401k Plan data: SHELLY ENTERPRISES, INC. 401(K) SAVINGS PLAN plan

SHELLY ENTERPRISES, INC. 401(K) SAVINGS PLAN 401k Plan overview

Plan Name	SHELLY ENTERPRISES, INC. 401(K) SAVINGS PLAN
Plan identification number	002

SHELLY ENTERPRISES, INC. 401(K) SAVINGS 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.
Life insurance

401k Sponsoring company profile

SHELLY ENTERPRISES, INC. has sponsored the creation of one or more 401k plans.

Company Name: SHELLY ENTERPRISES, INC.

Employer identification number (EIN): 231286527

NAIC Classification: 444190
NAIC Description: Other Building Material Dealers

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SHELLY ENTERPRISES, INC. 401(K) SAVINGS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2013-10-01 LARRY GOLD 2014-07-29
002 2012-10-01 LARRY GOLD
002 2011-10-01 LARRY GOLD
002 2009-10-01 LARRY GOLD
002 2008-10-01

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
002	2013-10-01	LARRY GOLD	2014-07-29
002	2012-10-01	LARRY GOLD
002	2011-10-01	LARRY GOLD
002	2009-10-01	LARRY GOLD
002	2008-10-01

Plan Statistics for SHELLY ENTERPRISES, INC. 401(K) SAVINGS PLAN

401k plan membership statisitcs for SHELLY ENTERPRISES, INC. 401(K) SAVINGS PLAN

Measure Date Value
2012: SHELLY ENTERPRISES, INC. 401(K) SAVINGS PLAN 2012 401k membership
Total participants, beginning-of-year 2012-10-01 223
Total number of active participants reported on line 7a of the Form 5500 2012-10-01 0
Number of retired or separated participants receiving benefits 2012-10-01 0
Number of other retired or separated participants entitled to future benefits 2012-10-01 33
Total of all active and inactive participants 2012-10-01 33
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-10-01 0
Total participants 2012-10-01 33
Number of participants with account balances 2012-10-01 33
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-10-01 0
2011: SHELLY ENTERPRISES, INC. 401(K) SAVINGS PLAN 2011 401k membership
Total participants, beginning-of-year 2011-10-01 243
Total number of active participants reported on line 7a of the Form 5500 2011-10-01 164
Number of retired or separated participants receiving benefits 2011-10-01 0
Number of other retired or separated participants entitled to future benefits 2011-10-01 59
Total of all active and inactive participants 2011-10-01 223
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-10-01 0
Total participants 2011-10-01 223
Number of participants with account balances 2011-10-01 201
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-10-01 1
2009: SHELLY ENTERPRISES, INC. 401(K) SAVINGS PLAN 2009 401k membership
Total participants, beginning-of-year 2009-10-01 303
Total number of active participants reported on line 7a of the Form 5500 2009-10-01 172
Number of retired or separated participants receiving benefits 2009-10-01 0
Number of other retired or separated participants entitled to future benefits 2009-10-01 67
Total of all active and inactive participants 2009-10-01 239
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-10-01 0
Total participants 2009-10-01 239
Number of participants with account balances 2009-10-01 229
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-10-01 7

Measure	Date	Value
2012: SHELLY ENTERPRISES, INC. 401(K) SAVINGS PLAN 2012 401k membership
Total participants, beginning-of-year	2012-10-01	223
Total number of active participants reported on line 7a of the Form 5500	2012-10-01	0
Number of retired or separated participants receiving benefits	2012-10-01	0
Number of other retired or separated participants entitled to future benefits	2012-10-01	33
Total of all active and inactive participants	2012-10-01	33
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-10-01	0
Total participants	2012-10-01	33
Number of participants with account balances	2012-10-01	33
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-10-01	0
2011: SHELLY ENTERPRISES, INC. 401(K) SAVINGS PLAN 2011 401k membership
Total participants, beginning-of-year	2011-10-01	243
Total number of active participants reported on line 7a of the Form 5500	2011-10-01	164
Number of retired or separated participants receiving benefits	2011-10-01	0
Number of other retired or separated participants entitled to future benefits	2011-10-01	59
Total of all active and inactive participants	2011-10-01	223
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-10-01	0
Total participants	2011-10-01	223
Number of participants with account balances	2011-10-01	201
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-10-01	1
2009: SHELLY ENTERPRISES, INC. 401(K) SAVINGS PLAN 2009 401k membership
Total participants, beginning-of-year	2009-10-01	303
Total number of active participants reported on line 7a of the Form 5500	2009-10-01	172
Number of retired or separated participants receiving benefits	2009-10-01	0
Number of other retired or separated participants entitled to future benefits	2009-10-01	67
Total of all active and inactive participants	2009-10-01	239
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-10-01	0
Total participants	2009-10-01	239
Number of participants with account balances	2009-10-01	229
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-10-01	7

