401k Plan data: THE BLACKFOX 401(K) AND SAVINGS PLAN plan

THE BLACKFOX 401(K) AND SAVINGS PLAN 401k Plan overview

Plan Name	THE BLACKFOX 401(K) AND SAVINGS PLAN
Plan identification number	001

THE BLACKFOX 401(K) AND SAVINGS PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Profit-sharing
ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
Plan covering Self-Employed individuals.
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.
Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

BLACKFOX, LLC has sponsored the creation of one or more 401k plans.

Company Name: BLACKFOX, LLC

Employer identification number (EIN): 261857564

NAIC Classification: 551112
NAIC Description: Offices of Other Holding Companies

Additional information about BLACKFOX, LLC

Jurisdiction of Incorporation: Colorado Department of State

Incorporation Date: 2008-01-02

Company Identification Number: 20071598269

Legal Registered Office Address: 1211 Lake Ave Ste 202

Berthoud
United States of America (USA)
80513

More information about BLACKFOX, LLC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan THE BLACKFOX 401(K) AND SAVINGS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2011-01-01 BRIAN J. HEPP
001 2010-01-01 BRIAN HEPP
001 2009-01-01 BRIAN HEPP
001 2009-01-01 BRIAN J. HEPP

Plan id#	Filing Submission Date	Name of Administrator
001	2011-01-01	BRIAN J. HEPP
001	2010-01-01	BRIAN HEPP
001	2009-01-01	BRIAN HEPP
001	2009-01-01	BRIAN J. HEPP

Plan Statistics for THE BLACKFOX 401(K) AND SAVINGS PLAN

401k plan membership statisitcs for THE BLACKFOX 401(K) AND SAVINGS PLAN

Measure Date Value
2011: THE BLACKFOX 401(K) AND SAVINGS PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 186
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 0
Number of retired or separated participants receiving benefits 2011-01-01 0
Number of other retired or separated participants entitled to future benefits 2011-01-01 0
Total of all active and inactive participants 2011-01-01 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 0
Number of participants with account balances 2011-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2010: THE BLACKFOX 401(K) AND SAVINGS PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 195
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 78
Number of retired or separated participants receiving benefits 2010-01-01 0
Number of other retired or separated participants entitled to future benefits 2010-01-01 108
Total of all active and inactive participants 2010-01-01 186
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 186
Number of participants with account balances 2010-01-01 152
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 7
2009: THE BLACKFOX 401(K) AND SAVINGS PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 274
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 75
Number of retired or separated participants receiving benefits 2009-01-01 1
Number of other retired or separated participants entitled to future benefits 2009-01-01 115
Total of all active and inactive participants 2009-01-01 191
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 191
Number of participants with account balances 2009-01-01 153
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 50

Measure	Date	Value
2011: THE BLACKFOX 401(K) AND SAVINGS PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	186
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	0
Number of retired or separated participants receiving benefits	2011-01-01	0
Number of other retired or separated participants entitled to future benefits	2011-01-01	0
Total of all active and inactive participants	2011-01-01	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	0
Number of participants with account balances	2011-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2010: THE BLACKFOX 401(K) AND SAVINGS PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	195
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	78
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	108
Total of all active and inactive participants	2010-01-01	186
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	186
Number of participants with account balances	2010-01-01	152
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	7
2009: THE BLACKFOX 401(K) AND SAVINGS PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	274
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	75
Number of retired or separated participants receiving benefits	2009-01-01	1
Number of other retired or separated participants entitled to future benefits	2009-01-01	115
Total of all active and inactive participants	2009-01-01	191
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	191
Number of participants with account balances	2009-01-01	153
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	50

