401k Plan data: CLEAVER CONSTRUCTION CO INC EMPLOYEES' PROFT SHARING & 401(K) PLAN plan

CLEAVER CONSTRUCTION CO INC EMPLOYEES' PROFT SHARING & 401(K) PLAN 401k Plan overview

Plan Name	CLEAVER CONSTRUCTION CO INC EMPLOYEES' PROFT SHARING & 401(K) PLAN
Plan identification number	002

CLEAVER CONSTRUCTION CO INC EMPLOYEES' PROFT SHARING & 401(K) PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Age/Service Weighted or new comparability or similar plan - Age/Service Weighted Plan: Allocations are based on age, service, or age and service. New comparability or similar plan: Allocations are based on participant classifications and a classification(s) consists entirely or predominantly of highly compensated employees; or the plan provides an additional allocation rate on compensation above a specified threshold, and the theshold or additional rate exceeds the maximum threshold or rate allowed under the permitted disparity rules of section 401(l).
Offset plan - Plan benefits are subject to offset for retirement benefits provided in another plan or arrangement of the employer.
Profit-sharing
ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
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

CLEAVER CONSTRUCTION CO., INC. has sponsored the creation of one or more 401k plans.

Company Name: CLEAVER CONSTRUCTION CO., INC.

Employer identification number (EIN): 610937678

NAIC Classification: 236200

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CLEAVER CONSTRUCTION CO INC EMPLOYEES' PROFT SHARING & 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2022-01-01 KATHERINE STEVENSON 2023-01-23
002 2021-01-01 KATHERINE STEVENSON 2022-03-30
002 2020-01-01 KATHERINE STEVENSON 2021-03-29
002 2019-01-01 KATHERINE STEVENSON 2020-05-26
002 2018-01-01 KATHERINE STEVENSON 2019-06-26
002 2017-01-01 KATHERINE STEVENSON 2018-07-31
002 2016-01-01 KATHERINE STEVENSON 2017-07-24
002 2015-01-01 KATHERINE STEVENSON 2016-09-22
002 2014-01-01 TERESA 2015-05-08
002 2013-01-01 TERESA
002 2012-01-01 MAX CLEAVER
002 2011-01-01 MAX CLEAVER
002 2010-01-01 MAX CLEAVER
002 2009-01-01 MAX CLEAVER

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
002	2022-01-01	KATHERINE STEVENSON	2023-01-23
002	2021-01-01	KATHERINE STEVENSON	2022-03-30
002	2020-01-01	KATHERINE STEVENSON	2021-03-29
002	2019-01-01	KATHERINE STEVENSON	2020-05-26
002	2018-01-01	KATHERINE STEVENSON	2019-06-26
002	2017-01-01	KATHERINE STEVENSON	2018-07-31
002	2016-01-01	KATHERINE STEVENSON	2017-07-24
002	2015-01-01	KATHERINE STEVENSON	2016-09-22
002	2014-01-01	TERESA	2015-05-08
002	2013-01-01	TERESA
002	2012-01-01	MAX CLEAVER
002	2011-01-01	MAX CLEAVER
002	2010-01-01	MAX CLEAVER
002	2009-01-01	MAX CLEAVER

Plan Statistics for CLEAVER CONSTRUCTION CO INC EMPLOYEES' PROFT SHARING & 401(K) PLAN

401k plan membership statisitcs for CLEAVER CONSTRUCTION CO INC EMPLOYEES' PROFT SHARING & 401(K) PLAN

Measure Date Value
2013: CLEAVER CONSTRUCTION CO INC EMPLOYEES' PROFT SHARING & 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 11
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 10
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 0
Total of all active and inactive participants 2013-01-01 10
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 10
Number of participants with account balances 2013-01-01 6
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0
2012: CLEAVER CONSTRUCTION CO INC EMPLOYEES' PROFT SHARING & 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 8
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 6
Total of all active and inactive participants 2012-01-01 6
Total participants 2012-01-01 6
Number of participants with account balances 2012-01-01 6
2011: CLEAVER CONSTRUCTION CO INC EMPLOYEES' PROFT SHARING & 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 8
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 7
Number of other retired or separated participants entitled to future benefits 2011-01-01 1
Total of all active and inactive participants 2011-01-01 8
Total participants 2011-01-01 8
Number of participants with account balances 2011-01-01 8
2010: CLEAVER CONSTRUCTION CO INC EMPLOYEES' PROFT SHARING & 401(K) PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 8
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 6
Number of other retired or separated participants entitled to future benefits 2010-01-01 2
Total of all active and inactive participants 2010-01-01 8
Total participants 2010-01-01 8
Number of participants with account balances 2010-01-01 8
2009: CLEAVER CONSTRUCTION CO INC EMPLOYEES' PROFT SHARING & 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 8
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 7
Number of other retired or separated participants entitled to future benefits 2009-01-01 1
Total of all active and inactive participants 2009-01-01 8
Total participants 2009-01-01 8
Number of participants with account balances 2009-01-01 8

