401k Plan data: PINE COVE 401(K) PLAN plan

PINE COVE 401(K) PLAN 401k Plan overview

Plan Name	PINE COVE 401(K) PLAN
Plan identification number	001

PINE COVE 401(K) PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Age/Service Weighted or new comparability or similar plan - Age/Service Weighted Plan: Allocations are based on age, service, or age and service. New comparability or similar plan: Allocations are based on participant classifications and a classification(s) consists entirely or predominantly of highly compensated employees; or the plan provides an additional allocation rate on compensation above a specified threshold, and the theshold or additional rate exceeds the maximum threshold or rate allowed under the permitted disparity rules of section 401(l).
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

PINE COVE, INC. has sponsored the creation of one or more 401k plans.

Company Name: PINE COVE, INC.

Employer identification number (EIN): 751254353

NAIC Classification: 721210
NAIC Description: RV (Recreational Vehicle) Parks and Recreational Camps

Additional information about PINE COVE, INC.

Jurisdiction of Incorporation: Texas Secretary of State

Incorporation Date: 1967-06-27

Company Identification Number: 0023605801

Legal Registered Office Address: PO BOX 9055

TYLER
United States of America (USA)
75711

More information about PINE COVE, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PINE COVE 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2016-01-01
001 2016-01-01
001 2015-01-01
001 2014-01-01 RANDY COLLINS RANDY COLLINS 2015-09-10
001 2013-01-01 RANDY COLLINS RANDY COLLINS 2014-10-13
001 2012-01-01 RANDY COLLINS RANDY COLLINS 2013-10-10
001 2011-01-01 RANDY COLLINS RANDY COLLINS 2012-10-08
001 2010-01-01 RANDY COLLINS RANDY COLLINS 2011-10-07
001 2009-01-01 RANDY COLLINS RANDY COLLINS 2010-10-07

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
001	2016-01-01
001	2016-01-01
001	2015-01-01
001	2014-01-01	RANDY COLLINS	RANDY COLLINS	2015-09-10
001	2013-01-01	RANDY COLLINS	RANDY COLLINS	2014-10-13
001	2012-01-01	RANDY COLLINS	RANDY COLLINS	2013-10-10
001	2011-01-01	RANDY COLLINS	RANDY COLLINS	2012-10-08
001	2010-01-01	RANDY COLLINS	RANDY COLLINS	2011-10-07
001	2009-01-01	RANDY COLLINS	RANDY COLLINS	2010-10-07

Plan Statistics for PINE COVE 401(K) PLAN

401k plan membership statisitcs for PINE COVE 401(K) PLAN

Measure Date Value
2016: PINE COVE 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 337
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 244
Number of retired or separated participants receiving benefits 2016-01-01 0
Number of other retired or separated participants entitled to future benefits 2016-01-01 83
Total of all active and inactive participants 2016-01-01 327
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 327
Number of participants with account balances 2016-01-01 309
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 11
2015: PINE COVE 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 272
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 196
Number of retired or separated participants receiving benefits 2015-01-01 0
Number of other retired or separated participants entitled to future benefits 2015-01-01 80
Total of all active and inactive participants 2015-01-01 276
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 276
Number of participants with account balances 2015-01-01 270
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 14
2014: PINE COVE 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 236
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 179
Number of retired or separated participants receiving benefits 2014-01-01 0
Number of other retired or separated participants entitled to future benefits 2014-01-01 59
Total of all active and inactive participants 2014-01-01 238
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 238
Number of participants with account balances 2014-01-01 229
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 10
2013: PINE COVE 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 198
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 162
Number of retired or separated participants receiving benefits 2013-01-01 0
Number of other retired or separated participants entitled to future benefits 2013-01-01 47
Total of all active and inactive participants 2013-01-01 209
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 209
Number of participants with account balances 2013-01-01 198
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 12
2012: PINE COVE 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 185
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 154
Number of retired or separated participants receiving benefits 2012-01-01 0
Number of other retired or separated participants entitled to future benefits 2012-01-01 35
Total of all active and inactive participants 2012-01-01 189
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 189
Number of participants with account balances 2012-01-01 180
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 4
2011: PINE COVE 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 173
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 133
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 36
Total of all active and inactive participants 2011-01-01 169
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 169
Number of participants with account balances 2011-01-01 132
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 3
2010: PINE COVE 401(K) PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 166
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 123
Number of retired or separated participants receiving benefits 2010-01-01 0
Number of other retired or separated participants entitled to future benefits 2010-01-01 34
Total of all active and inactive participants 2010-01-01 157
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 157
Number of participants with account balances 2010-01-01 124
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 4
2009: PINE COVE 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 159
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 134
Number of retired or separated participants receiving benefits 2009-01-01 0
Number of other retired or separated participants entitled to future benefits 2009-01-01 26
Total of all active and inactive participants 2009-01-01 160
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 160
Number of participants with account balances 2009-01-01 126
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 4

