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| Plan Name | CLOVER IMAGING 401(K) PLAN |
| Plan identification number | 001 |
| 401k Plan Type | Defined Contribution Pension |
| Plan Features/Benefits |
|
| Company Name: | CLOVER ENVIRONMENTAL SOLUTIONS LLC |
| Employer identification number (EIN): | 843663858 |
| NAIC Classification: | 334110 |
Additional information about CLOVER ENVIRONMENTAL SOLUTIONS LLC
| Jurisdiction of Incorporation: | Texas Secretary of State |
| Incorporation Date: | 2020-01-03 |
| Company Identification Number: | 0803508126 |
| Legal Registered Office Address: |
4200 COLUMBUS ST OTTAWA United States of America (USA) 61350 |
More information about CLOVER ENVIRONMENTAL SOLUTIONS LLC
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 001 | 2020-01-01 |
| Measure | Date | Value |
|---|---|---|
| 2020: CLOVER IMAGING 401(K) PLAN 2020 401k membership | ||
| Total participants, beginning-of-year | 2020-01-01 | 1,054 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-01-01 | 572 |
| Number of retired or separated participants receiving benefits | 2020-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2020-01-01 | 240 |
| Total of all active and inactive participants | 2020-01-01 | 812 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2020-01-01 | 3 |
| Total participants | 2020-01-01 | 815 |
| Number of participants with account balances | 2020-01-01 | 675 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2020-01-01 | 63 |
| Measure | Date | Value |
|---|---|---|
| 2020 : CLOVER IMAGING 401(K) PLAN 2020 401k financial data | ||
| Unrealized appreciation/depreciation of real estate assets | 2020-12-31 | $0 |
| Unrealized appreciation/depreciation of other (non real estate) assets | 2020-12-31 | $0 |
| Total unrealized appreciation/depreciation of assets | 2020-12-31 | $0 |
| Total transfer of assets to this plan | 2020-12-31 | $0 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2020-12-31 | $0 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2020-12-31 | $0 |
| Total income from all sources (including contributions) | 2020-12-31 | $8,855,745 |
| Total loss/gain on sale of assets | 2020-12-31 | $0 |
| Total of all expenses incurred | 2020-12-31 | $9,501,901 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2020-12-31 | $9,392,501 |
| Expenses. Certain deemed distributions of participant loans | 2020-12-31 | $0 |
| Value of total corrective distributions | 2020-12-31 | $0 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2020-12-31 | $2,322,293 |
| Value of total assets at end of year | 2020-12-31 | $46,821,594 |
| Value of total assets at beginning of year | 2020-12-31 | $47,467,750 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2020-12-31 | $109,400 |
| Total income from rents | 2020-12-31 | $0 |
| Total interest from all sources | 2020-12-31 | $63,719 |
| Total dividends received (eg from common stock, registered investment company shares) | 2020-12-31 | $69,933 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2020-12-31 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2020-12-31 | $69,933 |
| Administrative expenses professional fees incurred | 2020-12-31 | $0 |
| Was this plan covered by a fidelity bond | 2020-12-31 | Yes |
| Value of fidelity bond cover | 2020-12-31 | $10,000,000 |
| If this is an individual account plan, was there a blackout period | 2020-12-31 | No |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2020-12-31 | $0 |
| Were there any nonexempt tranactions with any party-in-interest | 2020-12-31 | No |
| Amount of non-exempt transactions with any party-in-interest | 2020-12-31 | $0 |
| Contributions received from participants | 2020-12-31 | $1,862,964 |
| Participant contributions at end of year | 2020-12-31 | $968,688 |
| Participant contributions at beginning of year | 2020-12-31 | $1,009,239 |
| Participant contributions at end of year | 2020-12-31 | $0 |
| Participant contributions at beginning of year | 2020-12-31 | $0 |
| Income. Received or receivable in cash from other sources (including rollovers) | 2020-12-31 | $245,883 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2020-12-31 | $0 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2020-12-31 | $0 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2020-12-31 | $0 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2020-12-31 | $0 |
| Other income not declared elsewhere | 2020-12-31 | $0 |