Measure	Date	Value
2013: CLEAVER CONSTRUCTION CO INC EMPLOYEES' PROFT SHARING & 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	11
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	10
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	0
Total of all active and inactive participants	2013-01-01	10
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	10
Number of participants with account balances	2013-01-01	6
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0
2012: CLEAVER CONSTRUCTION CO INC EMPLOYEES' PROFT SHARING & 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	8
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	6
Total of all active and inactive participants	2012-01-01	6
Total participants	2012-01-01	6
Number of participants with account balances	2012-01-01	6
2011: CLEAVER CONSTRUCTION CO INC EMPLOYEES' PROFT SHARING & 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	8
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	7
Number of other retired or separated participants entitled to future benefits	2011-01-01	1
Total of all active and inactive participants	2011-01-01	8
Total participants	2011-01-01	8
Number of participants with account balances	2011-01-01	8
2010: CLEAVER CONSTRUCTION CO INC EMPLOYEES' PROFT SHARING & 401(K) PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	8
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	6
Number of other retired or separated participants entitled to future benefits	2010-01-01	2
Total of all active and inactive participants	2010-01-01	8
Total participants	2010-01-01	8
Number of participants with account balances	2010-01-01	8
2009: CLEAVER CONSTRUCTION CO INC EMPLOYEES' PROFT SHARING & 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	8
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	7
Number of other retired or separated participants entitled to future benefits	2009-01-01	1
Total of all active and inactive participants	2009-01-01	8
Total participants	2009-01-01	8
Number of participants with account balances	2009-01-01	8

Financial Data on CLEAVER CONSTRUCTION CO INC EMPLOYEES' PROFT SHARING & 401(K) PLAN

Measure	Date	Value
2013 : CLEAVER CONSTRUCTION CO INC EMPLOYEES' PROFT SHARING & 401(K) PLAN 2013 401k financial data
Total income from all sources	2013-12-31	$64,523
Expenses. Total of all expenses incurred	2013-12-31	$32,696
Benefits paid (including direct rollovers)	2013-12-31	$31,250
Total plan assets at end of year	2013-12-31	$229,261
Total plan assets at beginning of year	2013-12-31	$197,434
Value of fidelity bond covering the plan	2013-12-31	$100,000
Total contributions received or receivable from participants	2013-12-31	$3,247
Expenses. Other expenses not covered elsewhere	2013-12-31	$1,446
Other income received	2013-12-31	$58,286
Net income (gross income less expenses)	2013-12-31	$31,827
Net plan assets at end of year (total assets less liabilities)	2013-12-31	$229,261
Net plan assets at beginning of year (total assets less liabilities)	2013-12-31	$197,434
Total contributions received or receivable from employer(s)	2013-12-31	$2,990
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-12-31	$0
2012 : CLEAVER CONSTRUCTION CO INC EMPLOYEES' PROFT SHARING & 401(K) PLAN 2012 401k financial data
Total income from all sources	2012-12-31	$36,074
Expenses. Total of all expenses incurred	2012-12-31	$23,907
Benefits paid (including direct rollovers)	2012-12-31	$21,998
Total plan assets at end of year	2012-12-31	$197,434
Total plan assets at beginning of year	2012-12-31	$185,267
Value of fidelity bond covering the plan	2012-12-31	$100,000
Total contributions received or receivable from participants	2012-12-31	$3,450
Expenses. Other expenses not covered elsewhere	2012-12-31	$1,909
Other income received	2012-12-31	$28,632
Net income (gross income less expenses)	2012-12-31	$12,167
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$197,434
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$185,267
Total contributions received or receivable from employer(s)	2012-12-31	$3,992
2011 : CLEAVER CONSTRUCTION CO INC EMPLOYEES' PROFT SHARING & 401(K) PLAN 2011 401k financial data
Total income from all sources	2011-12-31	$-1,240
Expenses. Total of all expenses incurred	2011-12-31	$1,391
Total plan assets at end of year	2011-12-31	$185,267
Total plan assets at beginning of year	2011-12-31	$187,898
Value of fidelity bond covering the plan	2011-12-31	$100,000
Total contributions received or receivable from participants	2011-12-31	$3,450
Expenses. Other expenses not covered elsewhere	2011-12-31	$1,391
Other income received	2011-12-31	$-7,918
Net income (gross income less expenses)	2011-12-31	$-2,631
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$185,267
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$187,898
Total contributions received or receivable from employer(s)	2011-12-31	$3,228
2010 : CLEAVER CONSTRUCTION CO INC EMPLOYEES' PROFT SHARING & 401(K) PLAN 2010 401k financial data
Total income from all sources	2010-12-31	$24,874
Expenses. Total of all expenses incurred	2010-12-31	$1,322
Total plan assets at end of year	2010-12-31	$187,898
Total plan assets at beginning of year	2010-12-31	$164,346
Value of fidelity bond covering the plan	2010-12-31	$100,000
Total contributions received or receivable from participants	2010-12-31	$3,257
Expenses. Other expenses not covered elsewhere	2010-12-31	$1,322
Other income received	2010-12-31	$21,617
Net income (gross income less expenses)	2010-12-31	$23,552
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$187,898
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$164,346