Financial Data on THE BLACKFOX 401(K) AND SAVINGS PLAN

Measure	Date	Value
2011 : THE BLACKFOX 401(K) AND SAVINGS PLAN 2011 401k financial data
Unrealized appreciation/depreciation of real estate assets	2011-12-01	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2011-12-01	$0
Total unrealized appreciation/depreciation of assets	2011-12-01	$0
Total transfer of assets to this plan	2011-12-01	$0
Total transfer of assets from this plan	2011-12-01	$78,384
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-01	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-01	$0
Expenses. Interest paid	2011-12-01	$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2011-12-01	$0
Total income from all sources (including contributions)	2011-12-01	$35,079
Total loss/gain on sale of assets	2011-12-01	$0
Total of all expenses incurred	2011-12-01	$2,037,627
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-01	$1,989,788
Expenses. Certain deemed distributions of participant loans	2011-12-01	$47,839
Value of total corrective distributions	2011-12-01	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-01	$0
Value of total assets at end of year	2011-12-01	$0
Value of total assets at beginning of year	2011-12-01	$2,080,932
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-01	$0
Total income from rents	2011-12-01	$0
Total interest from all sources	2011-12-01	$1,891
Total dividends received (eg from common stock, registered investment company shares)	2011-12-01	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-12-01	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2011-12-01	$0
Total dividends received from registered investment company shares (eg mutual funds)	2011-12-01	$0
Assets. Real estate other than employer real property at end of year	2011-12-01	$0
Assets. Real estate other than employer real property at beginning of year	2011-12-01	$0
Administrative expenses professional fees incurred	2011-12-01	$0
Assets. Corporate prefeered stocks other than exployer securities at end of year	2011-12-01	$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year	2011-12-01	$0
Was this plan covered by a fidelity bond	2011-12-01	Yes
Value of fidelity bond cover	2011-12-01	$450,000
If this is an individual account plan, was there a blackout period	2011-12-01	Yes
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-12-01	$0
Were there any nonexempt tranactions with any party-in-interest	2011-12-01	No
Contributions received from participants	2011-12-01	$0
Participant contributions at end of year	2011-12-01	$0
Participant contributions at beginning of year	2011-12-01	$22,284
Participant contributions at end of year	2011-12-01	$0
Participant contributions at beginning of year	2011-12-01	$0
Assets. Other investments not covered elsewhere at end of year	2011-12-01	$0
Assets. Other investments not covered elsewhere at beginning of year	2011-12-01	$0
Income. Received or receivable in cash from other sources (including rollovers)	2011-12-01	$0
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2011-12-01	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2011-12-01	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2011-12-01	$0
Assets. Loans (other than to participants) at end of year	2011-12-01	$0
Assets. Loans (other than to participants) at beginning of year	2011-12-01	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2011-12-01	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2011-12-01	$0
Other income not declared elsewhere	2011-12-01	$0
Administrative expenses (other) incurred	2011-12-01	$0
Liabilities. Value of operating payables at end of year	2011-12-01	$0
Liabilities. Value of operating payables at beginning of year	2011-12-01	$0
Total non interest bearing cash at end of year	2011-12-01	$0
Total non interest bearing cash at beginning of year	2011-12-01	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-01	No
Income. Non cash contributions	2011-12-01	$0
Value of net income/loss	2011-12-01	$-2,002,548
Value of net assets at end of year (total assets less liabilities)	2011-12-01	$0
Value of net assets at beginning of year (total assets less liabilities)	2011-12-01	$2,080,932
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2011-12-01	No
Were any loans by the plan or fixed income obligations due to the plan in default	2011-12-01	No
Were any leases to which the plan was party in default or uncollectible	2011-12-01	No
Assets. partnership/joint venture interests at end of year	2011-12-01	$0
Assets. partnership/joint venture interests at beginning of year	2011-12-01	$0
Investment advisory and management fees	2011-12-01	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2011-12-01	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-12-01	$0
Value of interest in pooled separate accounts at end of year	2011-12-01	$0
Value of interest in pooled separate accounts at beginning of year	2011-12-01	$1,905,731
Interest on participant loans	2011-12-01	$243
Income. Interest from loans (other than to participants)	2011-12-01	$0
Interest earned on other investments	2011-12-01	$1,648
Income. Interest from US Government securities	2011-12-01	$0
Income. Interest from corporate debt instruments	2011-12-01	$0
Value of interest in master investment trust accounts at end of year	2011-12-01	$0
Value of interest in master investment trust accounts at beginning of year	2011-12-01	$0
Value of interest in common/collective trusts at end of year	2011-12-01	$0
Value of interest in common/collective trusts at beginning of year	2011-12-01	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2011-12-01	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2011-12-01	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2011-12-01	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2011-12-01	$0
Assets. Value of investments in 103.12 investment entities at end of year	2011-12-01	$0
Assets. Value of investments in 103.12 investment entities at beginning of year	2011-12-01	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-12-01	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-12-01	$152,917
Expenses. Payments to insurance carriers foe the provision of benefits	2011-12-01	$0
Asset value of US Government securities at end of year	2011-12-01	$0
