401k Plan data: QUAIL VALLEY CLUB LLC 401 K PROFIT SHARING PLAN TRUST plan

QUAIL VALLEY CLUB LLC 401 K PROFIT SHARING PLAN TRUST 401k Plan overview

Plan Name	QUAIL VALLEY CLUB LLC 401 K PROFIT SHARING PLAN TRUST
Plan identification number	002

QUAIL VALLEY CLUB LLC 401 K PROFIT SHARING PLAN TRUST 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.
Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
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

QUAIL VALLEY CLUB LLC has sponsored the creation of one or more 401k plans.

Company Name: QUAIL VALLEY CLUB LLC

Employer identification number (EIN): 651020803

NAIC Classification: 713900

Form 5500 Filing Information

Submission information for form 5500 for 401k plan QUAIL VALLEY CLUB LLC 401 K PROFIT SHARING PLAN TRUST

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2021-01-01
002 2020-01-01 KEVIN GIVEN 2021-10-15
002 2019-01-01 KEVIN GIVEN 2020-10-13
002 2018-01-01 KEVIN GIVEN 2019-10-10
002 2018-01-01 KEVIN GIVEN 2019-11-25
002 2017-01-01 KEVIN GIVEN 2018-08-02
002 2016-01-01
002 2015-01-01
002 2014-01-01 QUAIL VALLEY CLUB LLC 2015-10-15
002 2013-01-01 QUAIL VALLEY CLUB LLC 2014-10-01
002 2012-01-01 QUAIL VALLEY CLUB LLC 2013-10-04
002 2011-01-01 QUAIL VALLEY CLUB LLC
002 2010-01-01 QUAIL VALLEY CLUB LLC 2011-10-14

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
002	2021-01-01
002	2020-01-01	KEVIN GIVEN	2021-10-15
002	2019-01-01	KEVIN GIVEN	2020-10-13
002	2018-01-01	KEVIN GIVEN	2019-10-10
002	2018-01-01	KEVIN GIVEN	2019-11-25
002	2017-01-01	KEVIN GIVEN	2018-08-02
002	2016-01-01
002	2015-01-01
002	2014-01-01	QUAIL VALLEY CLUB LLC	2015-10-15
002	2013-01-01	QUAIL VALLEY CLUB LLC	2014-10-01
002	2012-01-01	QUAIL VALLEY CLUB LLC	2013-10-04
002	2011-01-01	QUAIL VALLEY CLUB LLC
002	2010-01-01	QUAIL VALLEY CLUB LLC	2011-10-14

Plan Statistics for QUAIL VALLEY CLUB LLC 401 K PROFIT SHARING PLAN TRUST

401k plan membership statisitcs for QUAIL VALLEY CLUB LLC 401 K PROFIT SHARING PLAN TRUST

Measure Date Value
2021: QUAIL VALLEY CLUB LLC 401 K PROFIT SHARING PLAN TRUST 2021 401k membership
Total participants, beginning-of-year 2021-01-01 147
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 94
Number of retired or separated participants receiving benefits 2021-01-01 0
Number of other retired or separated participants entitled to future benefits 2021-01-01 0
Total of all active and inactive participants 2021-01-01 94
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 94
Number of participants with account balances 2021-01-01 94
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 0
2020: QUAIL VALLEY CLUB LLC 401 K PROFIT SHARING PLAN TRUST 2020 401k membership
Total participants, beginning-of-year 2020-01-01 149
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 127
Number of retired or separated participants receiving benefits 2020-01-01 0
Number of other retired or separated participants entitled to future benefits 2020-01-01 20
Total of all active and inactive participants 2020-01-01 147
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 147
Number of participants with account balances 2020-01-01 91
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 1
2019: QUAIL VALLEY CLUB LLC 401 K PROFIT SHARING PLAN TRUST 2019 401k membership
Total participants, beginning-of-year 2019-01-01 131
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 120
Number of retired or separated participants receiving benefits 2019-01-01 0
Number of other retired or separated participants entitled to future benefits 2019-01-01 19
Total of all active and inactive participants 2019-01-01 139
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 139
Number of participants with account balances 2019-01-01 86
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 4
2018: QUAIL VALLEY CLUB LLC 401 K PROFIT SHARING PLAN TRUST 2018 401k membership
Total participants, beginning-of-year 2018-01-01 130
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 120
Number of retired or separated participants receiving benefits 2018-01-01 2
Number of other retired or separated participants entitled to future benefits 2018-01-01 11
Total of all active and inactive participants 2018-01-01 133
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 133
Number of participants with account balances 2018-01-01 85
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 6
2011: QUAIL VALLEY CLUB LLC 401 K PROFIT SHARING PLAN TRUST 2011 401k membership
Total participants, beginning-of-year 2011-01-01 99
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 102
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 4
Total of all active and inactive participants 2011-01-01 106
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 106
Number of participants with account balances 2011-01-01 98
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0

