401k Plan data: THE LODGE AT SUGAR LAKE, INC. 401(K) PROFIT SHARING PLAN plan

THE LODGE AT SUGAR LAKE, INC. 401(K) PROFIT SHARING PLAN 401k Plan overview

Plan Name	THE LODGE AT SUGAR LAKE, INC. 401(K) PROFIT SHARING PLAN
Plan identification number	001

THE LODGE AT SUGAR LAKE, INC. 401(K) PROFIT SHARING 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.
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

THE LODGE AT SUGAR LAKE, INC. DBA RUTGERS SUGAR LAKE LODGE has sponsored the creation of one or more 401k plans.

Company Name: THE LODGE AT SUGAR LAKE, INC. DBA RUTGERS SUGAR LAKE LODGE

Employer identification number (EIN): 411723960

NAIC Classification: 721199
NAIC Description: All Other Traveler Accommodation

Form 5500 Filing Information

Submission information for form 5500 for 401k plan THE LODGE AT SUGAR LAKE, INC. 401(K) PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2015-11-01 JANE BOBICH 2017-04-12
001 2014-11-01 JANE BOBICH 2016-01-15
001 2013-11-01 JANE BOBICH 2015-04-10
001 2012-11-01 JANE BOBICH 2014-05-01
001 2011-11-01 JANE BOBICH 2013-05-17
001 2010-11-01 JANE BOBICH
001 2009-11-01 JANE BOBICH

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
001	2015-11-01	JANE BOBICH	2017-04-12
001	2014-11-01	JANE BOBICH	2016-01-15
001	2013-11-01	JANE BOBICH	2015-04-10
001	2012-11-01	JANE BOBICH	2014-05-01
001	2011-11-01	JANE BOBICH	2013-05-17
001	2010-11-01	JANE BOBICH
001	2009-11-01	JANE BOBICH

Plan Statistics for THE LODGE AT SUGAR LAKE, INC. 401(K) PROFIT SHARING PLAN

401k plan membership statisitcs for THE LODGE AT SUGAR LAKE, INC. 401(K) PROFIT SHARING PLAN

Measure Date Value
2010: THE LODGE AT SUGAR LAKE, INC. 401(K) PROFIT SHARING PLAN 2010 401k membership
Total participants, beginning-of-year 2010-11-01 26
Total number of active participants reported on line 7a of the Form 5500 2010-11-01 23
Number of retired or separated participants receiving benefits 2010-11-01 0
Number of other retired or separated participants entitled to future benefits 2010-11-01 2
Total of all active and inactive participants 2010-11-01 25
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-11-01 0
Total participants 2010-11-01 25
Number of participants with account balances 2010-11-01 13
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-11-01 0
2009: THE LODGE AT SUGAR LAKE, INC. 401(K) PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year 2009-11-01 31
Total number of active participants reported on line 7a of the Form 5500 2009-11-01 25
Number of retired or separated participants receiving benefits 2009-11-01 0
Number of other retired or separated participants entitled to future benefits 2009-11-01 1
Total of all active and inactive participants 2009-11-01 26
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-11-01 0
Total participants 2009-11-01 26
Number of participants with account balances 2009-11-01 13
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-11-01 0

Measure	Date	Value
2010: THE LODGE AT SUGAR LAKE, INC. 401(K) PROFIT SHARING PLAN 2010 401k membership
Total participants, beginning-of-year	2010-11-01	26
Total number of active participants reported on line 7a of the Form 5500	2010-11-01	23
Number of retired or separated participants receiving benefits	2010-11-01	0
Number of other retired or separated participants entitled to future benefits	2010-11-01	2
Total of all active and inactive participants	2010-11-01	25
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-11-01	0
Total participants	2010-11-01	25
Number of participants with account balances	2010-11-01	13
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-11-01	0
2009: THE LODGE AT SUGAR LAKE, INC. 401(K) PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year	2009-11-01	31
Total number of active participants reported on line 7a of the Form 5500	2009-11-01	25
Number of retired or separated participants receiving benefits	2009-11-01	0
Number of other retired or separated participants entitled to future benefits	2009-11-01	1
Total of all active and inactive participants	2009-11-01	26
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-11-01	0
Total participants	2009-11-01	26
Number of participants with account balances	2009-11-01	13
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-11-01	0

