401k Plan data: ZSCHIMMER AND SCHWARZ, INC. 401(K) PLAN plan

ZSCHIMMER AND SCHWARZ, INC. 401(K) PLAN 401k Plan overview

Plan Name	ZSCHIMMER AND SCHWARZ, INC. 401(K) PLAN
Plan identification number	001

ZSCHIMMER AND SCHWARZ, INC. 401(K) PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Profit-sharing
ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
Plan provides for automatic enrollment in plan that has employee contributions deducted from payroll.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

401k Sponsoring company profile

ZSCHIMMER AND SCHWARZ, INC. has sponsored the creation of one or more 401k plans.

Company Name: ZSCHIMMER AND SCHWARZ, INC.

Employer identification number (EIN): 582424308

NAIC Classification: 325100

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ZSCHIMMER AND SCHWARZ, INC. 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2022-01-01
001 2021-01-01
001 2020-01-01
001 2019-01-01
001 2019-01-01
001 2018-01-01
001 2017-01-01 KEITH W. NAGY KEITH W. NAGY 2018-10-15
001 2016-01-01 KEITH W, NAGY 2017-06-20 KEITH W. NAGY 2017-06-20
001 2015-01-01 KEITH W, NAGY 2016-07-19

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2022-01-01
001	2021-01-01
001	2020-01-01
001	2019-01-01
001	2019-01-01
001	2018-01-01
001	2017-01-01	KEITH W. NAGY		KEITH W. NAGY	2018-10-15
001	2016-01-01	KEITH W, NAGY	2017-06-20	KEITH W. NAGY	2017-06-20
001	2015-01-01	KEITH W, NAGY	2016-07-19

Plan Statistics for ZSCHIMMER AND SCHWARZ, INC. 401(K) PLAN

401k plan membership statisitcs for ZSCHIMMER AND SCHWARZ, INC. 401(K) PLAN

Measure Date Value
2022: ZSCHIMMER AND SCHWARZ, INC. 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 246
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 157
Number of retired or separated participants receiving benefits 2022-01-01 14
Number of other retired or separated participants entitled to future benefits 2022-01-01 87
Total of all active and inactive participants 2022-01-01 258
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 0
Total participants 2022-01-01 258
Number of participants with account balances 2022-01-01 254
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 4
2021: ZSCHIMMER AND SCHWARZ, INC. 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 212
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 162
Number of retired or separated participants receiving benefits 2021-01-01 10
Number of other retired or separated participants entitled to future benefits 2021-01-01 72
Total of all active and inactive participants 2021-01-01 244
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 1
Total participants 2021-01-01 245
Number of participants with account balances 2021-01-01 243
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 1
2020: ZSCHIMMER AND SCHWARZ, INC. 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 213
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 151
Number of retired or separated participants receiving benefits 2020-01-01 10
Number of other retired or separated participants entitled to future benefits 2020-01-01 52
Total of all active and inactive participants 2020-01-01 213
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 213
Number of participants with account balances 2020-01-01 210
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 5
2019: ZSCHIMMER AND SCHWARZ, INC. 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 195
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 159
Number of retired or separated participants receiving benefits 2019-01-01 8
Number of other retired or separated participants entitled to future benefits 2019-01-01 46
Total of all active and inactive participants 2019-01-01 213
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 213
Number of participants with account balances 2019-01-01 213
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 4
2018: ZSCHIMMER AND SCHWARZ, INC. 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 155
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 158
Number of retired or separated participants receiving benefits 2018-01-01 5
Number of other retired or separated participants entitled to future benefits 2018-01-01 32
Total of all active and inactive participants 2018-01-01 195
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 195
Number of participants with account balances 2018-01-01 193
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 0
2017: ZSCHIMMER AND SCHWARZ, INC. 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 124
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 129
Number of retired or separated participants receiving benefits 2017-01-01 4
Number of other retired or separated participants entitled to future benefits 2017-01-01 21
Total of all active and inactive participants 2017-01-01 154
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 154
Number of participants with account balances 2017-01-01 154
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 0