Measure	Date	Value
2016: PINE COVE 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	337
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	244
Number of retired or separated participants receiving benefits	2016-01-01	0
Number of other retired or separated participants entitled to future benefits	2016-01-01	83
Total of all active and inactive participants	2016-01-01	327
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	327
Number of participants with account balances	2016-01-01	309
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	11
2015: PINE COVE 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	272
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	196
Number of retired or separated participants receiving benefits	2015-01-01	0
Number of other retired or separated participants entitled to future benefits	2015-01-01	80
Total of all active and inactive participants	2015-01-01	276
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	276
Number of participants with account balances	2015-01-01	270
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	14
2014: PINE COVE 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	236
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	179
Number of retired or separated participants receiving benefits	2014-01-01	0
Number of other retired or separated participants entitled to future benefits	2014-01-01	59
Total of all active and inactive participants	2014-01-01	238
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	238
Number of participants with account balances	2014-01-01	229
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	10
2013: PINE COVE 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	198
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	162
Number of retired or separated participants receiving benefits	2013-01-01	0
Number of other retired or separated participants entitled to future benefits	2013-01-01	47
Total of all active and inactive participants	2013-01-01	209
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	209
Number of participants with account balances	2013-01-01	198
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	12
2012: PINE COVE 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	185
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	154
Number of retired or separated participants receiving benefits	2012-01-01	0
Number of other retired or separated participants entitled to future benefits	2012-01-01	35
Total of all active and inactive participants	2012-01-01	189
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	189
Number of participants with account balances	2012-01-01	180
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	4
2011: PINE COVE 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	173
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	133
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	36
Total of all active and inactive participants	2011-01-01	169
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	169
Number of participants with account balances	2011-01-01	132
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	3
2010: PINE COVE 401(K) PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	166
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	123
Number of retired or separated participants receiving benefits	2010-01-01	0
Number of other retired or separated participants entitled to future benefits	2010-01-01	34
Total of all active and inactive participants	2010-01-01	157
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	157
Number of participants with account balances	2010-01-01	124
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	4
2009: PINE COVE 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	159
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	134
Number of retired or separated participants receiving benefits	2009-01-01	0
Number of other retired or separated participants entitled to future benefits	2009-01-01	26
Total of all active and inactive participants	2009-01-01	160
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	160
Number of participants with account balances	2009-01-01	126
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	4

