PLAN AND TRUST 2011 401k membership
Total participants, beginning-of-year 2011-04-01 168
Total number of active participants reported on line 7a of the Form 5500 2011-04-01 154
Number of retired or separated participants receiving benefits 2011-04-01 0
Number of other retired or separated participants entitled to future benefits 2011-04-01 18
Total of all active and inactive participants 2011-04-01 172
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-04-01 0
Total participants 2011-04-01 172
Number of participants with account balances 2011-04-01 49
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-04-01 0
2010: M. LUIS CONSTRUCTION COMPANY, INC. 401(K) PROFIT SHARING PLAN AND TRUST 2010 401k membership
Total participants, beginning-of-year 2010-04-01 195
Total number of active participants reported on line 7a of the Form 5500 2010-04-01 144
Number of retired or separated participants receiving benefits 2010-04-01 0
Number of other retired or separated participants entitled to future benefits 2010-04-01 14
Total of all active and inactive participants 2010-04-01 158
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-04-01 0
Total participants 2010-04-01 158
Number of participants with account balances 2010-04-01 46
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-04-01 0

Measure	Date	Value
2012: M. LUIS CONSTRUCTION COMPANY, INC. 401(K) PROFIT SHARING PLAN AND TRUST 2012 401k membership
Total participants, beginning-of-year	2012-01-01	158
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	0
Number of retired or separated participants receiving benefits	2012-01-01	0
Number of other retired or separated participants entitled to future benefits	2012-01-01	0
Total of all active and inactive participants	2012-01-01	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	0
Number of participants with account balances	2012-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: M. LUIS CONSTRUCTION COMPANY, INC. 401(K) PROFIT SHARING PLAN AND TRUST 2011 401k membership
Total participants, beginning-of-year	2011-04-01	168
Total number of active participants reported on line 7a of the Form 5500	2011-04-01	154
Number of retired or separated participants receiving benefits	2011-04-01	0
Number of other retired or separated participants entitled to future benefits	2011-04-01	18
Total of all active and inactive participants	2011-04-01	172
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-04-01	0
Total participants	2011-04-01	172
Number of participants with account balances	2011-04-01	49
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-04-01	0
2010: M. LUIS CONSTRUCTION COMPANY, INC. 401(K) PROFIT SHARING PLAN AND TRUST 2010 401k membership
Total participants, beginning-of-year	2010-04-01	195
Total number of active participants reported on line 7a of the Form 5500	2010-04-01	144
Number of retired or separated participants receiving benefits	2010-04-01	0
Number of other retired or separated participants entitled to future benefits	2010-04-01	14
Total of all active and inactive participants	2010-04-01	158
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-04-01	0
Total participants	2010-04-01	158
Number of participants with account balances	2010-04-01	46
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-04-01	0