Measure	Date	Value
2022: ZSCHIMMER AND SCHWARZ, INC. 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	246
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	157
Number of retired or separated participants receiving benefits	2022-01-01	14
Number of other retired or separated participants entitled to future benefits	2022-01-01	87
Total of all active and inactive participants	2022-01-01	258
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	0
Total participants	2022-01-01	258
Number of participants with account balances	2022-01-01	254
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	4
2021: ZSCHIMMER AND SCHWARZ, INC. 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	212
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	162
Number of retired or separated participants receiving benefits	2021-01-01	10
Number of other retired or separated participants entitled to future benefits	2021-01-01	72
Total of all active and inactive participants	2021-01-01	244
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	1
Total participants	2021-01-01	245
Number of participants with account balances	2021-01-01	243
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	1
2020: ZSCHIMMER AND SCHWARZ, INC. 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	213
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	151
Number of retired or separated participants receiving benefits	2020-01-01	10
Number of other retired or separated participants entitled to future benefits	2020-01-01	52
Total of all active and inactive participants	2020-01-01	213
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	213
Number of participants with account balances	2020-01-01	210
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	5
2019: ZSCHIMMER AND SCHWARZ, INC. 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	195
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	159
Number of retired or separated participants receiving benefits	2019-01-01	8
Number of other retired or separated participants entitled to future benefits	2019-01-01	46
Total of all active and inactive participants	2019-01-01	213
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	213
Number of participants with account balances	2019-01-01	213
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	4
2018: ZSCHIMMER AND SCHWARZ, INC. 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	155
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	158
Number of retired or separated participants receiving benefits	2018-01-01	5
Number of other retired or separated participants entitled to future benefits	2018-01-01	32
Total of all active and inactive participants	2018-01-01	195
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	195
Number of participants with account balances	2018-01-01	193
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	0
2017: ZSCHIMMER AND SCHWARZ, INC. 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	124
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	129
Number of retired or separated participants receiving benefits	2017-01-01	4
Number of other retired or separated participants entitled to future benefits	2017-01-01	21
Total of all active and inactive participants	2017-01-01	154
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	154
Number of participants with account balances	2017-01-01	154
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	0