Measure	Date	Value
2021: QUAIL VALLEY CLUB LLC 401 K PROFIT SHARING PLAN TRUST 2021 401k membership
Total participants, beginning-of-year	2021-01-01	147
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	94
Number of retired or separated participants receiving benefits	2021-01-01	0
Number of other retired or separated participants entitled to future benefits	2021-01-01	0
Total of all active and inactive participants	2021-01-01	94
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	94
Number of participants with account balances	2021-01-01	94
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	0
2020: QUAIL VALLEY CLUB LLC 401 K PROFIT SHARING PLAN TRUST 2020 401k membership
Total participants, beginning-of-year	2020-01-01	149
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	127
Number of retired or separated participants receiving benefits	2020-01-01	0
Number of other retired or separated participants entitled to future benefits	2020-01-01	20
Total of all active and inactive participants	2020-01-01	147
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	147
Number of participants with account balances	2020-01-01	91
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	1
2019: QUAIL VALLEY CLUB LLC 401 K PROFIT SHARING PLAN TRUST 2019 401k membership
Total participants, beginning-of-year	2019-01-01	131
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	120
Number of retired or separated participants receiving benefits	2019-01-01	0
Number of other retired or separated participants entitled to future benefits	2019-01-01	19
Total of all active and inactive participants	2019-01-01	139
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	139
Number of participants with account balances	2019-01-01	86
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	4
2018: QUAIL VALLEY CLUB LLC 401 K PROFIT SHARING PLAN TRUST 2018 401k membership
Total participants, beginning-of-year	2018-01-01	130
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	120
Number of retired or separated participants receiving benefits	2018-01-01	2
Number of other retired or separated participants entitled to future benefits	2018-01-01	11
Total of all active and inactive participants	2018-01-01	133
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	133
Number of participants with account balances	2018-01-01	85
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	6
2011: QUAIL VALLEY CLUB LLC 401 K PROFIT SHARING PLAN TRUST 2011 401k membership
Total participants, beginning-of-year	2011-01-01	99
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	102
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	4
Total of all active and inactive participants	2011-01-01	106
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	106
Number of participants with account balances	2011-01-01	98
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0