Asset value of US Government securities at beginning of year	2011-12-01	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2011-12-01	$0
Net investment gain/loss from pooled separate accounts	2011-12-01	$33,188
Net investment gain or loss from common/collective trusts	2011-12-01	$0
Net gain/loss from 103.12 investment entities	2011-12-01	$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-12-01	No
Was there a failure to transmit to the plan any participant contributions	2011-12-01	No
Has the plan failed to provide any benefit when due under the plan	2011-12-01	No
Assets. Invements in employer securities at end of year	2011-12-01	$0
Assets. Invements in employer securities at beginning of year	2011-12-01	$0
Assets. Value of employer real property at end of year	2011-12-01	$0
Assets. Value of employer real property at beginning of year	2011-12-01	$0
Contributions received in cash from employer	2011-12-01	$0
Employer contributions (assets) at end of year	2011-12-01	$0
Employer contributions (assets) at beginning of year	2011-12-01	$0
Income. Dividends from preferred stock	2011-12-01	$0
Income. Dividends from common stock	2011-12-01	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-01	$1,989,788
Asset. Corporate debt instrument preferred debt at end of year	2011-12-01	$0
Asset. Corporate debt instrument preferred debt at beginning of year	2011-12-01	$0
Asset. Corporate debt instrument debt (other) at end of year	2011-12-01	$0
Asset. Corporate debt instrument debt (other) at beginning of year	2011-12-01	$0
Contract administrator fees	2011-12-01	$0
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2011-12-01	Yes
Assets. Corporate common stocks other than exployer securities at end of year	2011-12-01	$0
Assets. Corporate common stocks other than exployer securities at beginning of year	2011-12-01	$0
Liabilities. Value of benefit claims payable at end of year	2011-12-01	$0
Liabilities. Value of benefit claims payable at beginning of year	2011-12-01	$0
Assets. Value of buildings and other operty used in plan operation at end of year	2011-12-01	$0
Assets. Value of buildings and other operty used in plan operation at beginning of year	2011-12-01	$0
Did the plan have assets held for investment	2011-12-01	No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-01	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2011-12-01	Yes
Aggregate proceeds on sale of assets	2011-12-01	$0
Aggregate carrying amount (costs) on sale of assets	2011-12-01	$0
Liabilities. Value of acquisition indebtedness at end of year	2011-12-01	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2011-12-01	$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-12-01	Yes
Opinion of an independent qualified public accountant for this plan	2011-12-01	Disclaimer
Accountancy firm name	2011-12-01	SAMPLE & BAILEY
Accountancy firm EIN	2011-12-01	841041726
2010 : THE BLACKFOX 401(K) AND SAVINGS PLAN 2010 401k financial data
Unrealized appreciation/depreciation of real estate assets	2010-12-31	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2010-12-31	$0
Total unrealized appreciation/depreciation of assets	2010-12-31	$0
Total transfer of assets to this plan	2010-12-31	$97,911
Total transfer of assets from this plan	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
Expenses. Interest paid	2010-12-31	$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2010-12-31	$0
Total income from all sources (including contributions)	2010-12-31	$237,605
Total loss/gain on sale of assets	2010-12-31	$0
Total of all expenses incurred	2010-12-31	$204,288
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$202,708
Expenses. Certain deemed distributions of participant loans	2010-12-31	$0
Value of total corrective distributions	2010-12-31	$780
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$36,258
Value of total assets at end of year	2010-12-31	$2,080,932
Value of total assets at beginning of year	2010-12-31	$1,949,704
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$800
Total income from rents	2010-12-31	$0
Total interest from all sources	2010-12-31	$4,234
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
Total dividends received from registered investment company shares (eg mutual funds)	2010-12-31	$0
Assets. Real estate other than employer real property at end of year	2010-12-31	$0
Assets. Real estate other than employer real property at beginning of year	2010-12-31	$0
Administrative expenses professional fees incurred	2010-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at end of year	2010-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year	2010-12-31	$0
Was this plan covered by a fidelity bond	2010-12-31	Yes
Value of fidelity bond cover	2010-12-31	$450,000
If this is an individual account plan, was there a blackout period	2010-12-31	Yes
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2010-12-31	No
Contributions received from participants	2010-12-31	$33,252
Participant contributions at end of year	2010-12-31	$22,284
Participant contributions at beginning of year	2010-12-31	$5,872
Participant contributions at end of year	2010-12-31	$0
Participant contributions at beginning of year	2010-12-31	$0
Assets. Other investments not covered elsewhere at end of year	2010-12-31	$0
Assets. Other investments not covered elsewhere at beginning of year	2010-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2010-12-31	$0
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2010-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2010-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2010-12-31	$0
Assets. Loans (other than to participants) at end of year	2010-12-31	$0
Assets. Loans (other than to participants) at beginning of year	2010-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2010-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2010-12-31	$0
Other income not declared elsewhere	2010-12-31	$0
Administrative expenses (other) incurred	2010-12-31	$0
Liabilities. Value of operating payables at end of year	2010-12-31	$0
Liabilities. Value of operating payables at beginning of year	2010-12-31	$0
Total non interest bearing cash at end of year	2010-12-31	$0
Total non interest bearing cash at beginning of year	2010-12-31	$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	2010-12-31	No