Financial Data on ZSCHIMMER AND SCHWARZ, INC. 401(K) PLAN

Measure	Date	Value
2022 : ZSCHIMMER AND SCHWARZ, INC. 401(K) PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets	2022-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$0
Total income from all sources (including contributions)	2022-12-31	$-1,061,364
Total loss/gain on sale of assets	2022-12-31	$0
Total of all expenses incurred	2022-12-31	$1,281,746
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-31	$1,260,636
Expenses. Certain deemed distributions of participant loans	2022-12-31	$16,296
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-12-31	$1,494,642
Value of total assets at end of year	2022-12-31	$10,524,137
Value of total assets at beginning of year	2022-12-31	$12,867,247
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-12-31	$4,814
Total interest from all sources	2022-12-31	$9,988
Total dividends received (eg from common stock, registered investment company shares)	2022-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2022-12-31	No
Was this plan covered by a fidelity bond	2022-12-31	Yes
Value of fidelity bond cover	2022-12-31	$500,000
If this is an individual account plan, was there a blackout period	2022-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2022-12-31	No
Contributions received from participants	2022-12-31	$1,028,553
Participant contributions at end of year	2022-12-31	$228,842
Participant contributions at beginning of year	2022-12-31	$175,949
Participant contributions at end of year	2022-12-31	$14,702
Participant contributions at beginning of year	2022-12-31	$17,193
Income. Received or receivable in cash from other sources (including rollovers)	2022-12-31	$12,580
Value of other receiveables (less allowance for doubtful accounts) at end of year	2022-12-31	$25
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2022-12-31	$409
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-12-31	No
Value of net income/loss	2022-12-31	$-2,343,110
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$10,524,137
Value of net assets at beginning of year (total assets less liabilities)	2022-12-31	$12,867,247
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2022-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2022-12-31	No
Were any leases to which the plan was party in default or uncollectible	2022-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2022-12-31	$9,319,198
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2022-12-31	$12,048,123
Interest on participant loans	2022-12-31	$9,988
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2022-12-31	$947,500
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2022-12-31	$615,346
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2022-12-31	$-2,565,994
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2022-12-31	No
Was there a failure to transmit to the plan any participant contributions	2022-12-31	No
Has the plan failed to provide any benefit when due under the plan	2022-12-31	No
Contributions received in cash from employer	2022-12-31	$453,509
Employer contributions (assets) at end of year	2022-12-31	$13,870
Employer contributions (assets) at beginning of year	2022-12-31	$10,227
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-12-31	$1,260,636
Contract administrator fees	2022-12-31	$4,814
Did the plan have assets held for investment	2022-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2022-12-31	No
Opinion of an independent qualified public accountant for this plan	2022-12-31	Unqualified
Accountancy firm name	2022-12-31	ROEDL LANGFORD DE KOCK, LLP
Accountancy firm EIN	2022-12-31	582594719
2021 : ZSCHIMMER AND SCHWARZ, INC. 401(K) PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets	2021-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$0
Total income from all sources (including contributions)	2021-12-31	$3,158,546
Total loss/gain on sale of assets	2021-12-31	$0
Total of all expenses incurred	2021-12-31	$2,269,217
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$2,247,839
Expenses. Certain deemed distributions of participant loans	2021-12-31	$17,236
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$1,647,588
Value of total assets at end of year	2021-12-31	$12,867,247
Value of total assets at beginning of year	2021-12-31	$11,977,918
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$4,142
Total interest from all sources	2021-12-31	$8,512
Total dividends received (eg from common stock, registered investment company shares)	2021-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2021-12-31	No
Was this plan covered by a fidelity bond	2021-12-31	Yes
Value of fidelity bond cover	2021-12-31	$500,000
If this is an individual account plan, was there a blackout period	2021-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2021-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2021-12-31	No
Contributions received from participants	2021-12-31	$993,717
Participant contributions at end of year	2021-12-31	$175,949
Participant contributions at beginning of year	2021-12-31	$146,821
Participant contributions at end of year	2021-12-31	$17,193
Participant contributions at beginning of year	2021-12-31	$13,799
Income. Received or receivable in cash from other sources (including rollovers)	2021-12-31	$242,689
Value of other receiveables (less allowance for doubtful accounts) at end of year	2021-12-31	$409
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2021-12-31	$153
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Value of net income/loss	2021-12-31	$889,329
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$12,867,247
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$11,977,918
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2021-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2021-12-31	No
Were any leases to which the plan was party in default or uncollectible	2021-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2021-12-31	$12,048,123
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-12-31	$11,189,947
Interest on participant loans	2021-12-31	$8,512
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2021-12-31	$615,346
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2021-12-31	$621,066
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2021-12-31	$1,502,446
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2021-12-31	No
Was there a failure to transmit to the plan any participant contributions	2021-12-31	No
Has the plan failed to provide any benefit when due under the plan	2021-12-31	No
Contributions received in cash from employer	2021-12-31	$411,182
Employer contributions (assets) at end of year	2021-12-31	$10,227
Employer contributions (assets) at beginning of year	2021-12-31	$6,132
