401k Plan data: TREE ISLAND WIRE, USA EMPLOYEE WELFARE PLAN plan

TREE ISLAND WIRE, USA EMPLOYEE WELFARE PLAN 401k Plan overview

Plan Name	TREE ISLAND WIRE, USA EMPLOYEE WELFARE PLAN
Plan identification number	501

TREE ISLAND WIRE, USA EMPLOYEE WELFARE PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Dental Vision Long-term disability cover Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

TREE ISLAND WIRE (USA), INC. has sponsored the creation of one or more 401k plans.

Company Name: TREE ISLAND WIRE (USA), INC.

Employer identification number (EIN): 680189766

NAIC Classification: 332900

Form 5500 Filing Information

Submission information for form 5500 for 401k plan TREE ISLAND WIRE, USA EMPLOYEE WELFARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2017-07-01
501 2016-07-01 SONYA MENDOZA
501 2015-07-01 SONYA MENDOZA
501 2014-07-01 SONYA MENDOZA
501 2013-07-01 SONYA MENDOZA
501 2012-07-01 SONYA MENDOZA
501 2011-07-01 SONYA MENDOZA
501 2010-07-01 SONYA MENDOZA
501 2009-07-01 SONYA MENDOZA

Plan Statistics for TREE ISLAND WIRE, USA EMPLOYEE WELFARE PLAN

401k plan membership statisitcs for TREE ISLAND WIRE, USA EMPLOYEE WELFARE PLAN

Measure Date Value
2017: TREE ISLAND WIRE, USA EMPLOYEE WELFARE PLAN 2017 401k membership
Total participants, beginning-of-year 2017-07-01 170
Total number of active participants reported on line 7a of the Form 5500 2017-07-01 145
Total of all active and inactive participants 2017-07-01 145
Total participants 2017-07-01 145
2016: TREE ISLAND WIRE, USA EMPLOYEE WELFARE PLAN 2016 401k membership
Total participants, beginning-of-year 2016-07-01 184
Total number of active participants reported on line 7a of the Form 5500 2016-07-01 170
Total of all active and inactive participants 2016-07-01 170
Total participants 2016-07-01 170
2015: TREE ISLAND WIRE, USA EMPLOYEE WELFARE PLAN 2015 401k membership
Total participants, beginning-of-year 2015-07-01 172
Total number of active participants reported on line 7a of the Form 5500 2015-07-01 184
Total of all active and inactive participants 2015-07-01 184
Total participants 2015-07-01 0
2014: TREE ISLAND WIRE, USA EMPLOYEE WELFARE PLAN 2014 401k membership
Total participants, beginning-of-year 2014-07-01 141
Total number of active participants reported on line 7a of the Form 5500 2014-07-01 172
Total of all active and inactive participants 2014-07-01 172
Total participants 2014-07-01 0
2013: TREE ISLAND WIRE, USA EMPLOYEE WELFARE PLAN 2013 401k membership
Total participants, beginning-of-year 2013-07-01 123
Total number of active participants reported on line 7a of the Form 5500 2013-07-01 141
Total of all active and inactive participants 2013-07-01 141
Total participants 2013-07-01 0
2012: TREE ISLAND WIRE, USA EMPLOYEE WELFARE PLAN 2012 401k membership
Total participants, beginning-of-year 2012-07-01 127
Total number of active participants reported on line 7a of the Form 5500 2012-07-01 123
Total of all active and inactive participants 2012-07-01 123
Total participants 2012-07-01 0
2011: TREE ISLAND WIRE, USA EMPLOYEE WELFARE PLAN 2011 401k membership
Total participants, beginning-of-year 2011-07-01 123
Total number of active participants reported on line 7a of the Form 5500 2011-07-01 127
Total of all active and inactive participants 2011-07-01 127
Total participants 2011-07-01 127
2010: TREE ISLAND WIRE, USA EMPLOYEE WELFARE PLAN 2010 401k membership
Total participants, beginning-of-year 2010-07-01 100
Total number of active participants reported on line 7a of the Form 5500 2010-07-01 123
Total of all active and inactive participants 2010-07-01 123
Total participants 2010-07-01 123
2009: TREE ISLAND WIRE, USA EMPLOYEE WELFARE PLAN 2009 401k membership
Total participants, beginning-of-year 2009-07-01 108
Total number of active participants reported on line 7a of the Form 5500 2009-07-01 100
Total of all active and inactive participants 2009-07-01 100
Total participants 2009-07-01 100

