401k Plan data: BLUE RIDGE AREA FOUNDATION 401(K) PROFIT SHARING PLAN plan

BLUE RIDGE AREA FOUNDATION 401(K) PROFIT SHARING PLAN 401k Plan overview

Plan Name	BLUE RIDGE AREA FOUNDATION 401(K) PROFIT SHARING PLAN
Plan identification number	001

BLUE RIDGE AREA FOUNDATION 401(K) PROFIT SHARING PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

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

BLUE RIDGE AREA FOUNDATION, INC. has sponsored the creation of one or more 401k plans.

Company Name: BLUE RIDGE AREA FOUNDATION, INC.

Employer identification number (EIN): 581557339

NAIC Classification: 621420
NAIC Description: Outpatient Mental Health and Substance Abuse Centers

Form 5500 Filing Information

Submission information for form 5500 for 401k plan BLUE RIDGE AREA FOUNDATION 401(K) PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2016-01-01
001 2015-01-01
001 2015-01-01 CHRISSIE GULDEN 2016-10-13
001 2014-01-01 JILLIAN DYER
001 2013-01-01 LAWRENCE E. THOMPSON
001 2012-01-01 LAWRENCE E. THOMPSON P. RITCHIE GASTON 2013-09-03
001 2011-01-01 LAWRENCE E. THOMPSON P. RITCHIE GASTON 2012-09-06
001 2009-01-01 LAWRENCE E. THOMPSON BERNARD KOESTERS, CFO 2010-08-24

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2016-01-01
001	2015-01-01
001	2015-01-01	CHRISSIE GULDEN	2016-10-13
001	2014-01-01	JILLIAN DYER
001	2013-01-01	LAWRENCE E. THOMPSON
001	2012-01-01	LAWRENCE E. THOMPSON		P. RITCHIE GASTON	2013-09-03
001	2011-01-01	LAWRENCE E. THOMPSON		P. RITCHIE GASTON	2012-09-06
001	2009-01-01	LAWRENCE E. THOMPSON		BERNARD KOESTERS, CFO	2010-08-24

Plan Statistics for BLUE RIDGE AREA FOUNDATION 401(K) PROFIT SHARING PLAN

401k plan membership statisitcs for BLUE RIDGE AREA FOUNDATION 401(K) PROFIT SHARING PLAN

Measure Date Value
2015: BLUE RIDGE AREA FOUNDATION 401(K) PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 284
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 44
Number of retired or separated participants receiving benefits 2015-01-01 0
Number of other retired or separated participants entitled to future benefits 2015-01-01 35
Total of all active and inactive participants 2015-01-01 79
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 79
Number of participants with account balances 2015-01-01 79
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0
2014: BLUE RIDGE AREA FOUNDATION 401(K) PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 298
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 264
Number of retired or separated participants receiving benefits 2014-01-01 0
Number of other retired or separated participants entitled to future benefits 2014-01-01 26
Total of all active and inactive participants 2014-01-01 290
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 290
Number of participants with account balances 2014-01-01 74
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 3
2013: BLUE RIDGE AREA FOUNDATION 401(K) PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 257
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 269
Number of retired or separated participants receiving benefits 2013-01-01 0
Number of other retired or separated participants entitled to future benefits 2013-01-01 28
Total of all active and inactive participants 2013-01-01 297
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 297
Number of participants with account balances 2013-01-01 89
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 2
2012: BLUE RIDGE AREA FOUNDATION 401(K) PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 263
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 233
Number of retired or separated participants receiving benefits 2012-01-01 3
Number of other retired or separated participants entitled to future benefits 2012-01-01 21
Total of all active and inactive participants 2012-01-01 257
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 257
Number of participants with account balances 2012-01-01 86
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 6
2011: BLUE RIDGE AREA FOUNDATION 401(K) PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 282
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 242
Number of retired or separated participants receiving benefits 2011-01-01 0
Number of other retired or separated participants entitled to future benefits 2011-01-01 20
Total of all active and inactive participants 2011-01-01 262
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 262
Number of participants with account balances 2011-01-01 84
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 3
2009: BLUE RIDGE AREA FOUNDATION 401(K) PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 273
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 238
Number of retired or separated participants receiving benefits 2009-01-01 0
Number of other retired or separated participants entitled to future benefits 2009-01-01 18
Total of all active and inactive participants 2009-01-01 256
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 256
Number of participants with account balances 2009-01-01 85
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 9