Financial Data on M. LUIS CONSTRUCTION COMPANY, INC. 401(K) PROFIT SHARING PLAN AND TRUST

Measure	Date	Value
2012 : M. LUIS CONSTRUCTION COMPANY, INC. 401(K) PROFIT SHARING PLAN AND TRUST 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	$239,749
Total loss/gain on sale of assets	2012-12-31	$0
Total of all expenses incurred	2012-12-31	$1,826,240
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$1,804,168
Expenses. Certain deemed distributions of participant loans	2012-12-31	$8,279
Value of total corrective distributions	2012-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$37,369
Value of total assets at end of year	2012-12-31	$0
Value of total assets at beginning of year	2012-12-31	$1,586,491
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$13,793
Total interest from all sources	2012-12-31	$1,603
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	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2012-12-31	$0
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$200,000
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	$37,369
Participant contributions at end of year	2012-12-31	$0
Participant contributions at beginning of year	2012-12-31	$50,086
Administrative expenses (other) incurred	2012-12-31	$1,050
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	$-1,586,491
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$0
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$1,586,491
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 registered invesment companies (eg mutual funds) at end of year	2012-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-12-31	$1,981
Value of interest in pooled separate accounts at end of year	2012-12-31	$0
Value of interest in pooled separate accounts at beginning of year	2012-12-31	$1,534,424
Interest on participant loans	2012-12-31	$-98
Income. Interest from loans (other than to participants)	2012-12-31	$1,616
Interest earned on other investments	2012-12-31	$85
Net investment gain/loss from pooled separate accounts	2012-12-31	$200,777
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
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$1,804,168
Contract administrator fees	2012-12-31	$12,743
Did the plan have assets held for investment	2012-12-31	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	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	Yes
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	GROSS, MENDELSOHN, & ASSOCIATES
Accountancy firm EIN	2012-12-31	520982413
2011 : M. LUIS CONSTRUCTION COMPANY, INC. 401(K) PROFIT SHARING PLAN AND TRUST 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	$12,168
Total loss/gain on sale of assets	2011-12-31	$0
Total of all expenses incurred	2011-12-31	$43,613
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$29,500
Value of total corrective distributions	2011-12-31	$1,816
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$143,857
Value of total assets at end of year	2011-12-31	$1,586,491
Value of total assets at beginning of year	2011-12-31	$1,617,936
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$12,297
Total interest from all sources	2011-12-31	$138
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	$200,000
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	$86,205
Participant contributions at end of year	2011-12-31	$50,086
Administrative expenses (other) incurred	2011-12-31	$400
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	$-31,445
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$1,586,491
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$1,617,936
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 registered invesment companies (eg mutual funds) at end of year	2011-12-31	$1,981
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-12-31	$1,757
Value of interest in pooled separate accounts at end of year	2011-12-31	$1,534,424
Value of interest in pooled separate accounts at beginning of year	2011-12-31	$1,616,179
Interest on participant loans	2011-12-31	$86
Interest earned on other investments	2011-12-31	$52
Net investment gain/loss from pooled separate accounts	2011-12-31	$-131,827
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	$57,652
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$29,500
Contract administrator fees	2011-12-31	$11,897
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	LANIGAN, RYAN, MALCOLM & DOYLE PC
Accountancy firm EIN	2011-12-31	521259972
Total unrealized appreciation/depreciation of assets	2011-03-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-03-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-03-31	$0
Total income from all sources (including contributions)	2011-03-31	$387,776
Total loss/gain on sale of assets	2011-03-31	$0
Total of all expenses incurred	2011-03-31	$77,005
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-03-31	$62,229
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-03-31	$199,961
Value of total assets at end of year	2011-03-31	$1,616,285
Value of total assets at beginning of year	2011-03-31	$1,305,514
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-03-31	$14,776
Total interest from all sources	2011-03-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2011-03-31	$173,040
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-03-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2011-03-31	$173,040
Was this plan covered by a fidelity bond	2011-03-31	Yes
Value of fidelity bond cover	2011-03-31	$200,000
If this is an individual account plan, was there a blackout period	2011-03-31	No
Were there any nonexempt tranactions with any party-in-interest	2011-03-31	No
Contributions received from participants	2011-03-31	$114,338
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-03-31	No
Value of net income/loss	2011-03-31	$310,771
Value of net assets at end of year (total assets less liabilities)	2011-03-31	$1,616,285
Value of net assets at beginning of year (total assets less liabilities)	2011-03-31	$1,305,514
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2011-03-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2011-03-31	No
Were any leases to which the plan was party in default or uncollectible	2011-03-31	No
Investment advisory and management fees	2011-03-31	$200
Value of interest in registered invesment companies (eg mutual funds) at end of year	2011-03-31	$1,616,285
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-03-31	$1,305,514
Value of interest in pooled separate accounts at end of year	2011-03-31	$1,616,179
Value of interest in pooled separate accounts at beginning of year	2011-03-31	$1,303,210
Interest earned on other investments	2011-03-31	$82
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-03-31	$1,757
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-03-31	$0
Net investment gain/loss from pooled separate accounts	2011-03-31	$14,775
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-03-31	No
Was there a failure to transmit to the plan any participant contributions	2011-03-31	No
Has the plan failed to provide any benefit when due under the plan	2011-03-31	No
Contributions received in cash from employer	2011-03-31	$85,623
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-03-31	$62,229
Contract administrator fees	2011-03-31	$14,576
Did the plan have assets held for investment	2011-03-31	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	2011-03-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2011-03-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-03-31	Yes
Opinion of an independent qualified public accountant for this plan	2011-03-31	Disclaimer
Accountancy firm name	2011-03-31	LANIGAN, RYAN, MALCOLM & DOYLE PC
Accountancy firm EIN	2011-03-31	521259972

Form 5500 Responses for M. LUIS CONSTRUCTION COMPANY, INC. 401(K) PROFIT SHARING PLAN AND TRUST

2012: M. LUIS CONSTRUCTION COMPANY, INC. 401(K) PROFIT SHARING PLAN AND TRUST 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: M. LUIS CONSTRUCTION COMPANY, INC. 401(K) PROFIT SHARING PLAN AND TRUST 2011 form 5500 responses
2011-04-01	Type of plan entity	Single employer plan
2011-04-01	Submission has been amended	No
2011-04-01	This submission is the final filing	No
2011-04-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2011-04-01	Plan is a collectively bargained plan	No
2011-04-01	Plan funding arrangement – Insurance	Yes
2011-04-01	Plan funding arrangement – Trust	Yes
2011-04-01	Plan benefit arrangement – Insurance	Yes
2011-04-01	Plan benefit arrangement - Trust	Yes
2010: M. LUIS CONSTRUCTION COMPANY, INC. 401(K) PROFIT SHARING PLAN AND TRUST 2010 form 5500 responses
2010-04-01	Type of plan entity	Single employer plan
2010-04-01	Submission has been amended	Yes
2010-04-01	This submission is the final filing	No
2010-04-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-04-01	Plan is a collectively bargained plan	No
2010-04-01	Plan funding arrangement – Insurance	Yes
2010-04-01	Plan funding arrangement – Trust	Yes
2010-04-01	Plan benefit arrangement – Insurance	Yes
2010-04-01	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

45285

Policy instance

Insurance contract or identification number	45285
Number of Individuals Covered	0
Insurance policy start date	2012-01-01
Insurance policy end date	2012-10-31
Total amount of commissions paid to insurance broker	USD $7,116
Total amount of fees paid to insurance company	USD $1,770
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	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
Commission paid to Insurance Broker	USD $7,116
Insurance broker organization code?	4
Amount paid for insurance broker fees	714
Additional information about fees paid to insurance broker	TPA COMPENSATION
Insurance broker name	VANGUARD GROUP, INC.

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

Policy contract number

45285

Policy instance

Insurance contract or identification number	45285
Insurance policy start date	2011-04-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $5,963
Total amount of fees paid to insurance company	USD $989
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	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

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

Policy contract number

45285

Policy instance

Insurance contract or identification number	45285
Number of Individuals Covered	48
Insurance policy start date	2010-04-01
Insurance policy end date	2011-03-31
Total amount of commissions paid to insurance broker	USD $6,928
Total amount of fees paid to insurance company	USD $896
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	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:	M. LUIS CONSTRUCTION COMPANY, INC.
Employer identification number (EIN):	521418763
NAIC Classification:	238900