Financial Data on QUAIL VALLEY CLUB LLC 401 K PROFIT SHARING PLAN TRUST

Measure	Date	Value
2021 : QUAIL VALLEY CLUB LLC 401 K PROFIT SHARING PLAN TRUST 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	$22,982
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$24,324
Total income from all sources (including contributions)	2021-12-31	$740,847
Total loss/gain on sale of assets	2021-12-31	$253,134
Total of all expenses incurred	2021-12-31	$120,250
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$68,173
Expenses. Certain deemed distributions of participant loans	2021-12-31	$2,900
Value of total corrective distributions	2021-12-31	$22,982
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$322,079
Value of total assets at end of year	2021-12-31	$2,998,483
Value of total assets at beginning of year	2021-12-31	$2,379,228
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$26,195
Total interest from all sources	2021-12-31	$2,063
Total dividends received (eg from common stock, registered investment company shares)	2021-12-31	$163,571
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2021-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2021-12-31	$0
Administrative expenses professional fees incurred	2021-12-31	$26,195
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
Were there any nonexempt tranactions with any party-in-interest	2021-12-31	No
Contributions received from participants	2021-12-31	$266,315
Participant contributions at end of year	2021-12-31	$34,347
Participant contributions at beginning of year	2021-12-31	$42,278
Participant contributions at end of year	2021-12-31	$9,647
Participant contributions at beginning of year	2021-12-31	$1,500
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2021-12-31	$22,982
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2021-12-31	$24,324
Total non interest bearing cash at end of year	2021-12-31	$0
Total non interest bearing cash at beginning of year	2021-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Value of net income/loss	2021-12-31	$620,597
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$2,975,501
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$2,354,904
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 pooled separate accounts at end of year	2021-12-31	$2,900,306
Value of interest in pooled separate accounts at beginning of year	2021-12-31	$2,271,184
Interest on participant loans	2021-12-31	$2,063
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2021-12-31	$30,437
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2021-12-31	$64,232
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	Yes
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	$55,764
Employer contributions (assets) at end of year	2021-12-31	$23,746
Employer contributions (assets) at beginning of year	2021-12-31	$34
Income. Dividends from common stock	2021-12-31	$163,571
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$68,173
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
Aggregate proceeds on sale of assets	2021-12-31	$253,134
Opinion of an independent qualified public accountant for this plan	2021-12-31	Unqualified
Accountancy firm name	2021-12-31	EISNERAMPER LLP
Accountancy firm EIN	2021-12-31	871363769
2020 : QUAIL VALLEY CLUB LLC 401 K PROFIT SHARING PLAN TRUST 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	$24,324
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$5,727
Total income from all sources (including contributions)	2020-12-31	$578,249
Total loss/gain on sale of assets	2020-12-31	$0
Total of all expenses incurred	2020-12-31	$53,048
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$9,703
Expenses. Certain deemed distributions of participant loans	2020-12-31	$224
Value of total corrective distributions	2020-12-31	$24,324
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$273,048
Value of total assets at end of year	2020-12-31	$2,379,228
Value of total assets at beginning of year	2020-12-31	$1,835,430
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$18,797
Total interest from all sources	2020-12-31	$1,652
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	$206,430
Participant contributions at end of year	2020-12-31	$42,278
Participant contributions at beginning of year	2020-12-31	$29,861
Participant contributions at end of year	2020-12-31	$1,500
Participant contributions at beginning of year	2020-12-31	$5,936
Income. Received or receivable in cash from other sources (including rollovers)	2020-12-31	$38,145
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2020-12-31	$24,324
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2020-12-31	$5,727
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	$525,201
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$2,354,904
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$1,829,703
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 pooled separate accounts at end of year	2020-12-31	$2,271,184
Value of interest in pooled separate accounts at beginning of year	2020-12-31	$1,757,804
Interest on participant loans	2020-12-31	$1,652
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2020-12-31	$64,232
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2020-12-31	$40,856
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2020-12-31	$303,549
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	Yes
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	$28,473
Employer contributions (assets) at end of year	2020-12-31	$34
Employer contributions (assets) at beginning of year	2020-12-31	$973
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$9,703
Contract administrator fees	2020-12-31	$18,797
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	Disclaimer
Accountancy firm name	2020-12-31	CALER,DONTEN,LEVINE..ET AL P.A.
Accountancy firm EIN	2020-12-31	592831281
2019 : QUAIL VALLEY CLUB LLC 401 K PROFIT SHARING PLAN TRUST 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	$5,727
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$5,727
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$9,305
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$9,305
Total income from all sources (including contributions)	2019-12-31	$569,201
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	$183,373
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$162,952
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$162,952
Expenses. Certain deemed distributions of participant loans	2019-12-31	$1,452