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$2,247,839
Contract administrator fees	2021-12-31	$4,142
Did the plan have assets held for investment	2021-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2021-12-31	No
Opinion of an independent qualified public accountant for this plan	2021-12-31	Unqualified
Accountancy firm name	2021-12-31	ROEDL LANGFORD DE KOCK, LLP
Accountancy firm EIN	2021-12-31	582594719
2020 : ZSCHIMMER AND SCHWARZ, INC. 401(K) PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets	2020-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total income from all sources (including contributions)	2020-12-31	$2,980,323
Total loss/gain on sale of assets	2020-12-31	$0
Total of all expenses incurred	2020-12-31	$519,423
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$502,381
Expenses. Certain deemed distributions of participant loans	2020-12-31	$10,544
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$1,283,858
Value of total assets at end of year	2020-12-31	$11,977,918
Value of total assets at beginning of year	2020-12-31	$9,517,018
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$6,498
Total interest from all sources	2020-12-31	$10,583
Total dividends received (eg from common stock, registered investment company shares)	2020-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2020-12-31	No
Was this plan covered by a fidelity bond	2020-12-31	Yes
Value of fidelity bond cover	2020-12-31	$500,000
If this is an individual account plan, was there a blackout period	2020-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2020-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2020-12-31	No
Contributions received from participants	2020-12-31	$897,280
Participant contributions at end of year	2020-12-31	$146,821
Participant contributions at beginning of year	2020-12-31	$174,222
Participant contributions at end of year	2020-12-31	$13,799
Participant contributions at beginning of year	2020-12-31	$3,982
Value of other receiveables (less allowance for doubtful accounts) at end of year	2020-12-31	$153
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2020-12-31	$163
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Value of net income/loss	2020-12-31	$2,460,900
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$11,977,918
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$9,517,018
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2020-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2020-12-31	No
Were any leases to which the plan was party in default or uncollectible	2020-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2020-12-31	$11,189,947
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-12-31	$8,755,209
Interest on participant loans	2020-12-31	$10,583
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2020-12-31	$621,066
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2020-12-31	$580,761
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2020-12-31	$1,685,882
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2020-12-31	No
Was there a failure to transmit to the plan any participant contributions	2020-12-31	No
Has the plan failed to provide any benefit when due under the plan	2020-12-31	No
Contributions received in cash from employer	2020-12-31	$386,578
Employer contributions (assets) at end of year	2020-12-31	$6,132
Employer contributions (assets) at beginning of year	2020-12-31	$2,681
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$502,381
Contract administrator fees	2020-12-31	$6,498
Did the plan have assets held for investment	2020-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2020-12-31	No
Opinion of an independent qualified public accountant for this plan	2020-12-31	Unqualified
Accountancy firm name	2020-12-31	ROEDL LANGFORD DE KOCK, LLP
Accountancy firm EIN	2020-12-31	582594719
2019 : ZSCHIMMER AND SCHWARZ, INC. 401(K) 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	$3,052,372
Total income from all sources (including contributions)	2019-12-31	$3,052,372
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	$780,798
Total of all expenses incurred	2019-12-31	$780,798
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$775,647
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$775,647
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$1,350,067
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$1,350,067
Value of total assets at end of year	2019-12-31	$9,517,018
Value of total assets at end of year	2019-12-31	$9,517,018
Value of total assets at beginning of year	2019-12-31	$7,245,444
Value of total assets at beginning of year	2019-12-31	$7,245,444
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$5,151
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$5,151
Total interest from all sources	2019-12-31	$8,011
Total interest from all sources	2019-12-31	$8,011
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
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	$851,296
Contributions received from participants	2019-12-31	$851,296
Participant contributions at end of year	2019-12-31	$174,222
Participant contributions at end of year	2019-12-31	$174,222
Participant contributions at beginning of year	2019-12-31	$89,937
Participant contributions at beginning of year	2019-12-31	$89,937
Participant contributions at end of year	2019-12-31	$3,982
Participant contributions at end of year	2019-12-31	$3,982
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$110,073
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$110,073
Value of other receiveables (less allowance for doubtful accounts) at end of year	2019-12-31	$163
Value of other receiveables (less allowance for doubtful accounts) at end of year	2019-12-31	$163
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Value of net income/loss	2019-12-31	$2,271,574
Value of net income/loss	2019-12-31	$2,271,574
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$9,517,018
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$9,517,018
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$7,245,444
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$7,245,444
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-12-31	No
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$8,755,209
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$8,755,209
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$6,618,489
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$6,618,489
Interest on participant loans	2019-12-31	$8,011
Interest on participant loans	2019-12-31	$8,011
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$580,761
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$580,761
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$536,417