Measure	Date	Value
2017: TREE ISLAND WIRE, USA EMPLOYEE WELFARE PLAN 2017 401k membership
Total participants, beginning-of-year	2017-07-01	170
Total number of active participants reported on line 7a of the Form 5500	2017-07-01	145
Total of all active and inactive participants	2017-07-01	145
Total participants	2017-07-01	145
2016: TREE ISLAND WIRE, USA EMPLOYEE WELFARE PLAN 2016 401k membership
Total participants, beginning-of-year	2016-07-01	184
Total number of active participants reported on line 7a of the Form 5500	2016-07-01	170
Total of all active and inactive participants	2016-07-01	170
Total participants	2016-07-01	170
2015: TREE ISLAND WIRE, USA EMPLOYEE WELFARE PLAN 2015 401k membership
Total participants, beginning-of-year	2015-07-01	172
Total number of active participants reported on line 7a of the Form 5500	2015-07-01	184
Total of all active and inactive participants	2015-07-01	184
Total participants	2015-07-01	0
2014: TREE ISLAND WIRE, USA EMPLOYEE WELFARE PLAN 2014 401k membership
Total participants, beginning-of-year	2014-07-01	141
Total number of active participants reported on line 7a of the Form 5500	2014-07-01	172
Total of all active and inactive participants	2014-07-01	172
Total participants	2014-07-01	0
2013: TREE ISLAND WIRE, USA EMPLOYEE WELFARE PLAN 2013 401k membership
Total participants, beginning-of-year	2013-07-01	123
Total number of active participants reported on line 7a of the Form 5500	2013-07-01	141
Total of all active and inactive participants	2013-07-01	141
Total participants	2013-07-01	0
2012: TREE ISLAND WIRE, USA EMPLOYEE WELFARE PLAN 2012 401k membership
Total participants, beginning-of-year	2012-07-01	127
Total number of active participants reported on line 7a of the Form 5500	2012-07-01	123
Total of all active and inactive participants	2012-07-01	123
Total participants	2012-07-01	0
2011: TREE ISLAND WIRE, USA EMPLOYEE WELFARE PLAN 2011 401k membership
Total participants, beginning-of-year	2011-07-01	123
Total number of active participants reported on line 7a of the Form 5500	2011-07-01	127
Total of all active and inactive participants	2011-07-01	127
Total participants	2011-07-01	127
2010: TREE ISLAND WIRE, USA EMPLOYEE WELFARE PLAN 2010 401k membership
Total participants, beginning-of-year	2010-07-01	100
Total number of active participants reported on line 7a of the Form 5500	2010-07-01	123
Total of all active and inactive participants	2010-07-01	123
Total participants	2010-07-01	123
2009: TREE ISLAND WIRE, USA EMPLOYEE WELFARE PLAN 2009 401k membership
Total participants, beginning-of-year	2009-07-01	108
Total number of active participants reported on line 7a of the Form 5500	2009-07-01	100
Total of all active and inactive participants	2009-07-01	100
Total participants	2009-07-01	100