Financial Data on PINE COVE 401(K) PLAN

Measure	Date	Value
2016 : PINE COVE 401(K) PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets	2016-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total income from all sources (including contributions)	2016-12-31	$1,019,702
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$207,048
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$194,729
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$665,114
Value of total assets at end of year	2016-12-31	$5,305,425
Value of total assets at beginning of year	2016-12-31	$4,492,771
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$12,319
Total interest from all sources	2016-12-31	$9
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-12-31	No
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$500,000
If this is an individual account plan, was there a blackout period	2016-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Contributions received from participants	2016-12-31	$384,347
Participant contributions at end of year	2016-12-31	$256
Participant contributions at beginning of year	2016-12-31	$458
Income. Received or receivable in cash from other sources (including rollovers)	2016-12-31	$549
Administrative expenses (other) incurred	2016-12-31	$510
Total non interest bearing cash at end of year	2016-12-31	$1,061
Total non interest bearing cash at beginning of year	2016-12-31	$8,219
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Value of net income/loss	2016-12-31	$812,654
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$5,305,425
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$4,492,771
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2016-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2016-12-31	No
Were any leases to which the plan was party in default or uncollectible	2016-12-31	No
Value of interest in pooled separate accounts at end of year	2016-12-31	$5,023,475
Value of interest in pooled separate accounts at beginning of year	2016-12-31	$4,167,666
Interest earned on other investments	2016-12-31	$9
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-12-31	$756
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-12-31	$681
Net investment gain/loss from pooled separate accounts	2016-12-31	$354,579
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2016-12-31	No
Was there a failure to transmit to the plan any participant contributions	2016-12-31	No
Has the plan failed to provide any benefit when due under the plan	2016-12-31	No
Contributions received in cash from employer	2016-12-31	$280,218
Employer contributions (assets) at end of year	2016-12-31	$279,877
Employer contributions (assets) at beginning of year	2016-12-31	$315,747
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$194,729
Contract administrator fees	2016-12-31	$11,809
Did the plan have assets held for investment	2016-12-31	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	2016-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2016-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2016-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2016-12-31	Disclaimer
Accountancy firm name	2016-12-31	HENRY & PETERS, P. C.
Accountancy firm EIN	2016-12-31	751503978
2015 : PINE COVE 401(K) PLAN 2015 401k financial data
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$2
Total income from all sources (including contributions)	2015-12-31	$699,265
Total of all expenses incurred	2015-12-31	$803,542
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$792,644
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$767,099
Value of total assets at end of year	2015-12-31	$4,492,771
Value of total assets at beginning of year	2015-12-31	$4,597,050
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$10,898
Total interest from all sources	2015-12-31	$8
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-12-31	No
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$250,000
If this is an individual account plan, was there a blackout period	2015-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2015-12-31	No
Contributions received from participants	2015-12-31	$337,176
Participant contributions at end of year	2015-12-31	$458
Income. Received or receivable in cash from other sources (including rollovers)	2015-12-31	$112,887
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2015-12-31	$2
Administrative expenses (other) incurred	2015-12-31	$840
Total non interest bearing cash at end of year	2015-12-31	$8,219
Total non interest bearing cash at beginning of year	2015-12-31	$3,977
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Value of net income/loss	2015-12-31	$-104,277
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$4,492,771
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$4,597,048
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2015-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2015-12-31	No
Were any leases to which the plan was party in default or uncollectible	2015-12-31	No
Value of interest in pooled separate accounts at end of year	2015-12-31	$4,167,666
Value of interest in pooled separate accounts at beginning of year	2015-12-31	$4,310,803
Interest earned on other investments	2015-12-31	$8
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-12-31	$681
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-12-31	$611
Net investment gain/loss from pooled separate accounts	2015-12-31	$-67,842
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2015-12-31	No
Was there a failure to transmit to the plan any participant contributions	2015-12-31	No
Has the plan failed to provide any benefit when due under the plan	2015-12-31	No
Contributions received in cash from employer	2015-12-31	$317,036
Employer contributions (assets) at end of year	2015-12-31	$315,747
Employer contributions (assets) at beginning of year	2015-12-31	$281,659
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$792,644
Contract administrator fees	2015-12-31	$10,058
Did the plan have assets held for investment	2015-12-31	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	2015-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2015-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2015-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2015-12-31	Disclaimer
Accountancy firm name	2015-12-31	HENRY & PETERS, P. C.
Accountancy firm EIN	2015-12-31	751503978
2014 : PINE COVE 401(K) PLAN 2014 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$2
Total income from all sources (including contributions)	2014-12-31	$798,653
Total of all expenses incurred	2014-12-31	$391,756
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$375,646
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$617,948
Value of total assets at end of year	2014-12-31	$4,597,050
Value of total assets at beginning of year	2014-12-31	$4,190,151
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$16,110
Total interest from all sources	2014-12-31	$22
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-12-31	No
Was this plan covered by a fidelity bond	2014-12-31	Yes
Value of fidelity bond cover	2014-12-31	$250,000