Financial Data on THE LODGE AT SUGAR LAKE, INC. 401(K) PROFIT SHARING PLAN

Measure	Date	Value
2011 : THE LODGE AT SUGAR LAKE, INC. 401(K) PROFIT SHARING PLAN 2011 401k financial data
Transfers to/from the plan	2011-10-31	$0
Total plan liabilities at end of year	2011-10-31	$0
Total plan liabilities at beginning of year	2011-10-31	$0
Total income from all sources	2011-10-31	$15,431
Expenses. Total of all expenses incurred	2011-10-31	$0
Benefits paid (including direct rollovers)	2011-10-31	$0
Total plan assets at end of year	2011-10-31	$267,251
Total plan assets at beginning of year	2011-10-31	$251,820
Value of fidelity bond covering the plan	2011-10-31	$25,000
Total contributions received or receivable from participants	2011-10-31	$18,481
Contributions received from other sources (not participants or employers)	2011-10-31	$0
Other income received	2011-10-31	$-3,050
Noncash contributions received	2011-10-31	$0
Net income (gross income less expenses)	2011-10-31	$15,431
Net plan assets at end of year (total assets less liabilities)	2011-10-31	$267,251
Net plan assets at beginning of year (total assets less liabilities)	2011-10-31	$251,820
Assets. Value of participant loans	2011-10-31	$3,561
Total contributions received or receivable from employer(s)	2011-10-31	$0
Value of certain deemed distributions of participant loans	2011-10-31	$0
Value of corrective distributions	2011-10-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2011-10-31	$0
2010 : THE LODGE AT SUGAR LAKE, INC. 401(K) PROFIT SHARING PLAN 2010 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-10-31	$0

Form 5500 Responses for THE LODGE AT SUGAR LAKE, INC. 401(K) PROFIT SHARING PLAN

2010: THE LODGE AT SUGAR LAKE, INC. 401(K) PROFIT SHARING PLAN 2010 form 5500 responses
2010-11-01	Type of plan entity	Single employer plan
2010-11-01	Submission has been amended	No
2010-11-01	This submission is the final filing	No
2010-11-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-11-01	Plan is a collectively bargained plan	No
2010-11-01	Plan funding arrangement – Insurance	Yes
2010-11-01	Plan funding arrangement – Trust	Yes
2010-11-01	Plan benefit arrangement – Insurance	Yes
2010-11-01	Plan benefit arrangement - Trust	Yes
2009: THE LODGE AT SUGAR LAKE, INC. 401(K) PROFIT SHARING PLAN 2009 form 5500 responses
2009-11-01	Type of plan entity	Single employer plan
2009-11-01	Submission has been amended	No
2009-11-01	This submission is the final filing	No
2009-11-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-11-01	Plan is a collectively bargained plan	No
2009-11-01	Plan funding arrangement – Insurance	Yes
2009-11-01	Plan funding arrangement – Trust	Yes
2009-11-01	Plan benefit arrangement – Insurance	Yes
2009-11-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

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

Policy contract number

GA-022784

Policy instance

Insurance contract or identification number	GA-022784
Number of Individuals Covered	13
Insurance policy start date	2010-11-01
Insurance policy end date	2011-10-31
Total amount of commissions paid to insurance broker	USD $847
Total amount of fees paid to insurance company	USD $409
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	THE LODGE AT SUGAR LAKE, INC. DBA RUTGERS SUGAR LAKE LODGE
Employer identification number (EIN):	411723960
NAIC Classification:	721199
NAIC Description:	All Other Traveler Accommodation