401k Plan data: NORTHWEST TRUE VALUE HARDWARE EMPLOYEE RETIREMENT PLAN plan

NORTHWEST TRUE VALUE HARDWARE EMPLOYEE RETIREMENT PLAN 401k Plan overview

Plan Name	NORTHWEST TRUE VALUE HARDWARE EMPLOYEE RETIREMENT PLAN
Plan identification number	001

NORTHWEST TRUE VALUE HARDWARE EMPLOYEE RETIREMENT PLAN Benefits

401k Plan Type	Defined Contribution Pension
Plan Features/Benefits	Money purchase (other than target benefit) 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

NORTHWEST HARDWARE COMPANY, INC. has sponsored the creation of one or more 401k plans.

Company Name: NORTHWEST HARDWARE COMPANY, INC.

Employer identification number (EIN): 540554374

NAIC Classification: 444130
NAIC Description: Hardware Stores

Additional information about NORTHWEST HARDWARE COMPANY, INC.

Jurisdiction of Incorporation: Virginia Secretary of State

Incorporation Date: 1953-01-02

Company Identification Number: 0065968

Legal Registered Office Address: 2303 WILLIAMSON ROAD, NE
P.O. BOX 5537
ROANOKE
United States of America (USA)
24012

More information about NORTHWEST HARDWARE COMPANY, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan NORTHWEST TRUE VALUE HARDWARE EMPLOYEE RETIREMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2018-01-01
001 2017-01-01
001 2016-01-01 KATIE OBREMSKI
001 2015-01-01 KATIE OBREMSKI 2016-06-10
001 2014-01-01 KATIE OBREMSKI 2015-06-24
001 2013-01-01 FIACRE BRISSI 2014-07-01
001 2012-01-01 DON MARKWARDT 2013-07-16
001 2011-01-01 RACHEL BOSWORTH 2012-07-05
001 2010-01-01 MIKE BAHDE 2011-06-30

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
001	2018-01-01
001	2017-01-01
001	2016-01-01	KATIE OBREMSKI
001	2015-01-01	KATIE OBREMSKI	2016-06-10
001	2014-01-01	KATIE OBREMSKI	2015-06-24
001	2013-01-01	FIACRE BRISSI	2014-07-01
001	2012-01-01	DON MARKWARDT	2013-07-16
001	2011-01-01	RACHEL BOSWORTH	2012-07-05
001	2010-01-01	MIKE BAHDE	2011-06-30

Plan Statistics for NORTHWEST TRUE VALUE HARDWARE EMPLOYEE RETIREMENT PLAN

401k plan membership statisitcs for NORTHWEST TRUE VALUE HARDWARE EMPLOYEE RETIREMENT PLAN

Measure Date Value
2018: NORTHWEST TRUE VALUE HARDWARE EMPLOYEE RETIREMENT PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 133
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 0
Number of retired or separated participants receiving benefits 2018-01-01 0
Number of other retired or separated participants entitled to future benefits 2018-01-01 0
Total of all active and inactive participants 2018-01-01 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 0
Number of participants with account balances 2018-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 0
2017: NORTHWEST TRUE VALUE HARDWARE EMPLOYEE RETIREMENT PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 132
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 103
Number of retired or separated participants receiving benefits 2017-01-01 2
Number of other retired or separated participants entitled to future benefits 2017-01-01 9
Total of all active and inactive participants 2017-01-01 114
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 1
Total participants 2017-01-01 115
Number of participants with account balances 2017-01-01 115
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 11
2016: NORTHWEST TRUE VALUE HARDWARE EMPLOYEE RETIREMENT PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 122
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 91
Number of retired or separated participants receiving benefits 2016-01-01 5
Number of other retired or separated participants entitled to future benefits 2016-01-01 6
Total of all active and inactive participants 2016-01-01 102
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 1
Total participants 2016-01-01 103
Number of participants with account balances 2016-01-01 103
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 8

