401k Plan data: JACKSON EXCAVATING AND LEASING EMPLOYEE BENEFIT PLAN plan

JACKSON EXCAVATING AND LEASING EMPLOYEE BENEFIT PLAN 401k Plan overview

Plan Name	JACKSON EXCAVATING AND LEASING EMPLOYEE BENEFIT PLAN
Plan identification number	501

JACKSON EXCAVATING AND LEASING EMPLOYEE BENEFIT PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Life insurance Other welfare benefit cover

401k Sponsoring company profile

JACKSON EXCAVATING & LEASING COMPANY, INC. DBA BAKER SERVICES INC. has sponsored the creation of one or more 401k plans.

Company Name: JACKSON EXCAVATING & LEASING COMPANY, INC. DBA BAKER SERVICES INC.

Employer identification number (EIN): 640599352

NAIC Classification: 238900

Form 5500 Filing Information

Submission information for form 5500 for 401k plan JACKSON EXCAVATING AND LEASING EMPLOYEE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2017-01-01 DANA DEVINEY
501 2016-01-01 DANA DEVINEY DANA DEVINEY 2017-06-29
501 2015-01-01 DANA LOMAX
501 2014-01-01 DANA LOMAX
501 2013-01-01 DANA LOMAX
501 2012-01-01 DANA LOMAX
501 2011-01-01 DANA LOMAX
501 2010-01-01 DANA LOMAX
501 2009-01-01 DANA LOMAX
501 2008-01-01 DANA LOMAX
501 2007-01-01 DANA LOMAX
501 2006-01-01 DANA LOMAX
501 2005-01-01 DANA LOMAX

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
501	2017-01-01	DANA DEVINEY
501	2016-01-01	DANA DEVINEY	DANA DEVINEY	2017-06-29
501	2015-01-01	DANA LOMAX
501	2014-01-01	DANA LOMAX
501	2013-01-01	DANA LOMAX
501	2012-01-01	DANA LOMAX
501	2011-01-01	DANA LOMAX
501	2010-01-01	DANA LOMAX
501	2009-01-01	DANA LOMAX
501	2008-01-01	DANA LOMAX
501	2007-01-01	DANA LOMAX
501	2006-01-01	DANA LOMAX
501	2005-01-01	DANA LOMAX

Plan Statistics for JACKSON EXCAVATING AND LEASING EMPLOYEE BENEFIT PLAN

401k plan membership statisitcs for JACKSON EXCAVATING AND LEASING EMPLOYEE BENEFIT PLAN

Measure Date Value
2017: JACKSON EXCAVATING AND LEASING EMPLOYEE BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 308
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 283
Number of retired or separated participants receiving benefits 2017-01-01 0
Number of other retired or separated participants entitled to future benefits 2017-01-01 0
Total of all active and inactive participants 2017-01-01 283
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
2016: JACKSON EXCAVATING AND LEASING EMPLOYEE BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 274
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 296
Number of retired or separated participants receiving benefits 2016-01-01 0
Number of other retired or separated participants entitled to future benefits 2016-01-01 0
Total of all active and inactive participants 2016-01-01 296
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
2015: JACKSON EXCAVATING AND LEASING EMPLOYEE BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 252
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 269
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 0
Total of all active and inactive participants 2015-01-01 269
2014: JACKSON EXCAVATING AND LEASING EMPLOYEE BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 251
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 254
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 0
Total of all active and inactive participants 2014-01-01 254
2013: JACKSON EXCAVATING AND LEASING EMPLOYEE BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 272
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 243
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 2013-01-01 243
2012: JACKSON EXCAVATING AND LEASING EMPLOYEE BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 290
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 265
Number of retired or separated participants receiving benefits 2012-01-01 0
Number of other retired or separated participants entitled to future benefits 2012-01-01 0
Total of all active and inactive participants 2012-01-01 265
2011: JACKSON EXCAVATING AND LEASING EMPLOYEE BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 277
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 291
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 0
Total of all active and inactive participants 2011-01-01 291
2010: JACKSON EXCAVATING AND LEASING EMPLOYEE BENEFIT PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 304
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 277
Number of retired or separated participants receiving benefits 2010-01-01 0
Number of other retired or separated participants entitled to future benefits 2010-01-01 0
Total of all active and inactive participants 2010-01-01 277
2009: JACKSON EXCAVATING AND LEASING EMPLOYEE BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 313
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 304
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 0
Total of all active and inactive participants 2009-01-01 304
2008: JACKSON EXCAVATING AND LEASING EMPLOYEE BENEFIT PLAN 2008 401k membership
Total participants, beginning-of-year 2008-01-01 225
Total number of active participants reported on line 7a of the Form 5500 2008-01-01 313
Number of retired or separated participants receiving benefits 2008-01-01 0
Number of other retired or separated participants entitled to future benefits 2008-01-01 0
Total of all active and inactive participants 2008-01-01 313
2007: JACKSON EXCAVATING AND LEASING EMPLOYEE BENEFIT PLAN 2007 401k membership
Total participants, beginning-of-year 2007-01-01 78
Total number of active participants reported on line 7a of the Form 5500 2007-01-01 225
Number of retired or separated participants receiving benefits 2007-01-01 0
Number of other retired or separated participants entitled to future benefits 2007-01-01 0
Total of all active and inactive participants 2007-01-01 225
2006: JACKSON EXCAVATING AND LEASING EMPLOYEE BENEFIT PLAN 2006 401k membership
Total participants, beginning-of-year 2006-01-01 139
Total number of active participants reported on line 7a of the Form 5500 2006-01-01 78
Number of retired or separated participants receiving benefits 2006-01-01 0
Number of other retired or separated participants entitled to future benefits 2006-01-01 0
Total of all active and inactive participants 2006-01-01 78
2005: JACKSON EXCAVATING AND LEASING EMPLOYEE BENEFIT PLAN 2005 401k membership
Total participants, beginning-of-year 2005-01-01 134
Total number of active participants reported on line 7a of the Form 5500 2005-01-01 139
Number of retired or separated participants receiving benefits 2005-01-01 0
Number of other retired or separated participants entitled to future benefits 2005-01-01 0
Total of all active and inactive participants 2005-01-01 139