Form 5500 Responses for TREE ISLAND WIRE, USA EMPLOYEE WELFARE PLAN

2017: TREE ISLAND WIRE, USA EMPLOYEE WELFARE PLAN 2017 form 5500 responses
2017-07-01	Type of plan entity	Single employer plan
2017-07-01	Plan is a collectively bargained plan	Yes
2017-07-01	Plan funding arrangement – Insurance	Yes
2017-07-01	Plan benefit arrangement – Insurance	Yes
2016: TREE ISLAND WIRE, USA EMPLOYEE WELFARE PLAN 2016 form 5500 responses
2016-07-01	Type of plan entity	Single employer plan
2016-07-01	Plan is a collectively bargained plan	Yes
2016-07-01	Plan funding arrangement – Insurance	Yes
2016-07-01	Plan benefit arrangement – Insurance	Yes
2015: TREE ISLAND WIRE, USA EMPLOYEE WELFARE PLAN 2015 form 5500 responses
2015-07-01	Type of plan entity	Single employer plan
2015-07-01	Plan funding arrangement – Insurance	Yes
2015-07-01	Plan benefit arrangement – Insurance	Yes
2014: TREE ISLAND WIRE, USA EMPLOYEE WELFARE PLAN 2014 form 5500 responses
2014-07-01	Type of plan entity	Single employer plan
2014-07-01	Plan funding arrangement – Insurance	Yes
2014-07-01	Plan benefit arrangement – Insurance	Yes
2013: TREE ISLAND WIRE, USA EMPLOYEE WELFARE PLAN 2013 form 5500 responses
2013-07-01	Type of plan entity	Single employer plan
2013-07-01	Plan funding arrangement – Insurance	Yes
2013-07-01	Plan benefit arrangement – Insurance	Yes
2012: TREE ISLAND WIRE, USA EMPLOYEE WELFARE PLAN 2012 form 5500 responses
2012-07-01	Type of plan entity	Single employer plan
2012-07-01	Plan funding arrangement – Insurance	Yes
2012-07-01	Plan benefit arrangement – Insurance	Yes
2011: TREE ISLAND WIRE, USA EMPLOYEE WELFARE PLAN 2011 form 5500 responses
2011-07-01	Type of plan entity	Single employer plan
2011-07-01	Plan funding arrangement – Insurance	Yes
2011-07-01	Plan benefit arrangement – Insurance	Yes
2010: TREE ISLAND WIRE, USA EMPLOYEE WELFARE PLAN 2010 form 5500 responses
2010-07-01	Type of plan entity	Single employer plan
2010-07-01	Plan funding arrangement – Insurance	Yes
2010-07-01	Plan benefit arrangement – Insurance	Yes
2009: TREE ISLAND WIRE, USA EMPLOYEE WELFARE PLAN 2009 form 5500 responses
2009-07-01	Type of plan entity	Single employer plan
2009-07-01	Plan funding arrangement – Insurance	Yes
2009-07-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

UNITED CONCORDIA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 85766 )

Policy contract number

908167

Policy instance

Insurance contract or identification number	908167
Number of Individuals Covered	24
Insurance policy start date	2017-07-01
Insurance policy end date	2018-06-30
Total amount of commissions paid to insurance broker	USD $3,336
Total amount of fees paid to insurance company	USD $1,017
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $31,057
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

UNITED CONCORDIA DENTAL PLANS OF CALIFORNIA, INC. (National Association of Insurance Commissioners NAIC id number: 95789 )

Policy contract number

908167

Policy instance

Insurance contract or identification number	908167
Number of Individuals Covered	133
Insurance policy start date	2017-07-01
Insurance policy end date	2018-06-30
Total amount of commissions paid to insurance broker	USD $3,826
Total amount of fees paid to insurance company	USD $1,183
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $36,170
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

HEALTH NET (National Association of Insurance Commissioners NAIC id number: 00623 )

Policy contract number

120362

Policy instance

Insurance contract or identification number	120362
Number of Individuals Covered	119
Insurance policy start date	2017-07-01
Insurance policy end date	2018-06-30
Total amount of commissions paid to insurance broker	USD $71,570
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,473,752
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )

Policy contract number

10009801001

Policy instance

Insurance contract or identification number	10009801001
Number of Individuals Covered	119
Insurance policy start date	2017-07-01
Insurance policy end date	2018-06-30
Total amount of commissions paid to insurance broker	USD $2,159
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $21,454
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

SOK603661

Policy instance

Insurance contract or identification number	SOK603661
Number of Individuals Covered	22
Insurance policy start date	2017-07-01
Insurance policy end date	2018-06-30
Total amount of commissions paid to insurance broker	USD $313
Total amount of fees paid to insurance company	USD $28
Other welfare benefits provided	VOLUNTARY ACCIDENTAL DEATH
Welfare Benefit Premiums Paid to Carrier	USD $2,089
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

LABOR MANAGEMENT UNIVERSAL HEALTH BENEFITS TRUST FUND (National Association of Insurance Commissioners NAIC id number: )

Policy contract number

K20-C 100

Policy instance

Insurance contract or identification number	K20-C 100
Number of Individuals Covered	10
Insurance policy start date	2017-07-01
Insurance policy end date	2018-06-30
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $151,280
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

SOK603660

Policy instance

Insurance contract or identification number	SOK603660
Number of Individuals Covered	145
Insurance policy start date	2017-07-01
Insurance policy end date	2018-06-30
Total amount of commissions paid to insurance broker	USD $364
Total amount of fees paid to insurance company	USD $46
Other welfare benefits provided	GROUP ACCIDENTAL DEATH
Welfare Benefit Premiums Paid to Carrier	USD $3,637
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

