401k Plan data: BLUE DIAMOND DISPOSAL 401(K) SAVINGS AND RETIREMENT PLAN plan

BLUE DIAMOND DISPOSAL 401(K) SAVINGS AND RETIREMENT PLAN 401k Plan overview

Plan Name	BLUE DIAMOND DISPOSAL 401(K) SAVINGS AND RETIREMENT PLAN
Plan identification number	001

BLUE DIAMOND DISPOSAL 401(K) SAVINGS AND RETIREMENT 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

BLUE DIAMOND DISPOSAL , INC has sponsored the creation of one or more 401k plans.

Company Name: BLUE DIAMOND DISPOSAL , INC

Employer identification number (EIN): 223600408

NAIC Classification: 562000

Form 5500 Filing Information

Submission information for form 5500 for 401k plan BLUE DIAMOND DISPOSAL 401(K) SAVINGS AND RETIREMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2022-01-01 PAUL VALCUKAS 2023-03-14
001 2021-01-01 PAUL VALCUKAS 2022-06-20
001 2020-01-01 PAUL VALCUKAS 2021-05-28
001 2019-01-01 DENISE M SHORTINO 2020-08-13
001 2018-01-01 DENISE SHORTINO 2019-06-26
001 2017-01-01 DENISE SHORTINO 2018-05-30
001 2016-01-01 DENISE SHORTINO 2017-07-11
001 2015-01-01 DENISE SHORTINO
001 2014-01-01 DENISE SHORTINO
001 2013-01-01 DENISE SHORTINO
001 2012-01-01 DENISE SHORTINO 2013-05-23
001 2011-01-01 DENISE SHORTINO 2012-06-12
001 2010-01-01 DENISE SHORTINO 2011-06-02

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
001	2022-01-01	PAUL VALCUKAS	2023-03-14
001	2021-01-01	PAUL VALCUKAS	2022-06-20
001	2020-01-01	PAUL VALCUKAS	2021-05-28
001	2019-01-01	DENISE M SHORTINO	2020-08-13
001	2018-01-01	DENISE SHORTINO	2019-06-26
001	2017-01-01	DENISE SHORTINO	2018-05-30
001	2016-01-01	DENISE SHORTINO	2017-07-11
001	2015-01-01	DENISE SHORTINO
001	2014-01-01	DENISE SHORTINO
001	2013-01-01	DENISE SHORTINO
001	2012-01-01	DENISE SHORTINO	2013-05-23
001	2011-01-01	DENISE SHORTINO	2012-06-12
001	2010-01-01	DENISE SHORTINO	2011-06-02

Plan Statistics for BLUE DIAMOND DISPOSAL 401(K) SAVINGS AND RETIREMENT PLAN

401k plan membership statisitcs for BLUE DIAMOND DISPOSAL 401(K) SAVINGS AND RETIREMENT PLAN

Measure Date Value
2015: BLUE DIAMOND DISPOSAL 401(K) SAVINGS AND RETIREMENT PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 101
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 88
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 5
Total of all active and inactive participants 2015-01-01 93
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 93
Number of participants with account balances 2015-01-01 58
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 3
2014: BLUE DIAMOND DISPOSAL 401(K) SAVINGS AND RETIREMENT PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 123
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 85
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 10
Total of all active and inactive participants 2014-01-01 95
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 95
Number of participants with account balances 2014-01-01 61
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 3
2013: BLUE DIAMOND DISPOSAL 401(K) SAVINGS AND RETIREMENT PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 124
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 109
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 6
Total of all active and inactive participants 2013-01-01 115
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 115
Number of participants with account balances 2013-01-01 62
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 2

Measure	Date	Value
2015: BLUE DIAMOND DISPOSAL 401(K) SAVINGS AND RETIREMENT PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	101
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	88
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	5
Total of all active and inactive participants	2015-01-01	93
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	93
Number of participants with account balances	2015-01-01	58
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	3
2014: BLUE DIAMOND DISPOSAL 401(K) SAVINGS AND RETIREMENT PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	123
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	85
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	10
Total of all active and inactive participants	2014-01-01	95
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	95
Number of participants with account balances	2014-01-01	61
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	3
2013: BLUE DIAMOND DISPOSAL 401(K) SAVINGS AND RETIREMENT PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	124
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	109
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	6
Total of all active and inactive participants	2013-01-01	115
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	115
Number of participants with account balances	2013-01-01	62
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	2