Expenses. Certain deemed distributions of participant loans	2019-12-31	$1,452
Value of total corrective distributions	2019-12-31	$5,727
Value of total corrective distributions	2019-12-31	$5,727
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$224,614
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$224,614
Value of total assets at end of year	2019-12-31	$1,835,430
Value of total assets at end of year	2019-12-31	$1,835,430
Value of total assets at beginning of year	2019-12-31	$1,453,180
Value of total assets at beginning of year	2019-12-31	$1,453,180
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$13,242
Total interest from all sources	2019-12-31	$2,759
Total interest from all sources	2019-12-31	$2,759
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	$198,404
Contributions received from participants	2019-12-31	$198,404
Participant contributions at end of year	2019-12-31	$29,861
Participant contributions at end of year	2019-12-31	$29,861
Participant contributions at beginning of year	2019-12-31	$34,110
Participant contributions at beginning of year	2019-12-31	$34,110
Participant contributions at end of year	2019-12-31	$5,936
Participant contributions at end of year	2019-12-31	$5,936
Participant contributions at beginning of year	2019-12-31	$0
Participant contributions at beginning of year	2019-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$3,907
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$3,907
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2019-12-31	$5,727
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2019-12-31	$5,727
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2019-12-31	$9,305
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2019-12-31	$9,305
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	$385,828
Value of net income/loss	2019-12-31	$385,828
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$1,829,703
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$1,829,703
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$1,443,875
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$1,443,875
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 pooled separate accounts at end of year	2019-12-31	$1,757,804
Value of interest in pooled separate accounts at end of year	2019-12-31	$1,757,804
Value of interest in pooled separate accounts at beginning of year	2019-12-31	$1,380,119
Value of interest in pooled separate accounts at beginning of year	2019-12-31	$1,380,119
Interest on participant loans	2019-12-31	$1,988
Interest on participant loans	2019-12-31	$1,988
Interest earned on other investments	2019-12-31	$771
Interest earned on other investments	2019-12-31	$771
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$40,856
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$40,856
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$38,951
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$38,951
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$341,828
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$341,828
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	$22,303
Contributions received in cash from employer	2019-12-31	$22,303
Employer contributions (assets) at end of year	2019-12-31	$973
Employer contributions (assets) at end of year	2019-12-31	$973
Employer contributions (assets) at beginning of year	2019-12-31	$0
Employer contributions (assets) at beginning of year	2019-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$162,952
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$162,952
Contract administrator fees	2019-12-31	$13,242
Contract administrator fees	2019-12-31	$13,242
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
Accountancy firm name	2019-12-31	CALER,DONTEN,LEVINE..ET AL P.A.
Accountancy firm name	2019-12-31	CALER,DONTEN,LEVINE..ET AL P.A.
Accountancy firm EIN	2019-12-31	592831281
Accountancy firm EIN	2019-12-31	592831281
2018 : QUAIL VALLEY CLUB LLC 401 K PROFIT SHARING PLAN TRUST 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	$9,305
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	$112,654
Total loss/gain on sale of assets	2018-12-31	$0
Total of all expenses incurred	2018-12-31	$43,424
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$12,290
Value of total corrective distributions	2018-12-31	$29,992
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$230,754
Value of total assets at end of year	2018-12-31	$1,453,181
Value of total assets at beginning of year	2018-12-31	$1,374,646
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$1,142
Total interest from all sources	2018-12-31	$2,513
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	$201,285
Participant contributions at end of year	2018-12-31	$34,110
Participant contributions at beginning of year	2018-12-31	$36,004
Income. Received or receivable in cash from other sources (including rollovers)	2018-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2018-12-31	$9,305
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2018-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Value of net income/loss	2018-12-31	$69,230
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$1,443,876
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$1,374,646
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	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-12-31	$0
Value of interest in pooled separate accounts at end of year	2018-12-31	$1,380,120
Value of interest in pooled separate accounts at beginning of year	2018-12-31	$1,286,144
Interest on participant loans	2018-12-31	$1,916
Interest earned on other investments	2018-12-31	$597
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2018-12-31	$38,951
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2018-12-31	$52,498
Net investment gain/loss from pooled separate accounts	2018-12-31	$-120,613
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	$29,469
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$12,290
Contract administrator fees	2018-12-31	$1,142
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2018-12-31	No
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	CALER,DONTEN,LEVINE..ET AL P.A.
Accountancy firm EIN	2018-12-31	592831281
2011 : QUAIL VALLEY CLUB LLC 401 K PROFIT SHARING PLAN TRUST 2011 401k financial data
Total unrealized appreciation/depreciation of assets	2011-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$0
Total income from all sources (including contributions)	2011-12-31	$68,088