SGM605353

Policy instance

Insurance contract or identification number	SGM605353
Number of Individuals Covered	28
Insurance policy start date	2017-07-01
Insurance policy end date	2018-06-30
Total amount of commissions paid to insurance broker	USD $2,129
Total amount of fees paid to insurance company	USD $179
Other welfare benefits provided	VOL LIFE AND DEP VOL LIFE
Welfare Benefit Premiums Paid to Carrier	USD $14,194
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

SGM605352

Policy instance

Insurance contract or identification number	SGM605352
Number of Individuals Covered	145
Insurance policy start date	2017-07-01
Insurance policy end date	2018-06-30
Total amount of commissions paid to insurance broker	USD $2,485
Total amount of fees paid to insurance company	USD $313
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $24,854
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

SGD605433

Policy instance

Insurance contract or identification number	SGD605433
Number of Individuals Covered	44
Insurance policy start date	2017-07-01
Insurance policy end date	2018-06-30
Total amount of commissions paid to insurance broker	USD $1,265
Total amount of fees paid to insurance company	USD $161
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $12,653
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

SGD605432

Policy instance

Insurance contract or identification number	SGD605432
Number of Individuals Covered	44
Insurance policy start date	2017-07-01
Insurance policy end date	2018-06-30
Total amount of commissions paid to insurance broker	USD $439
Total amount of fees paid to insurance company	USD $56
Temporary Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $4,390
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

SOK603661

Policy instance

Insurance contract or identification number	SOK603661
Number of Individuals Covered	24
Insurance policy start date	2015-07-01
Insurance policy end date	2016-06-30
Total amount of commissions paid to insurance broker	USD $341
Other welfare benefits provided	VOLUNTARY ACCIDENTAL DEATH
Welfare Benefit Premiums Paid to Carrier	USD $2,275
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $341
Insurance broker organization code?	3
Insurance broker name	BENEFITS AMERICA INS SERV

LABOR MANAGEMENT UNIVERSAL HEALTH BENEFITS TRUST FUND (National Association of Insurance Commissioners NAIC id number: )

Policy contract number

K20-C 100

Policy instance

Insurance contract or identification number	K20-C 100
Number of Individuals Covered	23
Insurance policy start date	2015-07-01
Insurance policy end date	2016-06-30
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $279,157
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )

Policy contract number

10009801001

Policy instance

Insurance contract or identification number	10009801001
Number of Individuals Covered	137
Insurance policy start date	2015-07-01
Insurance policy end date	2016-06-30
Total amount of fees paid to insurance company	USD $1,819
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $21,789
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	1819
Insurance broker organization code?	3
Insurance broker name	BENEFITS AMERICA INSURANCE SERVICES

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

SGM605352

Policy instance

Insurance contract or identification number	SGM605352
Number of Individuals Covered	184
Insurance policy start date	2015-07-01
Insurance policy end date	2016-06-30
Total amount of commissions paid to insurance broker	USD $2,343
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $23,426
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,343
Insurance broker organization code?	3
Insurance broker name	BENEFITS AMERICA INSURANCE SERVICES

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

SOK603660

Policy instance

Insurance contract or identification number	SOK603660
Number of Individuals Covered	184
Insurance policy start date	2015-07-01
Insurance policy end date	2016-06-30
Total amount of commissions paid to insurance broker	USD $343
Other welfare benefits provided	GROUP ACCIDENTAL DEATH
Welfare Benefit Premiums Paid to Carrier	USD $3,427
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $343
Insurance broker organization code?	3
Insurance broker name	BENEFIT AMERICA INSURANCE SERVICES

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

SGM605353

Policy instance

Insurance contract or identification number	SGM605353
Number of Individuals Covered	30
Insurance policy start date	2015-07-01
Insurance policy end date	2016-06-30
Total amount of commissions paid to insurance broker	USD $1,738
Other welfare benefits provided	VOL LIFE AND DEP VOL LIFE
Welfare Benefit Premiums Paid to Carrier	USD $11,588
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,738
Insurance broker organization code?	3
Insurance broker name	BENEFITS AMERICA INSURANCE SERVICES

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

SGD605433

Policy instance

Insurance contract or identification number	SGD605433
Number of Individuals Covered	57
Insurance policy start date	2015-07-01
Insurance policy end date	2016-06-30
Total amount of commissions paid to insurance broker	USD $1,254
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $12,543
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,254
Insurance broker organization code?	3
Insurance broker name	BENEFITS AMERICA INSURANCE SERVICES