Measure	Date	Value
2015: BLUE RIDGE AREA FOUNDATION 401(K) PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	284
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	44
Number of retired or separated participants receiving benefits	2015-01-01	0
Number of other retired or separated participants entitled to future benefits	2015-01-01	35
Total of all active and inactive participants	2015-01-01	79
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	79
Number of participants with account balances	2015-01-01	79
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0
2014: BLUE RIDGE AREA FOUNDATION 401(K) PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	298
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	264
Number of retired or separated participants receiving benefits	2014-01-01	0
Number of other retired or separated participants entitled to future benefits	2014-01-01	26
Total of all active and inactive participants	2014-01-01	290
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	290
Number of participants with account balances	2014-01-01	74
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	3
2013: BLUE RIDGE AREA FOUNDATION 401(K) PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	257
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	269
Number of retired or separated participants receiving benefits	2013-01-01	0
Number of other retired or separated participants entitled to future benefits	2013-01-01	28
Total of all active and inactive participants	2013-01-01	297
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	297
Number of participants with account balances	2013-01-01	89
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	2
2012: BLUE RIDGE AREA FOUNDATION 401(K) PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	263
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	233
Number of retired or separated participants receiving benefits	2012-01-01	3
Number of other retired or separated participants entitled to future benefits	2012-01-01	21
Total of all active and inactive participants	2012-01-01	257
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	257
Number of participants with account balances	2012-01-01	86
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	6
2011: BLUE RIDGE AREA FOUNDATION 401(K) PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	282
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	242
Number of retired or separated participants receiving benefits	2011-01-01	0
Number of other retired or separated participants entitled to future benefits	2011-01-01	20
Total of all active and inactive participants	2011-01-01	262
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	262
Number of participants with account balances	2011-01-01	84
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	3
2009: BLUE RIDGE AREA FOUNDATION 401(K) PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	273
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	238
Number of retired or separated participants receiving benefits	2009-01-01	0
Number of other retired or separated participants entitled to future benefits	2009-01-01	18
Total of all active and inactive participants	2009-01-01	256
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	256
Number of participants with account balances	2009-01-01	85
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	9