Measure	Date	Value
2017: JACKSON EXCAVATING AND LEASING EMPLOYEE BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	308
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	283
Number of retired or separated participants receiving benefits	2017-01-01	0
Number of other retired or separated participants entitled to future benefits	2017-01-01	0
Total of all active and inactive participants	2017-01-01	283
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
2016: JACKSON EXCAVATING AND LEASING EMPLOYEE BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	274
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	296
Number of retired or separated participants receiving benefits	2016-01-01	0
Number of other retired or separated participants entitled to future benefits	2016-01-01	0
Total of all active and inactive participants	2016-01-01	296
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
2015: JACKSON EXCAVATING AND LEASING EMPLOYEE BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	252
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	269
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	0
Total of all active and inactive participants	2015-01-01	269
2014: JACKSON EXCAVATING AND LEASING EMPLOYEE BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	251
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	254
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	0
Total of all active and inactive participants	2014-01-01	254
2013: JACKSON EXCAVATING AND LEASING EMPLOYEE BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	272
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	243
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	243
2012: JACKSON EXCAVATING AND LEASING EMPLOYEE BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	290
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	265
Number of retired or separated participants receiving benefits	2012-01-01	0
Number of other retired or separated participants entitled to future benefits	2012-01-01	0
Total of all active and inactive participants	2012-01-01	265
2011: JACKSON EXCAVATING AND LEASING EMPLOYEE BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	277
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	291
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	0
Total of all active and inactive participants	2011-01-01	291
2010: JACKSON EXCAVATING AND LEASING EMPLOYEE BENEFIT PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	304
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	277
Number of retired or separated participants receiving benefits	2010-01-01	0
Number of other retired or separated participants entitled to future benefits	2010-01-01	0
Total of all active and inactive participants	2010-01-01	277
2009: JACKSON EXCAVATING AND LEASING EMPLOYEE BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	313
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	304
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	0
Total of all active and inactive participants	2009-01-01	304
2008: JACKSON EXCAVATING AND LEASING EMPLOYEE BENEFIT PLAN 2008 401k membership
Total participants, beginning-of-year	2008-01-01	225
Total number of active participants reported on line 7a of the Form 5500	2008-01-01	313
Number of retired or separated participants receiving benefits	2008-01-01	0
Number of other retired or separated participants entitled to future benefits	2008-01-01	0
Total of all active and inactive participants	2008-01-01	313
2007: JACKSON EXCAVATING AND LEASING EMPLOYEE BENEFIT PLAN 2007 401k membership
Total participants, beginning-of-year	2007-01-01	78
Total number of active participants reported on line 7a of the Form 5500	2007-01-01	225
Number of retired or separated participants receiving benefits	2007-01-01	0
Number of other retired or separated participants entitled to future benefits	2007-01-01	0
Total of all active and inactive participants	2007-01-01	225
2006: JACKSON EXCAVATING AND LEASING EMPLOYEE BENEFIT PLAN 2006 401k membership
Total participants, beginning-of-year	2006-01-01	139
Total number of active participants reported on line 7a of the Form 5500	2006-01-01	78
Number of retired or separated participants receiving benefits	2006-01-01	0
Number of other retired or separated participants entitled to future benefits	2006-01-01	0
Total of all active and inactive participants	2006-01-01	78
2005: JACKSON EXCAVATING AND LEASING EMPLOYEE BENEFIT PLAN 2005 401k membership
Total participants, beginning-of-year	2005-01-01	134
Total number of active participants reported on line 7a of the Form 5500	2005-01-01	139
Number of retired or separated participants receiving benefits	2005-01-01	0
Number of other retired or separated participants entitled to future benefits	2005-01-01	0
Total of all active and inactive participants	2005-01-01	139