Measure	Date	Value
2018: NORTHWEST TRUE VALUE HARDWARE EMPLOYEE RETIREMENT PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	133
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	0
Number of retired or separated participants receiving benefits	2018-01-01	0
Number of other retired or separated participants entitled to future benefits	2018-01-01	0
Total of all active and inactive participants	2018-01-01	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	0
Number of participants with account balances	2018-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	0
2017: NORTHWEST TRUE VALUE HARDWARE EMPLOYEE RETIREMENT PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	132
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	103
Number of retired or separated participants receiving benefits	2017-01-01	2
Number of other retired or separated participants entitled to future benefits	2017-01-01	9
Total of all active and inactive participants	2017-01-01	114
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	1
Total participants	2017-01-01	115
Number of participants with account balances	2017-01-01	115
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	11
2016: NORTHWEST TRUE VALUE HARDWARE EMPLOYEE RETIREMENT PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	122
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	91
Number of retired or separated participants receiving benefits	2016-01-01	5
Number of other retired or separated participants entitled to future benefits	2016-01-01	6
Total of all active and inactive participants	2016-01-01	102
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	1
Total participants	2016-01-01	103
Number of participants with account balances	2016-01-01	103
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	8

Financial Data on NORTHWEST TRUE VALUE HARDWARE EMPLOYEE RETIREMENT PLAN

Measure	Date	Value
2018 : NORTHWEST TRUE VALUE HARDWARE EMPLOYEE RETIREMENT PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets	2018-05-02	$0
Total transfer of assets from this plan	2018-05-02	$2,226,720
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-05-02	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-05-02	$0
Total income from all sources (including contributions)	2018-05-02	$12,367
Total loss/gain on sale of assets	2018-05-02	$0
Total of all expenses incurred	2018-05-02	$50,133
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-05-02	$50,133
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-05-02	$0
Value of total assets at end of year	2018-05-02	$0
Value of total assets at beginning of year	2018-05-02	$2,264,486
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-05-02	$0
Total interest from all sources	2018-05-02	$13,032
Total dividends received (eg from common stock, registered investment company shares)	2018-05-02	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-05-02	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2018-05-02	$0
Was this plan covered by a fidelity bond	2018-05-02	Yes
Value of fidelity bond cover	2018-05-02	$350,000
If this is an individual account plan, was there a blackout period	2018-05-02	No
Funding deficiency by the employer to the plan for this plan year	2018-05-02	$0
Minimum employer required contribution for this plan year	2018-05-02	$0
Amount contributed by the employer to the plan for this plan year	2018-05-02	$0
Were there any nonexempt tranactions with any party-in-interest	2018-05-02	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	2018-05-02	No
Value of net income/loss	2018-05-02	$-37,766
Value of net assets at end of year (total assets less liabilities)	2018-05-02	$0
Value of net assets at beginning of year (total assets less liabilities)	2018-05-02	$2,264,486
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2018-05-02	No
Were any loans by the plan or fixed income obligations due to the plan in default	2018-05-02	No
Were any leases to which the plan was party in default or uncollectible	2018-05-02	No
Value of interest in pooled separate accounts at end of year	2018-05-02	$0
Value of interest in pooled separate accounts at beginning of year	2018-05-02	$672,288
Interest earned on other investments	2018-05-02	$13,032
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2018-05-02	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2018-05-02	$1,564,348
Net investment gain/loss from pooled separate accounts	2018-05-02	$-665
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2018-05-02	No
Was there a failure to transmit to the plan any participant contributions	2018-05-02	No
Has the plan failed to provide any benefit when due under the plan	2018-05-02	No
Contributions received in cash from employer	2018-05-02	$0
Employer contributions (assets) at end of year	2018-05-02	$0
Employer contributions (assets) at beginning of year	2018-05-02	$27,850
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-05-02	$50,133
Did the plan have assets held for investment	2018-05-02	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	2018-05-02	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2018-05-02	Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2018-05-02	Yes
Opinion of an independent qualified public accountant for this plan	2018-05-02	Disclaimer
Accountancy firm name	2018-05-02	BROWN, EDWARDS & COMPANY LLP
Accountancy firm EIN	2018-05-02	540504608
2017 : NORTHWEST TRUE VALUE HARDWARE EMPLOYEE RETIREMENT PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets	2017-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$0
Total income from all sources (including contributions)	2017-12-31	$293,505
Total loss/gain on sale of assets	2017-12-31	$0
Total of all expenses incurred	2017-12-31	$92,982
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$92,982
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$135,850
Value of total assets at end of year	2017-12-31	$2,264,486
Value of total assets at beginning of year	2017-12-31	$2,063,963
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$0
Total interest from all sources	2017-12-31	$41,197
Total dividends received (eg from common stock, registered investment company shares)	2017-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-12-31	No
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$350,000
If this is an individual account plan, was there a blackout period	2017-12-31	No
Funding deficiency by the employer to the plan for this plan year	2017-12-31	$0
Minimum employer required contribution for this plan year	2017-12-31	$148,943
Amount contributed by the employer to the plan for this plan year	2017-12-31	$148,943
Were there any nonexempt tranactions with any party-in-interest	2017-12-31	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	2017-12-31	No
Value of net income/loss	2017-12-31	$200,523
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$2,264,486
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$2,063,963
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2017-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2017-12-31	No
Were any leases to which the plan was party in default or uncollectible	2017-12-31	No
Value of interest in pooled separate accounts at end of year	2017-12-31	$672,288
Value of interest in pooled separate accounts at beginning of year	2017-12-31	$563,952
Interest earned on other investments	2017-12-31	$41,197
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2017-12-31	$1,564,348
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-12-31	$1,500,011
Net investment gain/loss from pooled separate accounts	2017-12-31	$116,458
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2017-12-31	No
Was there a failure to transmit to the plan any participant contributions	2017-12-31	No
Has the plan failed to provide any benefit when due under the plan	2017-12-31	No
Contributions received in cash from employer	2017-12-31	$135,850
Employer contributions (assets) at end of year	2017-12-31	$27,850
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$92,982
Did the plan have assets held for investment	2017-12-31	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	2017-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2017-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2017-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2017-12-31	Disclaimer
Accountancy firm name	2017-12-31	BROWN, EDWARDS & COMPANY LLP
Accountancy firm EIN	2017-12-31	540504608
2016 : NORTHWEST TRUE VALUE HARDWARE 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	$258,350
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$501,408
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$501,408
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$144,000
Value of total assets at end of year	2016-12-31	$2,063,963
Value of total assets at beginning of year	2016-12-31	$2,307,021
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$0
Total interest from all sources	2016-12-31	$47,580
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	$350,000
If this is an individual account plan, was there a blackout period	2016-12-31	No
Funding deficiency by the employer to the plan for this plan year	2016-12-31	$0
Minimum employer required contribution for this plan year	2016-12-31	$152,715
Amount contributed by the employer to the plan for this plan year	2016-12-31	$152,715
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	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	2016-12-31	No
Value of net income/loss	2016-12-31	$-243,058
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$2,063,963
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$2,307,021
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	$563,952
Value of interest in pooled separate accounts at beginning of year	2016-12-31	$604,159
Interest earned on other investments	2016-12-31	$47,580
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-12-31	$1,500,011
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-12-31	$1,702,862
Net investment gain/loss from pooled separate accounts	2016-12-31	$66,770
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
Contributions received in cash from employer	2016-12-31	$144,000
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$501,408
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	BROWN, EDWARDS & COMPANY LLP
Accountancy firm EIN	2016-12-31	540504608