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$536,417
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$1,694,294
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$1,694,294
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-12-31	No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-12-31	No
Was there a failure to transmit to the plan any participant contributions	2019-12-31	No
Was there a failure to transmit to the plan any participant contributions	2019-12-31	No
Has the plan failed to provide any benefit when due under the plan	2019-12-31	No
Has the plan failed to provide any benefit when due under the plan	2019-12-31	No
Contributions received in cash from employer	2019-12-31	$388,698
Contributions received in cash from employer	2019-12-31	$388,698
Employer contributions (assets) at end of year	2019-12-31	$2,681
Employer contributions (assets) at end of year	2019-12-31	$2,681
Employer contributions (assets) at beginning of year	2019-12-31	$601
Employer contributions (assets) at beginning of year	2019-12-31	$601
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$775,647
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$775,647
Contract administrator fees	2019-12-31	$5,151
Contract administrator fees	2019-12-31	$5,151
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	ROEDL LANGFORD DE KOCK, LLP
Accountancy firm name	2019-12-31	ROEDL LANGFORD DE KOCK, LLP
Accountancy firm EIN	2019-12-31	582594717
Accountancy firm EIN	2019-12-31	582594717
2018 : ZSCHIMMER AND SCHWARZ, INC. 401(K) 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	$1,164,759
Total loss/gain on sale of assets	2018-12-31	$0
Total of all expenses incurred	2018-12-31	$192,398
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$188,884
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$1,644,029
Value of total assets at end of year	2018-12-31	$7,245,444
Value of total assets at beginning of year	2018-12-31	$6,273,083
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$3,514
Total interest from all sources	2018-12-31	$6,582
Total dividends received (eg from common stock, registered investment company shares)	2018-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-12-31	No
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	$722,837
Participant contributions at end of year	2018-12-31	$89,937
Participant contributions at beginning of year	2018-12-31	$134,563
Participant contributions at beginning of year	2018-12-31	$8,107
Income. Received or receivable in cash from other sources (including rollovers)	2018-12-31	$580,473
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	$972,361
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$7,245,444
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$6,273,083
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2018-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2018-12-31	No
Were any leases to which the plan was party in default or uncollectible	2018-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2018-12-31	$6,618,489
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-12-31	$5,619,168
Interest on participant loans	2018-12-31	$6,582
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2018-12-31	$536,417
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2018-12-31	$505,647
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2018-12-31	$-485,852
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2018-12-31	No
Was there a failure to transmit to the plan any participant contributions	2018-12-31	No
Has the plan failed to provide any benefit when due under the plan	2018-12-31	No
Contributions received in cash from employer	2018-12-31	$340,719
Employer contributions (assets) at end of year	2018-12-31	$601
Employer contributions (assets) at beginning of year	2018-12-31	$5,598
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$188,884
Contract administrator fees	2018-12-31	$3,514
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	ROEDL LANGFORD DE KOCK, LLP
Accountancy firm EIN	2018-12-31	582594717
2017 : ZSCHIMMER AND SCHWARZ, INC. 401(K) PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets	2017-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$0
Total income from all sources (including contributions)	2017-12-31	$2,225,830
Total loss/gain on sale of assets	2017-12-31	$0
Total of all expenses incurred	2017-12-31	$151,482
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$142,035
Expenses. Certain deemed distributions of participant loans	2017-12-31	$4,781
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$1,476,579
Value of total assets at end of year	2017-12-31	$6,273,083
Value of total assets at beginning of year	2017-12-31	$4,198,735
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$4,666
Total interest from all sources	2017-12-31	$4,144
Total dividends received (eg from common stock, registered investment company shares)	2017-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-12-31	No
Was this plan covered by a fidelity bond	2017-12-31	No
If this is an individual account plan, was there a blackout period	2017-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2017-12-31	No
Contributions received from participants	2017-12-31	$624,810
Participant contributions at end of year	2017-12-31	$134,563
Participant contributions at beginning of year	2017-12-31	$75,476
Participant contributions at end of year	2017-12-31	$8,107
Income. Received or receivable in cash from other sources (including rollovers)	2017-12-31	$566,281
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	$2,074,348
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$6,273,083
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$4,198,735
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2017-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2017-12-31	No
Were any leases to which the plan was party in default or uncollectible	2017-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2017-12-31	$5,619,168
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-12-31	$3,675,068
Interest on participant loans	2017-12-31	$4,144
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2017-12-31	$505,647
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-12-31	$448,191
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2017-12-31	$745,107
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	$285,488
Employer contributions (assets) at end of year	2017-12-31	$5,598
Employer contributions (assets) at beginning of year	2017-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$142,035
Contract administrator fees	2017-12-31	$4,666
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	ROEDL LANGFORD DE KOCK
Accountancy firm EIN	2017-12-31	582594717