If this is an individual account plan, was there a blackout period	2014-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2014-12-31	No
Contributions received from participants	2014-12-31	$303,458
Participant contributions at beginning of year	2014-12-31	$9,305
Income. Received or receivable in cash from other sources (including rollovers)	2014-12-31	$32,830
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2014-12-31	$2
Administrative expenses (other) incurred	2014-12-31	$420
Total non interest bearing cash at end of year	2014-12-31	$3,977
Total non interest bearing cash at beginning of year	2014-12-31	$5,984
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Value of net income/loss	2014-12-31	$406,897
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$4,597,048
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$4,190,151
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2014-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2014-12-31	No
Were any leases to which the plan was party in default or uncollectible	2014-12-31	No
Investment advisory and management fees	2014-12-31	$0
Value of interest in pooled separate accounts at end of year	2014-12-31	$4,310,803
Value of interest in pooled separate accounts at beginning of year	2014-12-31	$3,892,209
Interest earned on other investments	2014-12-31	$22
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-12-31	$611
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-12-31	$16,687
Net investment gain/loss from pooled separate accounts	2014-12-31	$180,683
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2014-12-31	No
Was there a failure to transmit to the plan any participant contributions	2014-12-31	No
Has the plan failed to provide any benefit when due under the plan	2014-12-31	No
Contributions received in cash from employer	2014-12-31	$281,660
Employer contributions (assets) at end of year	2014-12-31	$281,659
Employer contributions (assets) at beginning of year	2014-12-31	$265,966
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$375,646
Contract administrator fees	2014-12-31	$15,690
Did the plan have assets held for investment	2014-12-31	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	2014-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2014-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2014-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2014-12-31	Disclaimer
Accountancy firm name	2014-12-31	HENRY & PETERS, P. C.
Accountancy firm EIN	2014-12-31	751503978
2013 : PINE COVE 401(K) PLAN 2013 401k financial data
Total income from all sources (including contributions)	2013-12-31	$1,228,743
Total of all expenses incurred	2013-12-31	$201,782
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$179,727
Value of total corrective distributions	2013-12-31	$2,810
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$609,090
Value of total assets at end of year	2013-12-31	$4,190,151
Value of total assets at beginning of year	2013-12-31	$3,163,190
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$19,245
Total interest from all sources	2013-12-31	$102
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-12-31	No
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$250,000
If this is an individual account plan, was there a blackout period	2013-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2013-12-31	No
Contributions received from participants	2013-12-31	$244,857
Participant contributions at end of year	2013-12-31	$9,305
Participant contributions at beginning of year	2013-12-31	$8,424
Income. Received or receivable in cash from other sources (including rollovers)	2013-12-31	$98,267
Administrative expenses (other) incurred	2013-12-31	$615
Total non interest bearing cash at end of year	2013-12-31	$5,984
Total non interest bearing cash at beginning of year	2013-12-31	$3,431
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Income. Non cash contributions	2013-12-31	$0
Value of net income/loss	2013-12-31	$1,026,961
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$4,190,151
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$3,163,190
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2013-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2013-12-31	No
Were any leases to which the plan was party in default or uncollectible	2013-12-31	No
Value of interest in pooled separate accounts at end of year	2013-12-31	$3,892,209
Value of interest in pooled separate accounts at beginning of year	2013-12-31	$2,878,611
Interest earned on other investments	2013-12-31	$102
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2013-12-31	$16,687
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-12-31	$22,727
Net investment gain/loss from pooled separate accounts	2013-12-31	$619,551
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2013-12-31	No
Was there a failure to transmit to the plan any participant contributions	2013-12-31	No
Has the plan failed to provide any benefit when due under the plan	2013-12-31	No
Contributions received in cash from employer	2013-12-31	$265,966
Employer contributions (assets) at end of year	2013-12-31	$265,966
Employer contributions (assets) at beginning of year	2013-12-31	$249,997
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$179,727
Contract administrator fees	2013-12-31	$18,630
Did the plan have assets held for investment	2013-12-31	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	2013-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2013-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2013-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2013-12-31	Disclaimer
Accountancy firm name	2013-12-31	HENRY & PETERS, P. C.
Accountancy firm EIN	2013-12-31	751503978
2012 : PINE COVE 401(K) PLAN 2012 401k financial data
Total income from all sources (including contributions)	2012-12-31	$841,495
Total of all expenses incurred	2012-12-31	$208,544
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$192,376
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$492,438
Value of total assets at end of year	2012-12-31	$3,163,190
Value of total assets at beginning of year	2012-12-31	$2,530,239
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$16,168
Total interest from all sources	2012-12-31	$144
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-12-31	No
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$250,000
If this is an individual account plan, was there a blackout period	2012-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2012-12-31	No
Contributions received from participants	2012-12-31	$217,544
Participant contributions at end of year	2012-12-31	$8,424
Participant contributions at beginning of year	2012-12-31	$7,106
Income. Received or receivable in cash from other sources (including rollovers)	2012-12-31	$24,897
Other income not declared elsewhere	2012-12-31	$82
Administrative expenses (other) incurred	2012-12-31	$785
Total non interest bearing cash at end of year	2012-12-31	$3,431
Total non interest bearing cash at beginning of year	2012-12-31	$1,810
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Value of net income/loss	2012-12-31	$632,951
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$3,163,190