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

SGD605432

Policy instance

Insurance contract or identification number	SGD605432
Number of Individuals Covered	57
Insurance policy start date	2015-07-01
Insurance policy end date	2016-06-30
Total amount of commissions paid to insurance broker	USD $433
Temporary Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $4,328
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $433
Insurance broker organization code?	3
Insurance broker name	BENEFITS AMERICA INSURANCE SERVICES

UNITED CONCORDIA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 85766 )

Policy contract number

908167

Policy instance

Insurance contract or identification number	908167
Number of Individuals Covered	27
Insurance policy start date	2015-07-01
Insurance policy end date	2016-06-30
Total amount of commissions paid to insurance broker	USD $4,144
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $32,447
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,144
Insurance broker organization code?	3
Insurance broker name	BENEFITS AMERICA INSURANCE SERVICE

UNITED CONCORDIA DENTAL PLANS OF CALIFORNIA, INC. (National Association of Insurance Commissioners NAIC id number: 95789 )

Policy contract number

908167

Policy instance

Insurance contract or identification number	908167
Number of Individuals Covered	123
Insurance policy start date	2015-07-01
Insurance policy end date	2016-06-30
Total amount of commissions paid to insurance broker	USD $4,619
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $35,682
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,619
Insurance broker organization code?	3
Insurance broker name	BENEFITS AMERICA INSURANCE SERVICES

HEALTH NET (National Association of Insurance Commissioners NAIC id number: 00623 )

Policy contract number

120362

Policy instance

Insurance contract or identification number	120362
Number of Individuals Covered	123
Insurance policy start date	2015-07-01
Insurance policy end date	2016-06-30
Total amount of commissions paid to insurance broker	USD $66,964
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,363,096
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $66,964
Insurance broker organization code?	3
Insurance broker name	ANDREW D. GILMOUR, INC.

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

Policy contract number

H19

Policy instance

Insurance contract or identification number	H19
Number of Individuals Covered	75
Insurance policy start date	2014-07-01
Insurance policy end date	2015-06-30
Total amount of commissions paid to insurance broker	USD $4,040
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $40,399
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,040
Insurance broker organization code?	3
Insurance broker name	ANDREW D. GILMOUR. INC.

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

SGM605353

Policy instance

Insurance contract or identification number	SGM605353
Number of Individuals Covered	34
Insurance policy start date	2014-07-01
Insurance policy end date	2015-06-30
Total amount of commissions paid to insurance broker	USD $864
Total amount of fees paid to insurance company	USD $234
Other welfare benefits provided	VOL SUPP LIFE - DEPENDENT LIFE
Welfare Benefit Premiums Paid to Carrier	USD $5,757
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $864
Amount paid for insurance broker fees	234
Additional information about fees paid to insurance broker	OVERRIDE
Insurance broker organization code?	3
Insurance broker name	BENEFITS AMERICA INSURANCE SERVICES

LABOR MANAGEMENT UNIVERSAL HEALTH BENEFITS TRUST FUND (National Association of Insurance Commissioners NAIC id number: )

Policy contract number

K20-C 100

Policy instance

Insurance contract or identification number	K20-C 100
Number of Individuals Covered	20
Insurance policy start date	2014-07-01
Insurance policy end date	2015-06-30
Other welfare benefits provided	KAISER HMO UNION PLAN
Welfare Benefit Premiums Paid to Carrier	USD $225,307
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

HEALTH NET (National Association of Insurance Commissioners NAIC id number: 00623 )

Policy contract number

76031A,C/L6648A

Policy instance

Insurance contract or identification number	76031A,C/L6648A
Number of Individuals Covered	53
Insurance policy start date	2014-07-01
Insurance policy end date	2015-06-30
Total amount of commissions paid to insurance broker	USD $22,958
Health Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $449,621
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $22,958
Insurance broker organization code?	3
Insurance broker name	ANDREW D. GILMOUR, INC.

DENTAL HEALTH SERVICES (National Association of Insurance Commissioners NAIC id number: 41067 )

Policy contract number

3987H

Policy instance

Insurance contract or identification number	3987H
Number of Individuals Covered	66
Insurance policy start date	2014-07-01
Insurance policy end date	2015-06-30
Total amount of commissions paid to insurance broker	USD $1,919
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $19,194
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,919
Insurance broker organization code?	3
Insurance broker name	ANDREW D. GILMOUR, INC.

HEALTH NET (National Association of Insurance Commissioners NAIC id number: 00623 )

Policy contract number

76594A/Z7591A

Policy instance

Insurance contract or identification number	76594A/Z7591A
Number of Individuals Covered	73
Insurance policy start date	2014-07-01
Insurance policy end date	2015-06-30
Total amount of commissions paid to insurance broker	USD $41,880
Health Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $828,264
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $41,880
Insurance broker organization code?	3
Insurance broker name	ANDREW D. GILMOUR, INC.