Form 5500 Responses for JACKSON EXCAVATING AND LEASING EMPLOYEE BENEFIT PLAN

2017: JACKSON EXCAVATING AND LEASING EMPLOYEE BENEFIT 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 benefit arrangement – Insurance	Yes
2016: JACKSON EXCAVATING AND LEASING EMPLOYEE BENEFIT PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2015: JACKSON EXCAVATING AND LEASING EMPLOYEE BENEFIT PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
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 benefit arrangement – Insurance	Yes
2014: JACKSON EXCAVATING AND LEASING EMPLOYEE BENEFIT 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 benefit arrangement – Insurance	Yes
2013: JACKSON EXCAVATING AND LEASING EMPLOYEE BENEFIT 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 benefit arrangement – Insurance	Yes
2012: JACKSON EXCAVATING AND LEASING EMPLOYEE BENEFIT 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 benefit arrangement – Insurance	Yes
2011: JACKSON EXCAVATING AND LEASING EMPLOYEE BENEFIT PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	No
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 benefit arrangement – Insurance	Yes
2010: JACKSON EXCAVATING AND LEASING EMPLOYEE BENEFIT PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Submission has been amended	No
2010-01-01	This submission is the final filing	No
2010-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-01-01	Plan is a collectively bargained plan	No
2010-01-01	Plan funding arrangement – Insurance	Yes
2010-01-01	Plan benefit arrangement – Insurance	Yes
2009: JACKSON EXCAVATING AND LEASING EMPLOYEE BENEFIT 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 benefit arrangement – Insurance	Yes
2008: JACKSON EXCAVATING AND LEASING EMPLOYEE BENEFIT PLAN 2008 form 5500 responses
2008-01-01	Type of plan entity	Single employer plan
2008-01-01	Submission has been amended	No
2008-01-01	This submission is the final filing	No
2008-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2008-01-01	Plan is a collectively bargained plan	No
2008-01-01	Plan funding arrangement – Insurance	Yes
2008-01-01	Plan benefit arrangement – Insurance	Yes
2007: JACKSON EXCAVATING AND LEASING EMPLOYEE BENEFIT PLAN 2007 form 5500 responses
2007-01-01	Type of plan entity	Single employer plan
2007-01-01	Submission has been amended	No
2007-01-01	This submission is the final filing	No
2007-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2007-01-01	Plan is a collectively bargained plan	No
2007-01-01	Plan funding arrangement – Insurance	Yes
2007-01-01	Plan benefit arrangement – Insurance	Yes
2006: JACKSON EXCAVATING AND LEASING EMPLOYEE BENEFIT PLAN 2006 form 5500 responses
2006-01-01	Type of plan entity	Single employer plan
2006-01-01	Submission has been amended	No
2006-01-01	This submission is the final filing	No
2006-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2006-01-01	Plan is a collectively bargained plan	No
2006-01-01	Plan funding arrangement – Insurance	Yes
2006-01-01	Plan benefit arrangement – Insurance	Yes
2005: JACKSON EXCAVATING AND LEASING EMPLOYEE BENEFIT PLAN 2005 form 5500 responses
2005-01-01	Type of plan entity	Single employer plan
2005-01-01	First time form 5500 has been submitted	Yes
2005-01-01	Submission has been amended	No
2005-01-01	This submission is the final filing	No
2005-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2005-01-01	Plan is a collectively bargained plan	No
2005-01-01	Plan funding arrangement – Insurance	Yes
2005-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )

Policy contract number

FHM910454

Policy instance

Insurance contract or identification number	FHM910454
Number of Individuals Covered	298
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $2,619
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	Yes
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	AD & D
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $13,094
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,619
Insurance broker organization code?	3
Insurance broker name	HEALTHSMART BENEFIT SOLUTIONS

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Company Name:	JACKSON EXCAVATING & LEASING COMPANY, INC. DBA BAKER SERVICES INC.
Employer identification number (EIN):	640599352
NAIC Classification:	238900