Financial Data on BLUE RIDGE AREA FOUNDATION 401(K) PROFIT SHARING PLAN

Measure	Date	Value
2015 : BLUE RIDGE AREA FOUNDATION 401(K) PROFIT SHARING PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets	2015-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Total income from all sources (including contributions)	2015-12-31	$97,709
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$121,540
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$121,540
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$93,249
Value of total assets at end of year	2015-12-31	$1,424,437
Value of total assets at beginning of year	2015-12-31	$1,448,268
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$0
Total interest from all sources	2015-12-31	$13,449
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-12-31	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2015-12-31	$0
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$200,000
If this is an individual account plan, was there a blackout period	2015-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2015-12-31	No
Contributions received from participants	2015-12-31	$59,219
Participant contributions at end of year	2015-12-31	$117,360
Participant contributions at beginning of year	2015-12-31	$158,615
Other income not declared elsewhere	2015-12-31	$-22,666
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Value of net income/loss	2015-12-31	$-23,831
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$1,424,437
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$1,448,268
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2015-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2015-12-31	No
Were any leases to which the plan was party in default or uncollectible	2015-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2015-12-31	$853,753
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-12-31	$855,790
Income. Interest from loans (other than to participants)	2015-12-31	$7,152
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2015-12-31	$6,297
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-12-31	$453,324
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-12-31	$433,863
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2015-12-31	$-8,989
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2015-12-31	No
Was there a failure to transmit to the plan any participant contributions	2015-12-31	No
Has the plan failed to provide any benefit when due under the plan	2015-12-31	No
Contributions received in cash from employer	2015-12-31	$34,030
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$121,540
Did the plan have assets held for investment	2015-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2015-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2015-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2015-12-31	Disclaimer
Accountancy firm name	2015-12-31	GOULD KILLIAN CPA GROUP, PA
Accountancy firm EIN	2015-12-31	561042836
2014 : BLUE RIDGE AREA FOUNDATION 401(K) PROFIT SHARING PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets	2014-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Total income from all sources (including contributions)	2014-12-31	$175,110
Total loss/gain on sale of assets	2014-12-31	$0
Total of all expenses incurred	2014-12-31	$184,033
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$167,753
Expenses. Certain deemed distributions of participant loans	2014-12-31	$16,280
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$109,577
Value of total assets at end of year	2014-12-31	$1,448,268
Value of total assets at beginning of year	2014-12-31	$1,457,191
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$0
Total interest from all sources	2014-12-31	$14,132
Total dividends received (eg from common stock, registered investment company shares)	2014-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-12-31	No
Was this plan covered by a fidelity bond	2014-12-31	Yes
Value of fidelity bond cover	2014-12-31	$200,000
If this is an individual account plan, was there a blackout period	2014-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2014-12-31	No
Contributions received from participants	2014-12-31	$71,302
Participant contributions at end of year	2014-12-31	$158,615
Participant contributions at beginning of year	2014-12-31	$146,944
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Value of net income/loss	2014-12-31	$-8,923
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$1,448,268
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$1,457,191
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2014-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2014-12-31	No
Were any leases to which the plan was party in default or uncollectible	2014-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2014-12-31	$855,790
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-12-31	$815,750
Interest on participant loans	2014-12-31	$7,481
Interest earned on other investments	2014-12-31	$6,651
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-12-31	$433,863
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-12-31	$494,497
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2014-12-31	$51,401
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2014-12-31	No
Was there a failure to transmit to the plan any participant contributions	2014-12-31	No
Has the plan failed to provide any benefit when due under the plan	2014-12-31	No
Contributions received in cash from employer	2014-12-31	$38,275
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$167,753
Did the plan have assets held for investment	2014-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2014-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2014-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2014-12-31	Disclaimer
Accountancy firm name	2014-12-31	GOULD KILLIAN CPA GROUP, PA
Accountancy firm EIN	2014-12-31	561042836
2013 : BLUE RIDGE AREA FOUNDATION 401(K) PROFIT SHARING PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets	2013-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
Total income from all sources (including contributions)	2013-12-31	$329,144
Total loss/gain on sale of assets	2013-12-31	$0
Total of all expenses incurred	2013-12-31	$164,638
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$163,437
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$127,103
Value of total assets at end of year	2013-12-31	$1,457,191
Value of total assets at beginning of year	2013-12-31	$1,292,685
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$1,201
Total interest from all sources	2013-12-31	$16,714
Total dividends received (eg from common stock, registered investment company shares)	2013-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-12-31	No
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$200,000
If this is an individual account plan, was there a blackout period	2013-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2013-12-31	No
Contributions received from participants	2013-12-31	$83,968
Participant contributions at end of year	2013-12-31	$146,944
Participant contributions at beginning of year	2013-12-31	$118,904
Income. Received or receivable in cash from other sources (including rollovers)	2013-12-31	$884
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Value of net income/loss	2013-12-31	$164,506
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$1,457,191
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$1,292,685
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2013-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2013-12-31	No
Were any leases to which the plan was party in default or uncollectible	2013-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2013-12-31	$815,750
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2013-12-31	$0
Value of interest in pooled separate accounts at end of year	2013-12-31	$0
Value of interest in pooled separate accounts at beginning of year	2013-12-31	$769,458
Interest on participant loans	2013-12-31	$6,580
Interest earned on other investments	2013-12-31	$10,134
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2013-12-31	$494,497
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-12-31	$404,323
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2013-12-31	$155,522
Net investment gain/loss from pooled separate accounts	2013-12-31	$29,805
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2013-12-31	No
Was there a failure to transmit to the plan any participant contributions	2013-12-31	No
Has the plan failed to provide any benefit when due under the plan	2013-12-31	No
Contributions received in cash from employer	2013-12-31	$42,251
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$163,437
Contract administrator fees	2013-12-31	$1,201
Did the plan have assets held for investment	2013-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2013-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2013-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2013-12-31	Disclaimer
