401k Plan data: BLUESTONE OPERATING, L.L.C. 401(K) PROFIT SHARING PLAN plan

BLUESTONE OPERATING, L.L.C. 401(K) PROFIT SHARING PLAN 401k Plan overview

Plan Name	BLUESTONE OPERATING, L.L.C. 401(K) PROFIT SHARING PLAN
Plan identification number	001

BLUESTONE OPERATING, L.L.C. 401(K) PROFIT SHARING PLAN 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
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.
Plan covering Self-Employed individuals.
Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.
Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

BLUESTONE OPERATING, L.L.C. has sponsored the creation of one or more 401k plans.

Company Name: BLUESTONE OPERATING, L.L.C.

Employer identification number (EIN): 550913415

NAIC Classification: 211120
NAIC Description: Crude Petroleum Extraction

Form 5500 Filing Information

Submission information for form 5500 for 401k plan BLUESTONE OPERATING, L.L.C. 401(K) PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2019-01-01 JORDAN BARRETT 2020-10-15
001 2018-01-01 JORDAN BARRETT 2019-10-15
001 2017-01-01
001 2016-01-01
001 2015-01-01
001 2014-01-01
001 2013-01-01 CB ROWAN 2014-04-08
001 2012-01-01 CB ROWAN 2013-10-11
001 2011-01-01 CB ROWAN 2012-07-06
001 2010-01-01 CB ROWAN 2011-04-11

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
001	2019-01-01	JORDAN BARRETT	2020-10-15
001	2018-01-01	JORDAN BARRETT	2019-10-15
001	2017-01-01
001	2016-01-01
001	2015-01-01
001	2014-01-01
001	2013-01-01	CB ROWAN	2014-04-08
001	2012-01-01	CB ROWAN	2013-10-11
001	2011-01-01	CB ROWAN	2012-07-06
001	2010-01-01	CB ROWAN	2011-04-11

Plan Statistics for BLUESTONE OPERATING, L.L.C. 401(K) PROFIT SHARING PLAN

401k plan membership statisitcs for BLUESTONE OPERATING, L.L.C. 401(K) PROFIT SHARING PLAN

Measure Date Value
2019: BLUESTONE OPERATING, L.L.C. 401(K) PROFIT SHARING PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 171
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 124
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 24
Total of all active and inactive participants 2019-01-01 149
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 149
Number of participants with account balances 2019-01-01 133
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 0
2018: BLUESTONE OPERATING, L.L.C. 401(K) PROFIT SHARING PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 168
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 156
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 15
Total of all active and inactive participants 2018-01-01 171
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 171
Number of participants with account balances 2018-01-01 147
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 0
2017: BLUESTONE OPERATING, L.L.C. 401(K) PROFIT SHARING PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 156
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 155
Number of retired or separated participants receiving benefits 2017-01-01 1
Number of other retired or separated participants entitled to future benefits 2017-01-01 11
Total of all active and inactive participants 2017-01-01 167
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 1
Total participants 2017-01-01 168
Number of participants with account balances 2017-01-01 144
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 0

Measure	Date	Value
2019: BLUESTONE OPERATING, L.L.C. 401(K) PROFIT SHARING PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	171
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	124
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	24
Total of all active and inactive participants	2019-01-01	149
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	149
Number of participants with account balances	2019-01-01	133
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	0
2018: BLUESTONE OPERATING, L.L.C. 401(K) PROFIT SHARING PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	168
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	156
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	15
Total of all active and inactive participants	2018-01-01	171
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	171
Number of participants with account balances	2018-01-01	147
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	0
2017: BLUESTONE OPERATING, L.L.C. 401(K) PROFIT SHARING PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	156
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	155
Number of retired or separated participants receiving benefits	2017-01-01	1
Number of other retired or separated participants entitled to future benefits	2017-01-01	11
Total of all active and inactive participants	2017-01-01	167
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	1
Total participants	2017-01-01	168
Number of participants with account balances	2017-01-01	144
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	0