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$2,530,239
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-12-31	No
Were any leases to which the plan was party in default or uncollectible	2012-12-31	No
Value of interest in pooled separate accounts at end of year	2012-12-31	$2,878,611
Value of interest in pooled separate accounts at beginning of year	2012-12-31	$2,366,319
Interest earned on other investments	2012-12-31	$144
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-12-31	$22,727
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-12-31	$18,843
Net investment gain/loss from pooled separate accounts	2012-12-31	$348,831
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-12-31	No
Was there a failure to transmit to the plan any participant contributions	2012-12-31	No
Has the plan failed to provide any benefit when due under the plan	2012-12-31	No
Contributions received in cash from employer	2012-12-31	$249,997
Employer contributions (assets) at end of year	2012-12-31	$249,997
Employer contributions (assets) at beginning of year	2012-12-31	$136,161
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$192,376
Contract administrator fees	2012-12-31	$15,383
Did the plan have assets held for investment	2012-12-31	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	2012-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2012-12-31	Disclaimer
Accountancy firm name	2012-12-31	HENRY & PETERS, P. C.
Accountancy firm EIN	2012-12-31	751503978
2011 : PINE COVE 401(K) PLAN 2011 401k financial data
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	$214,025
Total of all expenses incurred	2011-12-31	$57,763
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$43,472
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$322,038
Value of total assets at end of year	2011-12-31	$2,530,239
Value of total assets at beginning of year	2011-12-31	$2,373,977
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$14,291
Total interest from all sources	2011-12-31	$162
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-12-31	No
Was this plan covered by a fidelity bond	2011-12-31	Yes
Value of fidelity bond cover	2011-12-31	$250,000
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	$185,877
Participant contributions at end of year	2011-12-31	$7,106
Participant contributions at beginning of year	2011-12-31	$6,870
Administrative expenses (other) incurred	2011-12-31	$241
Total non interest bearing cash at end of year	2011-12-31	$1,810
Total non interest bearing cash at beginning of year	2011-12-31	$795
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	$156,262
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$2,530,239
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$2,373,977
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
Value of interest in pooled separate accounts at end of year	2011-12-31	$2,366,319
Value of interest in pooled separate accounts at beginning of year	2011-12-31	$2,227,701
Interest earned on other investments	2011-12-31	$162
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-12-31	$18,843
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-12-31	$15,099
Net investment gain/loss from pooled separate accounts	2011-12-31	$-108,175
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
Contributions received in cash from employer	2011-12-31	$136,161
Employer contributions (assets) at end of year	2011-12-31	$136,161
Employer contributions (assets) at beginning of year	2011-12-31	$123,512
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$43,472
Contract administrator fees	2011-12-31	$14,050
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
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2011-12-31	Disclaimer
Accountancy firm name	2011-12-31	HENRY & PETERS, P. C.
Accountancy firm EIN	2011-12-31	751503978
2010 : PINE COVE 401(K) PLAN 2010 401k financial data
Total unrealized appreciation/depreciation of assets	2010-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$0
Total income from all sources (including contributions)	2010-12-31	$588,917
Total loss/gain on sale of assets	2010-12-31	$0
Total of all expenses incurred	2010-12-31	$89,642
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$76,737
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$303,498
Value of total assets at end of year	2010-12-31	$2,373,977
Value of total assets at beginning of year	2010-12-31	$1,874,702
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$12,905
Total interest from all sources	2010-12-31	$209
Total dividends received (eg from common stock, registered investment company shares)	2010-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2010-12-31	No
Was this plan covered by a fidelity bond	2010-12-31	Yes
Value of fidelity bond cover	2010-12-31	$250,000
If this is an individual account plan, was there a blackout period	2010-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2010-12-31	No
Contributions received from participants	2010-12-31	$179,914
Participant contributions at end of year	2010-12-31	$6,870
Participant contributions at beginning of year	2010-12-31	$12,495
Other income not declared elsewhere	2010-12-31	$30
Administrative expenses (other) incurred	2010-12-31	$300
Total non interest bearing cash at end of year	2010-12-31	$795
Total non interest bearing cash at beginning of year	2010-12-31	$6,267
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Value of net income/loss	2010-12-31	$499,275
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$2,373,977
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$1,874,702
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2010-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2010-12-31	No
Were any leases to which the plan was party in default or uncollectible	2010-12-31	No
Value of interest in pooled separate accounts at end of year	2010-12-31	$2,227,701
Value of interest in pooled separate accounts at beginning of year	2010-12-31	$1,747,916
Interest earned on other investments	2010-12-31	$209
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2010-12-31	$15,099
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2010-12-31	$11,283
Net investment gain/loss from pooled separate accounts	2010-12-31	$285,180
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2010-12-31	No
Was there a failure to transmit to the plan any participant contributions	2010-12-31	No
Has the plan failed to provide any benefit when due under the plan	2010-12-31	No
Contributions received in cash from employer	2010-12-31	$123,584
Employer contributions (assets) at end of year	2010-12-31	$123,512
Employer contributions (assets) at beginning of year	2010-12-31	$96,741
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$76,737
Contract administrator fees	2010-12-31	$12,605
Did the plan have assets held for investment	2010-12-31	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	2010-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2010-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2010-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2010-12-31	Disclaimer
Accountancy firm name	2010-12-31	HENRY & PETERS, P. C.
Accountancy firm EIN	2010-12-31	751503978