Accountancy firm name	2013-12-31	GOULD KILLIAN CPA GROUP, PA
Accountancy firm EIN	2013-12-31	561042836
2012 : BLUE RIDGE AREA FOUNDATION 401(K) PROFIT SHARING PLAN 2012 401k financial data
Total unrealized appreciation/depreciation of assets	2012-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$0
Total income from all sources (including contributions)	2012-12-31	$238,587
Total loss/gain on sale of assets	2012-12-31	$0
Total of all expenses incurred	2012-12-31	$27,504
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$24,620
Expenses. Certain deemed distributions of participant loans	2012-12-31	$2,884
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$134,756
Value of total assets at end of year	2012-12-31	$1,292,685
Value of total assets at beginning of year	2012-12-31	$1,081,602
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$0
Total interest from all sources	2012-12-31	$22,688
Total dividends received (eg from common stock, registered investment company shares)	2012-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-12-31	No
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$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	$88,462
Participant contributions at end of year	2012-12-31	$118,904
Participant contributions at beginning of year	2012-12-31	$120,897
Participant contributions at beginning of year	2012-12-31	$3,362
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2012-12-31	$2,005
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	$211,083
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$1,292,685
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$1,081,602
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-12-31	No
Were any leases to which the plan was party in default or uncollectible	2012-12-31	No
Value of interest in pooled separate accounts at end of year	2012-12-31	$769,458
Value of interest in pooled separate accounts at beginning of year	2012-12-31	$612,077
Interest on participant loans	2012-12-31	$6,633
Interest earned on other investments	2012-12-31	$16,055
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-12-31	$404,323
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-12-31	$341,425
Net investment gain/loss from pooled separate accounts	2012-12-31	$81,143
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	No
Has the plan failed to provide any benefit when due under the plan	2012-12-31	No
Contributions received in cash from employer	2012-12-31	$46,294
Employer contributions (assets) at beginning of year	2012-12-31	$1,836
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$24,620
Did the plan have assets held for investment	2012-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2012-12-31	Disclaimer
Accountancy firm name	2012-12-31	GOULD KILLIAN CPA GROUP, PA
Accountancy firm EIN	2012-12-31	561042836
2011 : BLUE RIDGE AREA FOUNDATION 401(K) PROFIT SHARING PLAN 2011 401k financial data
Total unrealized appreciation/depreciation of assets	2011-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$0
Total income from all sources (including contributions)	2011-12-31	$124,166
Total loss/gain on sale of assets	2011-12-31	$0
Total of all expenses incurred	2011-12-31	$111,467
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$111,467
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$132,125
Value of total assets at end of year	2011-12-31	$1,081,602
Value of total assets at beginning of year	2011-12-31	$1,068,903
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$0
Total interest from all sources	2011-12-31	$15,964
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	$85,847
Participant contributions at end of year	2011-12-31	$120,897
Participant contributions at beginning of year	2011-12-31	$67,014
Participant contributions at end of year	2011-12-31	$3,362
Participant contributions at beginning of year	2011-12-31	$3,209
Value of other receiveables (less allowance for doubtful accounts) at end of year	2011-12-31	$2,005
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2011-12-31	$1,273
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	$12,699
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$1,081,602
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$1,068,903
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2011-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2011-12-31	No
Were any leases to which the plan was party in default or uncollectible	2011-12-31	No
Value of interest in pooled separate accounts at end of year	2011-12-31	$612,077
Value of interest in pooled separate accounts at beginning of year	2011-12-31	$672,000
Interest on participant loans	2011-12-31	$5,133
Interest earned on other investments	2011-12-31	$10,831
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-12-31	$341,425
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-12-31	$323,648
Net investment gain/loss from pooled separate accounts	2011-12-31	$-23,923
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	No
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	$46,278
Employer contributions (assets) at end of year	2011-12-31	$1,836
Employer contributions (assets) at beginning of year	2011-12-31	$1,759
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$111,467
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	GOULD, KILLIAN,CPA GROUP, PA
Accountancy firm EIN	2011-12-31	561042836
2010 : BLUE RIDGE AREA FOUNDATION 401(K) PROFIT SHARING PLAN 2010 401k financial data
Total unrealized appreciation/depreciation of assets	2010-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$0
Total income from all sources (including contributions)	2010-12-31	$222,115
Total loss/gain on sale of assets	2010-12-31	$0
Total of all expenses incurred	2010-12-31	$27,423
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$25,698
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$121,798
Value of total assets at end of year	2010-12-31	$1,068,903
Value of total assets at beginning of year	2010-12-31	$874,211
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$1,725
Total interest from all sources	2010-12-31	$13,450
Total dividends received (eg from common stock, registered investment company shares)	2010-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2010-12-31	No
Was this plan covered by a fidelity bond	2010-12-31	Yes
Value of fidelity bond cover	2010-12-31	$200,000
If this is an individual account plan, was there a blackout period	2010-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2010-12-31	No
Contributions received from participants	2010-12-31	$81,090
Participant contributions at end of year	2010-12-31	$67,014
Participant contributions at beginning of year	2010-12-31	$47,728
Participant contributions at end of year	2010-12-31	$3,209
Participant contributions at beginning of year	2010-12-31	$2,855
Value of other receiveables (less allowance for doubtful accounts) at end of year	2010-12-31	$1,273
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2010-12-31	$1,012
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Value of net income/loss	2010-12-31	$194,692
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$1,068,903
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$874,211
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2010-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2010-12-31	No
Were any leases to which the plan was party in default or uncollectible	2010-12-31	No
Value of interest in pooled separate accounts at end of year	2010-12-31	$672,000
Value of interest in pooled separate accounts at beginning of year	2010-12-31	$551,745
Interest on participant loans	2010-12-31	$3,149
Interest earned on other investments	2010-12-31	$10,301
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2010-12-31	$323,648
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2010-12-31	$269,172
Net investment gain/loss from pooled separate accounts	2010-12-31	$86,867
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2010-12-31	No
Was there a failure to transmit to the plan any participant contributions	2010-12-31	No
Has the plan failed to provide any benefit when due under the plan	2010-12-31	No
Contributions received in cash from employer	2010-12-31	$40,708
Employer contributions (assets) at end of year	2010-12-31	$1,759
Employer contributions (assets) at beginning of year	2010-12-31	$1,699
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$25,698
Contract administrator fees	2010-12-31	$1,725
Did the plan have assets held for investment	2010-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2010-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2010-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2010-12-31	Disclaimer
Accountancy firm name	2010-12-31	GOULD, KILLIAN, CPA GROUP, PA
Accountancy firm EIN	2010-12-31	561042836
2009 : BLUE RIDGE AREA FOUNDATION 401(K) PROFIT SHARING PLAN 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2009-12-31	$0