Income. Non cash contributions	2010-12-31	$0
Value of net income/loss	2010-12-31	$33,317
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$2,080,932
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$1,949,704
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
Assets. partnership/joint venture interests at end of year	2010-12-31	$0
Assets. partnership/joint venture interests at beginning of year	2010-12-31	$0
Investment advisory and management fees	2010-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2010-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2010-12-31	$0
Value of interest in pooled separate accounts at end of year	2010-12-31	$1,905,731
Value of interest in pooled separate accounts at beginning of year	2010-12-31	$1,795,612
Interest on participant loans	2010-12-31	$602
Income. Interest from loans (other than to participants)	2010-12-31	$0
Interest earned on other investments	2010-12-31	$3,632
Income. Interest from US Government securities	2010-12-31	$0
Income. Interest from corporate debt instruments	2010-12-31	$0
Value of interest in master investment trust accounts at end of year	2010-12-31	$0
Value of interest in master investment trust accounts at beginning of year	2010-12-31	$0
Value of interest in common/collective trusts at end of year	2010-12-31	$0
Value of interest in common/collective trusts at beginning of year	2010-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2010-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2010-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2010-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2010-12-31	$0
Assets. Value of investments in 103.12 investment entities at end of year	2010-12-31	$0
Assets. Value of investments in 103.12 investment entities at beginning of year	2010-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2010-12-31	$152,917
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2010-12-31	$148,220
Expenses. Payments to insurance carriers foe the provision of benefits	2010-12-31	$0
Asset value of US Government securities at end of year	2010-12-31	$0
Asset value of US Government securities at beginning of year	2010-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2010-12-31	$0
Net investment gain/loss from pooled separate accounts	2010-12-31	$197,113
Net investment gain or loss from common/collective trusts	2010-12-31	$0
Net gain/loss from 103.12 investment entities	2010-12-31	$0
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	Yes
Has the plan failed to provide any benefit when due under the plan	2010-12-31	No
Assets. Invements in employer securities at end of year	2010-12-31	$0
Assets. Invements in employer securities at beginning of year	2010-12-31	$0
Assets. Value of employer real property at end of year	2010-12-31	$0
Assets. Value of employer real property at beginning of year	2010-12-31	$0
Contributions received in cash from employer	2010-12-31	$3,006
Employer contributions (assets) at end of year	2010-12-31	$0
Employer contributions (assets) at beginning of year	2010-12-31	$0
Income. Dividends from preferred stock	2010-12-31	$0
Income. Dividends from common stock	2010-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$202,708
Asset. Corporate debt instrument preferred debt at end of year	2010-12-31	$0
Asset. Corporate debt instrument preferred debt at beginning of year	2010-12-31	$0
Asset. Corporate debt instrument debt (other) at end of year	2010-12-31	$0
Asset. Corporate debt instrument debt (other) at beginning of year	2010-12-31	$0
Contract administrator fees	2010-12-31	$800
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2010-12-31	Yes
Assets. Corporate common stocks other than exployer securities at end of year	2010-12-31	$0
Assets. Corporate common stocks other than exployer securities at beginning of year	2010-12-31	$0
Liabilities. Value of benefit claims payable at end of year	2010-12-31	$0
Liabilities. Value of benefit claims payable at beginning of year	2010-12-31	$0
Assets. Value of buildings and other operty used in plan operation at end of year	2010-12-31	$0
Assets. Value of buildings and other operty used in plan operation at beginning of year	2010-12-31	$0
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
Aggregate proceeds on sale of assets	2010-12-31	$0
Aggregate carrying amount (costs) on sale of assets	2010-12-31	$0
Liabilities. Value of acquisition indebtedness at end of year	2010-12-31	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2010-12-31	$0
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	SAMPLE & BAILEY
Accountancy firm EIN	2010-12-31	841041726
2009 : THE BLACKFOX 401(K) AND SAVINGS PLAN 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2009-12-31	$0

Form 5500 Responses for THE BLACKFOX 401(K) AND SAVINGS PLAN

2011: THE BLACKFOX 401(K) AND SAVINGS PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Mulitple employer plan
2011-01-01	Submission has been amended	No
2011-01-01	This submission is the final filing	Yes
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2011-01-01	Plan is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2010: THE BLACKFOX 401(K) AND SAVINGS PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Mulitple employer plan
2010-01-01	Submission has been amended	No
2010-01-01	This submission is the final filing	No
2010-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-01-01	Plan is a collectively bargained plan	No
2010-01-01	Plan funding arrangement – Insurance	Yes
2010-01-01	Plan benefit arrangement – Insurance	Yes
2009: THE BLACKFOX 401(K) AND SAVINGS PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Mulitple employer plan
2009-01-01	Submission has been amended	No
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	No
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes

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Company Name:	BLACKFOX, LLC
Employer identification number (EIN):	261857564
NAIC Classification:	551112
NAIC Description:	Offices of Other Holding Companies

Jurisdiction of Incorporation:	Colorado Department of State
Incorporation Date:	2008-01-02
Company Identification Number:	20071598269
Legal Registered Office Address:	1211 Lake Ave Ste 202 Berthoud United States of America (USA) 80513