Financial Data on BLUESTONE OPERATING, L.L.C. 401(K) PROFIT SHARING PLAN

Measure	Date	Value
2019 : BLUESTONE OPERATING, L.L.C. 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	$3,780,040
Total income from all sources (including contributions)	2019-12-31	$3,780,040
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	$3,021,311
Total of all expenses incurred	2019-12-31	$3,021,311
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$2,945,767
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$2,945,767
Expenses. Certain deemed distributions of participant loans	2019-12-31	$0
Expenses. Certain deemed distributions of participant loans	2019-12-31	$0
Value of total corrective distributions	2019-12-31	$1,312
Value of total corrective distributions	2019-12-31	$1,312
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$1,679,738
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$1,679,738
Value of total assets at end of year	2019-12-31	$11,143,591
Value of total assets at end of year	2019-12-31	$11,143,591
Value of total assets at beginning of year	2019-12-31	$10,384,862
Value of total assets at beginning of year	2019-12-31	$10,384,862
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$74,232
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$74,232
Total interest from all sources	2019-12-31	$23,384
Total interest from all sources	2019-12-31	$23,384
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$503,830
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$503,830
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
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	$1,012,244
Contributions received from participants	2019-12-31	$1,012,244
Participant contributions at end of year	2019-12-31	$13,359
Participant contributions at end of year	2019-12-31	$13,359
Participant contributions at beginning of year	2019-12-31	$34,478
Participant contributions at beginning of year	2019-12-31	$34,478
Participant contributions at end of year	2019-12-31	$885
Participant contributions at end of year	2019-12-31	$885
Participant contributions at beginning of year	2019-12-31	$65,490
Participant contributions at beginning of year	2019-12-31	$65,490
Other income not declared elsewhere	2019-12-31	$0
Other income not declared elsewhere	2019-12-31	$0
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	$758,729
Value of net income/loss	2019-12-31	$758,729
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$11,143,591
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$11,143,591
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$10,384,862
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$10,384,862
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
Investment advisory and management fees	2019-12-31	$74,232
Investment advisory and management fees	2019-12-31	$74,232
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$9,592,166
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$9,592,166
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$8,433,885
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$8,433,885
Interest on participant loans	2019-12-31	$1,129
Interest on participant loans	2019-12-31	$1,129
Interest earned on other investments	2019-12-31	$22,255
Interest earned on other investments	2019-12-31	$22,255
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$1,536,297
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$1,536,297
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$1,811,046
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$1,811,046
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$1,573,088
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$1,573,088
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	Yes
Was there a failure to transmit to the plan any participant contributions	2019-12-31	Yes
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	$667,494
Contributions received in cash from employer	2019-12-31	$667,494
Employer contributions (assets) at end of year	2019-12-31	$884
Employer contributions (assets) at end of year	2019-12-31	$884
Employer contributions (assets) at beginning of year	2019-12-31	$39,963
Employer contributions (assets) at beginning of year	2019-12-31	$39,963
Income. Dividends from preferred stock	2019-12-31	$503,830
Income. Dividends from preferred stock	2019-12-31	$503,830
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$2,945,767
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$2,945,767
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	EIDE BAILLY, LP
Accountancy firm name	2019-12-31	EIDE BAILLY, LP
Accountancy firm EIN	2019-12-31	450250958
Accountancy firm EIN	2019-12-31	450250958
2018 : BLUESTONE OPERATING, L.L.C. 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	$1,191,209
Total loss/gain on sale of assets	2018-12-31	$0
Total of all expenses incurred	2018-12-31	$568,556
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$458,872
Expenses. Certain deemed distributions of participant loans	2018-12-31	$45,874
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$1,737,122
Value of total assets at end of year	2018-12-31	$10,384,862
Value of total assets at beginning of year	2018-12-31	$9,762,209
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$63,810
Total interest from all sources	2018-12-31	$3,025
Total dividends received (eg from common stock, registered investment company shares)	2018-12-31	$621,424
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2018-12-31	$621,424
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	$1,029,727
Participant contributions at end of year	2018-12-31	$34,478
Participant contributions at beginning of year	2018-12-31	$105,969
Participant contributions at end of year	2018-12-31	$65,490