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

SGM605352

Policy instance

Insurance contract or identification number	SGM605352
Number of Individuals Covered	172
Insurance policy start date	2014-07-01
Insurance policy end date	2015-06-30
Total amount of commissions paid to insurance broker	USD $1,859
Total amount of fees paid to insurance company	USD $380
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $18,591
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,859
Amount paid for insurance broker fees	380
Additional information about fees paid to insurance broker	OVERRIDE
Insurance broker organization code?	3
Insurance broker name	BENEFITS AMERICA INSURANCE SERVICES

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

SGD605432

Policy instance

Insurance contract or identification number	SGD605432
Number of Individuals Covered	52
Insurance policy start date	2014-07-01
Insurance policy end date	2015-06-30
Total amount of commissions paid to insurance broker	USD $340
Total amount of fees paid to insurance company	USD $65
Temporary Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $3,401
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $340
Amount paid for insurance broker fees	65
Additional information about fees paid to insurance broker	OVERRIDE
Insurance broker organization code?	3
Insurance broker name	BENEFITS AMERICA INSURAMCE SERVICES

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

SOK603660

Policy instance

Insurance contract or identification number	SOK603660
Number of Individuals Covered	172
Insurance policy start date	2014-07-01
Insurance policy end date	2015-06-30
Total amount of commissions paid to insurance broker	USD $268
Total amount of fees paid to insurance company	USD $56
Other welfare benefits provided	ACCIDENTAL DEATH
Welfare Benefit Premiums Paid to Carrier	USD $2,680
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $268
Amount paid for insurance broker fees	56
Additional information about fees paid to insurance broker	OVERRIDE
Insurance broker organization code?	3
Insurance broker name	BENEFITS AMERICA INSURANCE SERVICES

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

SGD605433

Policy instance

Insurance contract or identification number	SGD605433
Number of Individuals Covered	52
Insurance policy start date	2014-07-01
Insurance policy end date	2015-06-30
Total amount of commissions paid to insurance broker	USD $991
Total amount of fees paid to insurance company	USD $189
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $9,911
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $991
Amount paid for insurance broker fees	189
Additional information about fees paid to insurance broker	OVERRIDE
Insurance broker organization code?	3
Insurance broker name	BENEFITS AMERICA INSURANCE SERVICES

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

SOK603661

Policy instance

Insurance contract or identification number	SOK603661
Number of Individuals Covered	28
Insurance policy start date	2014-07-01
Insurance policy end date	2015-06-30
Total amount of commissions paid to insurance broker	USD $169
Total amount of fees paid to insurance company	USD $44
Other welfare benefits provided	VOL ACCIDENTAL DEATH
Welfare Benefit Premiums Paid to Carrier	USD $1,125
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $169
Amount paid for insurance broker fees	44
Additional information about fees paid to insurance broker	OVERRIDE
Insurance broker organization code?	3
Insurance broker name	BENEFITS AMERICA INSURANCE SERVICES

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )

Policy contract number

2948544/298545

Policy instance

Insurance contract or identification number	2948544/298545
Number of Individuals Covered	47
Insurance policy start date	2013-07-01
Insurance policy end date	2014-06-30
Total amount of commissions paid to insurance broker	USD $2,384
Life Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $15,892
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes
Commission paid to Insurance Broker	USD $2,384
Insurance broker organization code?	3
Insurance broker name	ANDREW D. GILMOUR INC.

DENTAL HEALTH SERVICES (National Association of Insurance Commissioners NAIC id number: 41067 )

Policy contract number

3987H

Policy instance

Insurance contract or identification number	3987H
Number of Individuals Covered	60
Insurance policy start date	2013-07-01
Insurance policy end date	2014-06-30
Total amount of commissions paid to insurance broker	USD $1,786
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $17,857
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,786
Insurance broker organization code?	3
Insurance broker name	ANDREW D. GILMOUR, INC.

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

00426973

Policy instance

Insurance contract or identification number	00426973
Number of Individuals Covered	141
Insurance policy start date	2013-07-01
Insurance policy end date	2014-06-30
Total amount of commissions paid to insurance broker	USD $6,413
Dental Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	BASIC LIFE AD & D
Welfare Benefit Premiums Paid to Carrier	USD $64,127
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $6,413
Insurance broker organization code?	3
Insurance broker name	J.D. GILMOUR COMPANY INC.