Total loss/gain on sale of assets	2011-12-31	$0
Total of all expenses incurred	2011-12-31	$70,455
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$54,692
Expenses. Certain deemed distributions of participant loans	2011-12-31	$0
Value of total corrective distributions	2011-12-31	$15,525
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$91,018
Value of total assets at end of year	2011-12-31	$564,185
Value of total assets at beginning of year	2011-12-31	$566,552
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$238
Total interest from all sources	2011-12-31	$782
Total dividends received (eg from common stock, registered investment company shares)	2011-12-31	$5,585
Transfers to/from the plan	2011-12-31	$0
Total plan liabilities at end of year	2011-12-31	$0
Total plan liabilities at beginning of year	2011-12-31	$0
Total income from all sources	2011-12-31	$68,088
Expenses. Total of all expenses incurred	2011-12-31	$70,455
Benefits paid (including direct rollovers)	2011-12-31	$54,692
Total plan assets at end of year	2011-12-31	$564,185
Total plan assets at beginning of year	2011-12-31	$566,552
Value of fidelity bond covering the plan	2011-12-31	$0
Total contributions received or receivable from participants	2011-12-31	$77,240
Expenses. Other expenses not covered elsewhere	2011-12-31	$238
Contributions received from other sources (not participants or employers)	2011-12-31	$0
Other income received	2011-12-31	$-22,930
Net income (gross income less expenses)	2011-12-31	$-2,367
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$564,185
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$566,552
Assets. Value of participant loans	2011-12-31	$18,790
Total contributions received or receivable from employer(s)	2011-12-31	$13,778
Value of certain deemed distributions of participant loans	2011-12-31	$0
Value of corrective distributions	2011-12-31	$15,525
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2011-12-31	$5,585
Assets. Real estate other than employer real property at beginning of year	2011-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year	2011-12-31	$0
Was this plan covered by a fidelity bond	2011-12-31	No
If this is an individual account plan, was there a blackout period	2011-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2011-12-31	No
Contributions received from participants	2011-12-31	$77,240
Participant contributions at end of year	2011-12-31	$18,790
Participant contributions at beginning of year	2011-12-31	$19,405
Participant contributions at end of year	2011-12-31	$0
Participant contributions at beginning of year	2011-12-31	$0
Assets. Other investments not covered elsewhere at end of year	2011-12-31	$0
Assets. Other investments not covered elsewhere at beginning of year	2011-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2011-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2011-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2011-12-31	$0
Assets. Loans (other than to participants) at beginning of year	2011-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2011-12-31	$0
Administrative expenses (other) incurred	2011-12-31	$238
Liabilities. Value of operating payables at beginning of year	2011-12-31	$0
Total non interest bearing cash at beginning of year	2011-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Value of net income/loss	2011-12-31	$-2,367
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$564,185
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$566,552
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2011-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2011-12-31	No
Were any leases to which the plan was party in default or uncollectible	2011-12-31	No
Assets. partnership/joint venture interests at beginning of year	2011-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2011-12-31	$438,491
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-12-31	$413,403
Interest on participant loans	2011-12-31	$782
Value of interest in master investment trust accounts at end of year	2011-12-31	$0
Value of interest in master investment trust accounts at beginning of year	2011-12-31	$0
Value of interest in common/collective trusts at end of year	2011-12-31	$0
Value of interest in common/collective trusts at beginning of year	2011-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2011-12-31	$106,904
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2011-12-31	$133,744
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2011-12-31	$133,744
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2011-12-31	$0
Assets. Value of investments in 103.12 investment entities at end of year	2011-12-31	$0
Assets. Value of investments in 103.12 investment entities at beginning of year	2011-12-31	$0
Asset value of US Government securities at beginning of year	2011-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2011-12-31	$-29,297
Net investment gain/loss from pooled separate accounts	2011-12-31	$0
Net investment gain or loss from common/collective trusts	2011-12-31	$0
Net gain/loss from 103.12 investment entities	2011-12-31	$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-12-31	No
Was there a failure to transmit to the plan any participant contributions	2011-12-31	No
Has the plan failed to provide any benefit when due under the plan	2011-12-31	No
Assets. Invements in employer securities at beginning of year	2011-12-31	$0
Assets. Value of employer real property at beginning of year	2011-12-31	$0
Contributions received in cash from employer	2011-12-31	$13,778
Employer contributions (assets) at end of year	2011-12-31	$0
Employer contributions (assets) at beginning of year	2011-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$54,692
Asset. Corporate debt instrument preferred debt at beginning of year	2011-12-31	$0
Asset. Corporate debt instrument debt (other) at beginning of year	2011-12-31	$0
Contract administrator fees	2011-12-31	$0
Assets. Corporate common stocks other than exployer securities at beginning of year	2011-12-31	$0
Liabilities. Value of benefit claims payable at beginning of year	2011-12-31	$0
Assets. Value of buildings and other operty used in plan operation at beginning of year	2011-12-31	$0
Did the plan have assets held for investment	2011-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2011-12-31	No
Liabilities. Value of acquisition indebtedness at beginning of year	2011-12-31	$0
Opinion of an independent qualified public accountant for this plan	2011-12-31	Unqualified