Participant contributions at beginning of year	2018-12-31	$50,660
Other income not declared elsewhere	2018-12-31	$1,670
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	$622,653
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$10,384,862
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$9,762,209
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
Investment advisory and management fees	2018-12-31	$63,810
Value of interest in registered invesment companies (eg mutual funds) at end of year	2018-12-31	$8,433,885
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-12-31	$7,845,500
Interest on participant loans	2018-12-31	$3,025
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2018-12-31	$1,811,046
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2018-12-31	$1,726,946
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2018-12-31	$-1,172,032
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	Yes
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	$707,395
Employer contributions (assets) at end of year	2018-12-31	$39,963
Employer contributions (assets) at beginning of year	2018-12-31	$33,134
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$458,872
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	EIDE BAILLY, LP
Accountancy firm EIN	2018-12-31	450250958
2017 : BLUESTONE OPERATING, L.L.C. 401(K) PROFIT SHARING PLAN 2017 401k financial data
Total income from all sources (including contributions)	2017-12-31	$2,839,204
Total of all expenses incurred	2017-12-31	$1,195,538
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$1,148,335
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$1,549,807
Value of total assets at end of year	2017-12-31	$9,762,209
Value of total assets at beginning of year	2017-12-31	$8,118,543
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$47,203
Total interest from all sources	2017-12-31	$5,853
Total dividends received (eg from common stock, registered investment company shares)	2017-12-31	$415,429
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2017-12-31	$415,429
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$500,000
If this is an individual account plan, was there a blackout period	2017-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2017-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2017-12-31	No
Contributions received from participants	2017-12-31	$890,277
Participant contributions at end of year	2017-12-31	$105,969
Participant contributions at beginning of year	2017-12-31	$160,617
Participant contributions at end of year	2017-12-31	$50,660
Participant contributions at beginning of year	2017-12-31	$25
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2017-12-31	$21,231
Other income not declared elsewhere	2017-12-31	$20,469
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	$1,643,666
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$9,762,209
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$8,118,543
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
Investment advisory and management fees	2017-12-31	$47,203
Value of interest in registered invesment companies (eg mutual funds) at end of year	2017-12-31	$7,845,500
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-12-31	$6,855,749
Interest on participant loans	2017-12-31	$5,853
Interest earned on other investments	2017-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2017-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2017-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2017-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2017-12-31	$1,726,946
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-12-31	$1,102,127
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2017-12-31	$847,646
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	Yes
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	$659,530
Employer contributions (assets) at end of year	2017-12-31	$33,134
Employer contributions (assets) at beginning of year	2017-12-31	$25
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$1,127,104
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	EIDE BAILLY, LP
Accountancy firm EIN	2017-12-31	450250958

Form 5500 Responses for BLUESTONE OPERATING, L.L.C. 401(K) PROFIT SHARING PLAN

2019: BLUESTONE OPERATING, L.L.C. 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: BLUESTONE OPERATING, L.L.C. 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
2017: BLUESTONE OPERATING, L.L.C. 401(K) PROFIT SHARING 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 - Trust	Yes

Insurance Providers Used on plan

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

370624-01

Policy instance

Insurance contract or identification number	370624-01
Number of Individuals Covered	90
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
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?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
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

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

370624-01

Policy instance

Insurance contract or identification number	370624-01
Number of Individuals Covered	90
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
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?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
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

GREAT WEST LIFE & ANNUITY INS CO (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

370624-01

Policy instance

Insurance contract or identification number	370624-01
Number of Individuals Covered	144
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	BLUESTONE OPERATING, L.L.C.
Employer identification number (EIN):	550913415
NAIC Classification:	211120
NAIC Description:	Crude Petroleum Extraction