Form 5500 Responses for BLUE RIDGE AREA FOUNDATION 401(K) PROFIT SHARING PLAN

2015: BLUE RIDGE AREA FOUNDATION 401(K) PROFIT SHARING PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	Yes
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: BLUE RIDGE AREA FOUNDATION 401(K) PROFIT SHARING PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: BLUE RIDGE AREA FOUNDATION 401(K) PROFIT SHARING PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: BLUE RIDGE AREA FOUNDATION 401(K) PROFIT SHARING PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: BLUE RIDGE AREA FOUNDATION 401(K) PROFIT SHARING PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	Yes
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2009: BLUE RIDGE AREA FOUNDATION 401(K) PROFIT SHARING PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	No
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	No
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )

Policy contract number

GAP-CP-FA9K

Policy instance

Insurance contract or identification number	GAP-CP-FA9K
Number of Individuals Covered	220
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $2,158
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	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 $1,884
Insurance broker organization code?	7
Insurance broker name	INVEST FINANCIAL CORPORATION

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )

Policy contract number

GAP-CP-FA9K

Policy instance

Insurance contract or identification number	GAP-CP-FA9K
Number of Individuals Covered	74
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $2,380
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	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 $2,380
Insurance broker organization code?	7
Insurance broker name	INVEST FINANCIAL CORPORATION

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )

Policy contract number

GAP-CP-FA9K

Policy instance

Insurance contract or identification number	GAP-CP-FA9K
Number of Individuals Covered	89
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $1,856
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	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 $1,856
Insurance broker organization code?	7
Insurance broker name	INVEST FINANCIAL CORPORATION

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )

Policy contract number

GAP 54 R165

Policy instance

Insurance contract or identification number	GAP 54 R165
Number of Individuals Covered	0
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $186
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $186
Insurance broker organization code?	3
Insurance broker name	INVEST FINANCIAL CORP

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )

Policy contract number

013-06489

Policy instance

Insurance contract or identification number	013-06489
Number of Individuals Covered	86
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $2,567
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	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
Commission paid to Insurance Broker	USD $2,278
Insurance broker organization code?	7
Insurance broker name	INVEST FINANCIAL CORPORATION

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )

Policy contract number

013-06489

Policy instance

Insurance contract or identification number	013-06489
Number of Individuals Covered	84
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $1,288
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	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

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )

Policy contract number

013-06489

Policy instance

Insurance contract or identification number	013-06489
Number of Individuals Covered	89
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $1,128
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	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
Commission paid to Insurance Broker	USD $1,128
Insurance broker organization code?	7
Insurance broker name	NATIONWIDE RETIREMENT SOLUTION

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Company Name:	BLUE RIDGE AREA FOUNDATION, INC.
Employer identification number (EIN):	581557339
NAIC Classification:	621420
NAIC Description:	Outpatient Mental Health and Substance Abuse Centers