Financial Data on BLUE DIAMOND DISPOSAL 401(K) SAVINGS AND RETIREMENT PLAN

Measure	Date	Value
2015 : BLUE DIAMOND DISPOSAL 401(K) SAVINGS AND RETIREMENT PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets	2015-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Total income from all sources (including contributions)	2015-12-31	$180,089
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$105,842
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$103,961
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$224,464
Value of total assets at end of year	2015-12-31	$1,849,795
Value of total assets at beginning of year	2015-12-31	$1,775,548
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$1,881
Total interest from all sources	2015-12-31	$1,378
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$0
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	$96,000
If this is an individual account plan, was there a blackout period	2015-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2015-12-31	No
Contributions received from participants	2015-12-31	$161,035
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	$74,247
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$1,849,795
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$1,775,548
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	$1,753,107
Value of interest in pooled separate accounts at beginning of year	2015-12-31	$1,686,750
Interest earned on other investments	2015-12-31	$1,378
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-12-31	$96,688
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-12-31	$88,798
Net investment gain/loss from pooled separate accounts	2015-12-31	$-45,753
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	$63,429
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$103,961
Contract administrator fees	2015-12-31	$1,881
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	MILLS AND DEFILIPPIS CPAS
Accountancy firm EIN	2015-12-31	222217716
2014 : BLUE DIAMOND DISPOSAL 401(K) SAVINGS AND RETIREMENT PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets	2014-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Total income from all sources (including contributions)	2014-12-31	$330,722
Total loss/gain on sale of assets	2014-12-31	$0
Total of all expenses incurred	2014-12-31	$158,564
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$155,317
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$227,447
Value of total assets at end of year	2014-12-31	$1,775,548
Value of total assets at beginning of year	2014-12-31	$1,603,390
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$3,247
Total interest from all sources	2014-12-31	$1,316
Total dividends received (eg from common stock, registered investment company shares)	2014-12-31	$0
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	$96,000
If this is an individual account plan, was there a blackout period	2014-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2014-12-31	No
Contributions received from participants	2014-12-31	$161,762
Participant contributions at end of year	2014-12-31	$0
Participant contributions at beginning of year	2014-12-31	$0
Other income not declared elsewhere	2014-12-31	$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	2014-12-31	No
Value of net income/loss	2014-12-31	$172,158
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$1,775,548
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$1,603,390
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
Value of interest in pooled separate accounts at end of year	2014-12-31	$1,686,750
Value of interest in pooled separate accounts at beginning of year	2014-12-31	$1,517,140
Interest on participant loans	2014-12-31	$0
Interest earned on other investments	2014-12-31	$1,316
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-12-31	$88,798
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-12-31	$86,250
Net investment gain/loss from pooled separate accounts	2014-12-31	$101,959
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	$65,685
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$155,317
Contract administrator fees	2014-12-31	$3,247
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	MILLS AND DEFILIPPIS CPAS, LLP
Accountancy firm EIN	2014-12-31	222217716
2013 : BLUE DIAMOND DISPOSAL 401(K) SAVINGS AND RETIREMENT PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets	2013-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
Total income from all sources (including contributions)	2013-12-31	$468,711
Total loss/gain on sale of assets	2013-12-31	$0
Total of all expenses incurred	2013-12-31	$146,484
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$144,035
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$248,762
Value of total assets at end of year	2013-12-31	$1,603,390
Value of total assets at beginning of year	2013-12-31	$1,281,163
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$2,449
Total interest from all sources	2013-12-31	$1,173
Total dividends received (eg from common stock, registered investment company shares)	2013-12-31	$0
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	$96,000
If this is an individual account plan, was there a blackout period	2013-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2013-12-31	No
Contributions received from participants	2013-12-31	$174,516
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
Value of net income/loss	2013-12-31	$322,227
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$1,603,390
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$1,281,163
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	$1,517,140
Value of interest in pooled separate accounts at beginning of year	2013-12-31	$1,212,869
Interest earned on other investments	2013-12-31	$1,173
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2013-12-31	$86,250
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-12-31	$68,294
Net investment gain/loss from pooled separate accounts	2013-12-31	$218,776
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	$74,246
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$144,035
Contract administrator fees	2013-12-31	$2,449
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	2013-12-31	No
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	MILLS AND DEFILIPPIS CPAS, LLP
Accountancy firm EIN	2013-12-31	222217716

Form 5500 Responses for BLUE DIAMOND DISPOSAL 401(K) SAVINGS AND RETIREMENT PLAN

2015: BLUE DIAMOND DISPOSAL 401(K) SAVINGS AND RETIREMENT 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: BLUE DIAMOND DISPOSAL 401(K) SAVINGS AND RETIREMENT 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: BLUE DIAMOND DISPOSAL 401(K) SAVINGS AND RETIREMENT 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

Insurance Providers Used on plan

MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 )

Policy contract number

064724

Policy instance

Insurance contract or identification number	064724
Number of Individuals Covered	93
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $9,145
Total amount of fees paid to insurance company	USD $0
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?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
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
Commission paid to Insurance Broker	USD $9,145
Insurance broker organization code?	3
Insurance broker name	SECURIAN FINANCIAL SERVICS, INC

MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 )

Policy contract number

64724

Policy instance

Insurance contract or identification number	64724
Number of Individuals Covered	95
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $8,576
Total amount of fees paid to insurance company	USD $0
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?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
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
Commission paid to Insurance Broker	USD $8,576
Insurance broker organization code?	3
Insurance broker name	SECURIAN FINANCIAL SERVICS, INC

MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 )

Policy contract number

64724

Policy instance

Insurance contract or identification number	64724
Number of Individuals Covered	115
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $7,377
Total amount of fees paid to insurance company	USD $0
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?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
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
Commission paid to Insurance Broker	USD $7,377
Insurance broker organization code?	3
Insurance broker name	SECURIAN FINANCIAL SERVICS, INC

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Company Name:	BLUE DIAMOND DISPOSAL , INC
Employer identification number (EIN):	223600408
NAIC Classification:	562000