LABOR MANAGEMENT UNIVERSAL HEALTH BENEFITS TRUST FUND (National Association of Insurance Commissioners NAIC id number: )

Policy contract number

K20-C 100

Policy instance

Insurance contract or identification number	K20-C 100
Number of Individuals Covered	20
Insurance policy start date	2013-07-01
Insurance policy end date	2014-06-30
Other welfare benefits provided	KAISER HMO UNION PLAN
Welfare Benefit Premiums Paid to Carrier	USD $121,630
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

HEALTH NET (National Association of Insurance Commissioners NAIC id number: 00623 )

Policy contract number

76594A/Z7591A

Policy instance

Insurance contract or identification number	76594A/Z7591A
Number of Individuals Covered	58
Insurance policy start date	2013-07-01
Insurance policy end date	2014-06-30
Total amount of commissions paid to insurance broker	USD $31,585
Health Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $632,212
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $31,585
Insurance broker organization code?	3
Insurance broker name	ANDREW D. GILMOUR, INC.

HEALTH NET (National Association of Insurance Commissioners NAIC id number: 00623 )

Policy contract number

76031A,C/L6648A

Policy instance

Insurance contract or identification number	76031A,C/L6648A
Number of Individuals Covered	40
Insurance policy start date	2013-07-01
Insurance policy end date	2014-06-30
Total amount of commissions paid to insurance broker	USD $24,816
Health Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $495,272
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $24,816
Insurance broker organization code?	3
Insurance broker name	ANDREW D. GILMOUR, INC.

HEALTH NET (National Association of Insurance Commissioners NAIC id number: 00623 )

Policy contract number

76031A,C/L6648A

Policy instance

Insurance contract or identification number	76031A,C/L6648A
Number of Individuals Covered	59
Insurance policy start date	2012-07-01
Insurance policy end date	2013-06-30
Total amount of commissions paid to insurance broker	USD $27,353
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $548,394
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $27,353
Insurance broker organization code?	3
Insurance broker name	ANDREW D. GILMOUR, INC.

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

00426973

Policy instance

Insurance contract or identification number	00426973
Number of Individuals Covered	123
Insurance policy start date	2012-07-01
Insurance policy end date	2013-06-30
Total amount of commissions paid to insurance broker	USD $5,985
Total amount of fees paid to insurance company	USD $1,101
Dental Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	BASIC LIFE AD & D
Welfare Benefit Premiums Paid to Carrier	USD $59,849
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $5,985
Amount paid for insurance broker fees	1101
Additional information about fees paid to insurance broker	PRODUCER BONUS
Insurance broker organization code?	3
Insurance broker name	J.D. GILMOUR & CO., INC.

DENTAL HEALTH SERVICES (National Association of Insurance Commissioners NAIC id number: 41067 )

Policy contract number

3987H

Policy instance

Insurance contract or identification number	3987H
Number of Individuals Covered	59
Insurance policy start date	2012-07-01
Insurance policy end date	2013-06-30
Total amount of commissions paid to insurance broker	USD $1,600
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $16,004
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,600
Insurance broker organization code?	3
Insurance broker name	ANDREW D. GILMOUR, INC.

HEALTH NET (National Association of Insurance Commissioners NAIC id number: 00623 )

Policy contract number

76594A/Z7591A

Policy instance

Insurance contract or identification number	76594A/Z7591A
Number of Individuals Covered	56
Insurance policy start date	2012-07-01
Insurance policy end date	2013-06-30
Total amount of commissions paid to insurance broker	USD $28,975
Health Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $574,565
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $28,975
Insurance broker organization code?	3
Insurance broker name	ANDREW D. GILMOUR INC.

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )

Policy contract number

R0279364

Policy instance

Insurance contract or identification number	R0279364
Insurance policy start date	2012-07-01
Insurance policy end date	2013-06-30
Total amount of commissions paid to insurance broker	USD $142
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $938
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
Insurance broker organization code?	3
Insurance broker name	ANDREW D. GILMOUR, INC.