Form 5500 Responses for PINE COVE 401(K) PLAN

2016: PINE COVE 401(K) PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: PINE COVE 401(K) PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: PINE COVE 401(K) PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: PINE COVE 401(K) PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: PINE COVE 401(K) PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: PINE COVE 401(K) PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	No
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2010: PINE COVE 401(K) PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Submission has been amended	No
2010-01-01	This submission is the final filing	No
2010-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-01-01	Plan is a collectively bargained plan	No
2010-01-01	Plan funding arrangement – Insurance	Yes
2010-01-01	Plan funding arrangement – Trust	Yes
2010-01-01	Plan benefit arrangement – Insurance	Yes
2010-01-01	Plan benefit arrangement - Trust	Yes
2009: PINE COVE 401(K) PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	No
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	No
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

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

Policy contract number

11698

Policy instance

Insurance contract or identification number	11698
Number of Individuals Covered	231
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $10,779
Total amount of fees paid to insurance company	USD $840
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Commission paid to Insurance Broker	USD $10,779
Insurance broker organization code?	3
Amount paid for insurance broker fees	840
Additional information about fees paid to insurance broker	TPA FEES
Insurance broker name	RETIREMENTPLANS.COM

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

Policy contract number

11698

Policy instance

Insurance contract or identification number	11698
Number of Individuals Covered	214
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $10,527
Total amount of fees paid to insurance company	USD $420
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Commission paid to Insurance Broker	USD $10,527
Insurance broker organization code?	3
Amount paid for insurance broker fees	420
Additional information about fees paid to insurance broker	TPA DISTRIBUTION FEES
Insurance broker name	PENSION ANALYSIS BUREAU

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

Policy contract number

11698

Policy instance

Insurance contract or identification number	11698
Number of Individuals Covered	185
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $8,577
Total amount of fees paid to insurance company	USD $615
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Commission paid to Insurance Broker	USD $8,577
Insurance broker organization code?	3
Amount paid for insurance broker fees	615
Additional information about fees paid to insurance broker	TPA FEES PAID
Insurance broker name	PENSION ANALYSIS BUREAU

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

Policy contract number

11698

Policy instance

Insurance contract or identification number	11698
Number of Individuals Covered	144
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $6,798
Total amount of fees paid to insurance company	USD $899
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Commission paid to Insurance Broker	USD $6,798
Insurance broker organization code?	3
Amount paid for insurance broker fees	729
Additional information about fees paid to insurance broker	TPA FEES TPA COMPENSATION TPA JH IRA R/O PAYMENT
Insurance broker name	VANGUARD GROUP, INC.

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

Policy contract number

11698

Policy instance

Insurance contract or identification number	11698
Number of Individuals Covered	138
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $5,950
Total amount of fees paid to insurance company	USD $1,420
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes

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

Policy contract number

11698

Policy instance

Insurance contract or identification number	11698
Number of Individuals Covered	130
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $4,799
Total amount of fees paid to insurance company	USD $1,191
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Commission paid to Insurance Broker	USD $4,799
Insurance broker organization code?	3
Amount paid for insurance broker fees	1191
Additional information about fees paid to insurance broker	TPA FEES TPA COMPENSATION
Insurance broker name	PENSION ANALYSIS BUREAU

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The information published is supplied by third parties so we make no warranty on the accuracy, completeness etc. This information is provided "as-is". The information is subject to change as we obtain updates and corrections from the primary information sources.
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Company Name:	PINE COVE, INC.
Employer identification number (EIN):	751254353
NAIC Classification:	721210
NAIC Description:	RV (Recreational Vehicle) Parks and Recreational Camps

Jurisdiction of Incorporation:	Texas Secretary of State
Incorporation Date:	1967-06-27
Company Identification Number:	0023605801
Legal Registered Office Address:	PO BOX 9055 TYLER United States of America (USA) 75711