Form 5500 Responses for ZSCHIMMER AND SCHWARZ, INC. 401(K) PLAN

2022: ZSCHIMMER AND SCHWARZ, INC. 401(K) PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Submission has been amended	No
2022-01-01	This submission is the final filing	No
2022-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2022-01-01	Plan is a collectively bargained plan	No
2022-01-01	Plan funding arrangement – Insurance	Yes
2022-01-01	Plan funding arrangement – Trust	Yes
2022-01-01	Plan benefit arrangement – Insurance	Yes
2022-01-01	Plan benefit arrangement - Trust	Yes
2021: ZSCHIMMER AND SCHWARZ, INC. 401(K) PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Submission has been amended	No
2021-01-01	This submission is the final filing	No
2021-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-01-01	Plan is a collectively bargained plan	No
2021-01-01	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan funding arrangement – Trust	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes
2021-01-01	Plan benefit arrangement - Trust	Yes
2020: ZSCHIMMER AND SCHWARZ, INC. 401(K) PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Submission has been amended	No
2020-01-01	This submission is the final filing	No
2020-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-01-01	Plan is a collectively bargained plan	No
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan funding arrangement – Trust	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement - Trust	Yes
2019: ZSCHIMMER AND SCHWARZ, INC. 401(K) 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: ZSCHIMMER AND SCHWARZ, INC. 401(K) 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: ZSCHIMMER AND SCHWARZ, INC. 401(K) PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	No
2017-01-01	This submission is the final filing	No
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

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

Policy contract number

GAP-CP-JF2M

Policy instance

Insurance contract or identification number	GAP-CP-JF2M
Number of Individuals Covered	254
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $2,645
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Commission paid to Insurance Broker	USD $2,645
Insurance broker organization code?	7

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

Policy contract number

GAP-CP-JF2M

Policy instance

Insurance contract or identification number	GAP-CP-JF2M
Number of Individuals Covered	243
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $2,387
Total amount of fees paid to insurance company	USD $0
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?	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 $2,387
Amount paid for insurance broker fees	0
Insurance broker organization code?	7

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

Policy contract number

GAP-CP-JF2M

Policy instance

Insurance contract or identification number	GAP-CP-JF2M
Number of Individuals Covered	210
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $2,413
Total amount of fees paid to insurance company	USD $0
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?	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 $2,413
Amount paid for insurance broker fees	0
Insurance broker organization code?	7

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

Policy contract number

GAP-CP-JF2M

Policy instance

Insurance contract or identification number	GAP-CP-JF2M
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $3,182
Total amount of fees paid to insurance company	USD $0
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?	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 $3,182
Amount paid for insurance broker fees	0
Insurance broker organization code?	7

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

Policy contract number

GAP-CP-JF2M

Policy instance

Insurance contract or identification number	GAP-CP-JF2M
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $3,642
Total amount of fees paid to insurance company	USD $0
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?	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 $3,642
Amount paid for insurance broker fees	0
Insurance broker organization code?	7

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

Policy contract number

GAP-CP-JF2M

Policy instance

Insurance contract or identification number	GAP-CP-JF2M
Number of Individuals Covered	154
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $3,379
Total amount of fees paid to insurance company	USD $0
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?	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 $3,379
Amount paid for insurance broker fees	0
Insurance broker organization code?	7
Insurance broker name	AMERIPRISE FINANCIAL SERVICES

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Company Name:	ZSCHIMMER AND SCHWARZ, INC.
Employer identification number (EIN):	582424308
NAIC Classification:	325100