HEALTH NET (National Association of Insurance Commissioners NAIC id number: 00623 )

Policy contract number

76031A,C/L6648A

Policy instance

Insurance contract or identification number	76031A,C/L6648A
Number of Individuals Covered	48
Insurance policy start date	2011-07-01
Insurance policy end date	2012-06-30
Total amount of commissions paid to insurance broker	USD $22,802
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $463,210
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )

Policy contract number

226260

Policy instance

Insurance contract or identification number	226260
Number of Individuals Covered	8
Insurance policy start date	2011-07-01
Insurance policy end date	2012-06-30
Total amount of commissions paid to insurance broker	USD $3,276
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $86,900
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

DENTAL HEALTH SERVICES (National Association of Insurance Commissioners NAIC id number: 41067 )

Policy contract number

3987H

Policy instance

Insurance contract or identification number	3987H
Number of Individuals Covered	56
Insurance policy start date	2011-07-01
Insurance policy end date	2012-06-30
Total amount of commissions paid to insurance broker	USD $1,491
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $14,914
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )

Policy contract number

R0279364

Policy instance

Insurance contract or identification number	R0279364
Number of Individuals Covered	43
Insurance policy start date	2011-07-01
Insurance policy end date	2012-06-30
Total amount of commissions paid to insurance broker	USD $1,706
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $11,208
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

HEALTH NET (National Association of Insurance Commissioners NAIC id number: 00623 )

Policy contract number

76594A/Z7591A

Policy instance

Insurance contract or identification number	76594A/Z7591A
Number of Individuals Covered	58
Insurance policy start date	2011-07-01
Insurance policy end date	2012-06-30
Total amount of commissions paid to insurance broker	USD $26,141
Health Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $515,189
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

00426973

Policy instance

Insurance contract or identification number	00426973
Number of Individuals Covered	127
Insurance policy start date	2011-07-01
Insurance policy end date	2012-06-30
Total amount of commissions paid to insurance broker	USD $5,922
Dental Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	BASIC LIFE AD & D
Welfare Benefit Premiums Paid to Carrier	USD $59,224
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

HEALTH NET (National Association of Insurance Commissioners NAIC id number: 00623 )

Policy contract number

76031A,C/L6648A

Policy instance

Insurance contract or identification number	76031A,C/L6648A
Number of Individuals Covered	43
Insurance policy start date	2010-07-01
Insurance policy end date	2011-06-30
Total amount of commissions paid to insurance broker	USD $20,217
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $452,565
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

00426973

Policy instance

Insurance contract or identification number	00426973
Number of Individuals Covered	123
Insurance policy start date	2010-07-01
Insurance policy end date	2011-06-30
Total amount of commissions paid to insurance broker	USD $5,491
Total amount of fees paid to insurance company	USD $1,720
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	BASIC LIFE AD & D
Welfare Benefit Premiums Paid to Carrier	USD $52,717
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

DENTAL HEALTH SERVICES (National Association of Insurance Commissioners NAIC id number: 41067 )

Policy contract number

3987H

Policy instance

Insurance contract or identification number	3987H
Number of Individuals Covered	57
Insurance policy start date	2010-07-01
Insurance policy end date	2011-06-30
Total amount of commissions paid to insurance broker	USD $1,636
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $16,360
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

HEALTH NET (National Association of Insurance Commissioners NAIC id number: 00623 )

Policy contract number

76594A/Z7591A

Policy instance

Insurance contract or identification number	76594A/Z7591A
Number of Individuals Covered	52
Insurance policy start date	2010-07-01
Insurance policy end date	2011-06-30
Total amount of commissions paid to insurance broker	USD $24,562
Health Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $436,404
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )

Policy contract number

R0279364

Policy instance

Insurance contract or identification number	R0279364
Number of Individuals Covered	42
Insurance policy start date	2010-07-01
Insurance policy end date	2011-06-30
Total amount of commissions paid to insurance broker	USD $2,322
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $11,647
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )

Policy contract number

226260

Policy instance

Insurance contract or identification number	226260
Number of Individuals Covered	12
Insurance policy start date	2010-07-01
Insurance policy end date	2011-06-30
Total amount of commissions paid to insurance broker	USD $3,572
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $114,901
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	TREE ISLAND WIRE (USA), INC.
Employer identification number (EIN):	680189766
NAIC Classification:	332900

Plan id#	Filing Submission Date	Name of Administrator
501	2017-07-01
501	2016-07-01	SONYA MENDOZA
501	2015-07-01	SONYA MENDOZA
501	2014-07-01	SONYA MENDOZA
501	2013-07-01	SONYA MENDOZA
501	2012-07-01	SONYA MENDOZA
501	2011-07-01	SONYA MENDOZA
501	2010-07-01	SONYA MENDOZA
501	2009-07-01	SONYA MENDOZA