| Administrative expenses (other) incurred | 2020-12-31 | $0 |
| Liabilities. Value of operating payables at beginning of year | 2020-12-31 | $0 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2020-12-31 | No |
| Value of net income/loss | 2020-12-31 | $-646,156 |
| Value of net assets at end of year (total assets less liabilities) | 2020-12-31 | $46,821,594 |
| Value of net assets at beginning of year (total assets less liabilities) | 2020-12-31 | $47,467,750 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2020-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2020-12-31 | No |
| Amount of loans by the plan or fixed income obligations due to the plan which were in default/classified-as-uncollectible as of the close of the plan year | 2020-12-31 | $0 |
| Were any leases to which the plan was party in default or uncollectible | 2020-12-31 | No |
| Amount of leases to which the plan was a party which were in default/classified-as-uncollectible during the year | 2020-12-31 | $0 |
| Investment advisory and management fees | 2020-12-31 | $0 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2020-12-31 | $6,703,409 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2020-12-31 | $6,757,004 |
| Value of interest in pooled separate accounts at end of year | 2020-12-31 | $16,611,144 |
| Value of interest in pooled separate accounts at beginning of year | 2020-12-31 | $14,644,316 |
| Interest on participant loans | 2020-12-31 | $63,719 |
| Income. Interest from loans (other than to participants) | 2020-12-31 | $0 |
| Interest earned on other investments | 2020-12-31 | $0 |
| Income. Interest from US Government securities | 2020-12-31 | $0 |
| Income. Interest from corporate debt instruments | 2020-12-31 | $0 |
| Value of interest in common/collective trusts at end of year | 2020-12-31 | $22,538,353 |
| Value of interest in common/collective trusts at beginning of year | 2020-12-31 | $25,057,191 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2020-12-31 | $0 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2020-12-31 | $0 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2020-12-31 | $883,421 |
| Net investment gain/loss from pooled separate accounts | 2020-12-31 | $2,558,716 |
| Net investment gain or loss from common/collective trusts | 2020-12-31 | $2,957,663 |
| Net gain/loss from 103.12 investment entities | 2020-12-31 | $0 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2020-12-31 | No |
| Was there a failure to transmit to the plan any participant contributions | 2020-12-31 | Yes |
| Has the plan failed to provide any benefit when due under the plan | 2020-12-31 | No |
| Contributions received in cash from employer | 2020-12-31 | $213,446 |
| Employer contributions (assets) at end of year | 2020-12-31 | $0 |
| Employer contributions (assets) at beginning of year | 2020-12-31 | $0 |
| Income. Dividends from preferred stock | 2020-12-31 | $0 |
| Income. Dividends from common stock | 2020-12-31 | $0 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2020-12-31 | $9,392,501 |
| Contract administrator fees | 2020-12-31 | $109,400 |
| Liabilities. Value of benefit claims payable at beginning of year | 2020-12-31 | $0 |
| Did the plan have assets held for investment | 2020-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2020-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2020-12-31 | No |
| Aggregate proceeds on sale of assets | 2020-12-31 | $0 |
| Aggregate carrying amount (costs) on sale of assets | 2020-12-31 | $0 |
| Liabilities. Value of acquisition indebtedness at beginning of year | 2020-12-31 | $0 |
| Opinion of an independent qualified public accountant for this plan | 2020-12-31 | Disclaimer |
| Accountancy firm name | 2020-12-31 | FGMK LLC |
| Accountancy firm EIN | 2020-12-31 | 362929601 |
| 2020: CLOVER IMAGING 401(K) PLAN 2020 form 5500 responses | ||
|---|---|---|
| 2020-01-01 | Type of plan entity | Single employer plan |
| 2020-01-01 | This submission is the final filing | No |
| 2020-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2020-01-01 | Plan is a collectively bargained plan | No |
| 2020-01-01 | Plan funding arrangement – Insurance | Yes |
| 2020-01-01 | Plan funding arrangement – Trust | Yes |
| 2020-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2020-01-01 | Plan benefit arrangement - Trust | Yes |
| PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) | |
| Policy contract number | 453615 |
| Policy instance | 1 |