Form 5500 Responses for CLEAVER CONSTRUCTION CO INC EMPLOYEES' PROFT SHARING & 401(K) PLAN

2013: CLEAVER CONSTRUCTION CO INC EMPLOYEES' PROFT SHARING & 401(K) 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: CLEAVER CONSTRUCTION CO INC EMPLOYEES' PROFT SHARING & 401(K) PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
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: CLEAVER CONSTRUCTION CO INC EMPLOYEES' PROFT SHARING & 401(K) PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
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
2010: CLEAVER CONSTRUCTION CO INC EMPLOYEES' PROFT SHARING & 401(K) PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Plan funding arrangement – Insurance	Yes
2010-01-01	Plan funding arrangement – Trust	Yes
2010-01-01	Plan benefit arrangement – Insurance	Yes
2010-01-01	Plan benefit arrangement - Trust	Yes
2009: CLEAVER CONSTRUCTION CO INC EMPLOYEES' PROFT SHARING & 401(K) PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
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

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

Policy contract number

2349951

Policy instance

Insurance contract or identification number	2349951
Number of Individuals Covered	1
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $11
Are there contracts with allocated funds for individual policies?	Yes
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 $0
Amount paid for insurance broker fees	11
Additional information about fees paid to insurance broker	BROKER
Insurance broker organization code?	3
Insurance broker name	STEVEN G. SACORA/LPL

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

Policy contract number

2349952

Policy instance

Insurance contract or identification number	2349952
Number of Individuals Covered	1
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $13
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 $0
Amount paid for insurance broker fees	13
Additional information about fees paid to insurance broker	BROKER
Insurance broker organization code?	3
Insurance broker name	STEVE SACORA

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

Policy contract number

2349954

Policy instance

Insurance contract or identification number	2349954
Number of Individuals Covered	1
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $25
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 $0
Amount paid for insurance broker fees	25
Additional information about fees paid to insurance broker	BROKER
Insurance broker organization code?	3
Insurance broker name	STEVE SACORA

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

Policy contract number

2349956

Policy instance

Insurance contract or identification number	2349956
Number of Individuals Covered	1
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $241
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 $0
Amount paid for insurance broker fees	241
Additional information about fees paid to insurance broker	BROKER
Insurance broker organization code?	3
Insurance broker name	STEVE SACORA

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

Policy contract number

2349957

Policy instance

Insurance contract or identification number	2349957
Number of Individuals Covered	1
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $155
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 $0
Amount paid for insurance broker fees	155
Additional information about fees paid to insurance broker	BROKER
Insurance broker organization code?	3
Insurance broker name	STEVE SACORA

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

Policy contract number

2349958

Policy instance

Insurance contract or identification number	2349958
Number of Individuals Covered	1
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $266
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 $0
Amount paid for insurance broker fees	266
Additional information about fees paid to insurance broker	BROKER
Insurance broker organization code?	3
Insurance broker name	STEVE SACORA

JOHN HANCOCK LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 90425 )

Policy contract number

MULTI

Policy instance

Insurance contract or identification number	MULTI
Number of Individuals Covered	6
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $1,032
Are there contracts with allocated funds for individual policies?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,032
Insurance broker organization code?	3
Insurance broker name	STEVEN G. SACORA/LPL

JOHN HANCOCK LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 90425 )

Policy contract number

MULTI

Policy instance

Insurance contract or identification number	MULTI
Number of Individuals Covered	8
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $172
Are there contracts with allocated funds for individual policies?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

JOHN HANCOCK LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 90425 )

Policy contract number

MULTI

Policy instance

Insurance contract or identification number	MULTI
Number of Individuals Covered	8
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $573
Are there contracts with allocated funds for individual policies?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $573
Insurance broker organization code?	3
Insurance broker name	STEVEN G. SACORA/LPL

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Company Name:	CLEAVER CONSTRUCTION CO., INC.
Employer identification number (EIN):	610937678
NAIC Classification:	236200