Form 5500 Responses for NORTHWEST TRUE VALUE HARDWARE EMPLOYEE RETIREMENT PLAN

2018: NORTHWEST TRUE VALUE HARDWARE EMPLOYEE RETIREMENT 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	Yes
2018-01-01	This return/report is a short plan year return/report (less than 12 months)	Yes
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
2017: NORTHWEST TRUE VALUE HARDWARE EMPLOYEE RETIREMENT PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	No
2017-01-01	This submission is the final filing	No
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes
2016: NORTHWEST TRUE VALUE HARDWARE 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

Insurance Providers Used on plan

SENTRY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68810 )

Policy contract number

89-60187-71

Policy instance

Insurance contract or identification number	89-60187-71
Number of Individuals Covered	0
Insurance policy start date	2018-01-01
Insurance policy end date	2018-05-02
Total amount of commissions paid to insurance broker	USD $625
Total amount of fees paid to insurance company	USD $38
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	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 $625
Amount paid for insurance broker fees	38
Additional information about fees paid to insurance broker	INCENTIVES
Insurance broker organization code?	3

SENTRY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68810 )

Policy contract number

89-60187-71

Policy instance

Insurance contract or identification number	89-60187-71
Number of Individuals Covered	115
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $1,822
Total amount of fees paid to insurance company	USD $182
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	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 $1,822
Amount paid for insurance broker fees	182
Additional information about fees paid to insurance broker	INCENTIVES
Insurance broker organization code?	3
Insurance broker name	JOHN SPADEA III

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Company Name:	NORTHWEST HARDWARE COMPANY, INC.
Employer identification number (EIN):	540554374
NAIC Classification:	444130
NAIC Description:	Hardware Stores

Jurisdiction of Incorporation:	Virginia Secretary of State
Incorporation Date:	1953-01-02
Company Identification Number:	0065968
Legal Registered Office Address:	2303 WILLIAMSON ROAD, NE P.O. BOX 5537 ROANOKE United States of America (USA) 24012