Form 5500 Responses for QUAIL VALLEY CLUB LLC 401 K PROFIT SHARING PLAN TRUST

2021: QUAIL VALLEY CLUB LLC 401 K PROFIT SHARING PLAN TRUST 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 - Trust	Yes
2020: QUAIL VALLEY CLUB LLC 401 K PROFIT SHARING PLAN TRUST 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 - Trust	Yes
2019: QUAIL VALLEY CLUB LLC 401 K PROFIT SHARING PLAN TRUST 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 - Trust	Yes
2018: QUAIL VALLEY CLUB LLC 401 K PROFIT SHARING PLAN TRUST 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 - Trust	Yes
2011: QUAIL VALLEY CLUB LLC 401 K PROFIT SHARING PLAN TRUST 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	Yes
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

GA-833395

Policy instance

Insurance contract or identification number	GA-833395
Number of Individuals Covered	94
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $1,245
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	1245
Additional information about fees paid to insurance broker	TPA SERVICE FEE
Insurance broker organization code?	5

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

GA-833395

Policy instance

Insurance contract or identification number	GA-833395
Number of Individuals Covered	93
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $903
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?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $903
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	TPA SERVICE FEE
Insurance broker organization code?	5

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

GA-833395

Policy instance

Insurance contract or identification number	GA-833395
Number of Individuals Covered	88
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $1,593
Total amount of fees paid to insurance company	USD $772
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,548
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	COMMISSION
Insurance broker organization code?	3

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

GA-833395

Policy instance

Insurance contract or identification number	GA-833395
Number of Individuals Covered	87
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $6,503
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	5795
Additional information about fees paid to insurance broker	COMISSION
Insurance broker organization code?	3

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Company Name:	QUAIL VALLEY CLUB LLC
Employer identification number (EIN):	651020803
NAIC Classification:	713900