Financial Data on SHELLY ENTERPRISES, INC. 401(K) SAVINGS PLAN

Measure	Date	Value
2013 : SHELLY ENTERPRISES, INC. 401(K) SAVINGS PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets	2013-09-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-09-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-09-30	$0
Total income from all sources (including contributions)	2013-09-30	$814,269
Total loss/gain on sale of assets	2013-09-30	$0
Total of all expenses incurred	2013-09-30	$9,996,721
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-09-30	$9,885,863
Value of total corrective distributions	2013-09-30	$234
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-09-30	$93,526
Value of total assets at end of year	2013-09-30	$792,038
Value of total assets at beginning of year	2013-09-30	$9,974,490
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-09-30	$110,624
Total interest from all sources	2013-09-30	$1,762
Total dividends received (eg from common stock, registered investment company shares)	2013-09-30	$204,802
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-09-30	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2013-09-30	$0
Total dividends received from registered investment company shares (eg mutual funds)	2013-09-30	$204,802
Administrative expenses professional fees incurred	2013-09-30	$46,800
Was this plan covered by a fidelity bond	2013-09-30	Yes
Value of fidelity bond cover	2013-09-30	$1,000,000
If this is an individual account plan, was there a blackout period	2013-09-30	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-09-30	$0
Were there any nonexempt tranactions with any party-in-interest	2013-09-30	No
Participant contributions at end of year	2013-09-30	$0
Participant contributions at beginning of year	2013-09-30	$71,497
Participant contributions at beginning of year	2013-09-30	$1,707
Other income not declared elsewhere	2013-09-30	$-117
Administrative expenses (other) incurred	2013-09-30	$12,280
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-09-30	No
Value of net income/loss	2013-09-30	$-9,182,452
Value of net assets at end of year (total assets less liabilities)	2013-09-30	$792,038
Value of net assets at beginning of year (total assets less liabilities)	2013-09-30	$9,974,490
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2013-09-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2013-09-30	No
Were any leases to which the plan was party in default or uncollectible	2013-09-30	No
Investment advisory and management fees	2013-09-30	$27,215
Value of interest in registered invesment companies (eg mutual funds) at end of year	2013-09-30	$711,801
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2013-09-30	$8,576,235
Interest on participant loans	2013-09-30	$1,758
Value of interest in common/collective trusts at end of year	2013-09-30	$0
Value of interest in common/collective trusts at beginning of year	2013-09-30	$999,356
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2013-09-30	$54,323
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2013-09-30	$3,275
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2013-09-30	$3,275
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2013-09-30	$4
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2013-09-30	$25,914
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-09-30	$322,420
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2013-09-30	$510,993
Net investment gain or loss from common/collective trusts	2013-09-30	$3,303
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2013-09-30	No
Was there a failure to transmit to the plan any participant contributions	2013-09-30	Yes
Has the plan failed to provide any benefit when due under the plan	2013-09-30	No
Assets. Invements in employer securities at end of year	2013-09-30	$0
Contributions received in cash from employer	2013-09-30	$93,526
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-09-30	$9,885,863
Contract administrator fees	2013-09-30	$24,329
Did the plan have assets held for investment	2013-09-30	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	2013-09-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2013-09-30	Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2013-09-30	Yes
Opinion of an independent qualified public accountant for this plan	2013-09-30	Disclaimer
Accountancy firm name	2013-09-30	PRITCHARD,BIELER,GRUVER,& WILLISON
Accountancy firm EIN	2013-09-30	233019016
2012 : SHELLY ENTERPRISES, INC. 401(K) SAVINGS PLAN 2012 401k financial data
Total unrealized appreciation/depreciation of assets	2012-09-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-09-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-09-30	$0
Total income from all sources (including contributions)	2012-09-30	$1,721,859
Total loss/gain on sale of assets	2012-09-30	$0
Total of all expenses incurred	2012-09-30	$721,001
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-09-30	$650,660
Expenses. Certain deemed distributions of participant loans	2012-09-30	$29,321
Value of total corrective distributions	2012-09-30	$104
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-09-30	$155,715
Value of total assets at end of year	2012-09-30	$9,974,490
Value of total assets at beginning of year	2012-09-30	$8,973,632
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-09-30	$40,916
Total interest from all sources	2012-09-30	$7,003
Total dividends received (eg from common stock, registered investment company shares)	2012-09-30	$225,067
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-09-30	No
Total dividends received from registered investment company shares (eg mutual funds)	2012-09-30	$225,067
Administrative expenses professional fees incurred	2012-09-30	$10,860
Was this plan covered by a fidelity bond	2012-09-30	Yes
Value of fidelity bond cover	2012-09-30	$1,000,000
If this is an individual account plan, was there a blackout period	2012-09-30	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-09-30	$0
Were there any nonexempt tranactions with any party-in-interest	2012-09-30	No
Contributions received from participants	2012-09-30	$155,715
Participant contributions at end of year	2012-09-30	$71,497
Participant contributions at beginning of year	2012-09-30	$182,077
Participant contributions at end of year	2012-09-30	$1,707
Other income not declared elsewhere	2012-09-30	$10,054
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-09-30	No
Value of net income/loss	2012-09-30	$1,000,858
Value of net assets at end of year (total assets less liabilities)	2012-09-30	$9,974,490
Value of net assets at beginning of year (total assets less liabilities)	2012-09-30	$8,973,632
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-09-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-09-30	No
Were any leases to which the plan was party in default or uncollectible	2012-09-30	No
Investment advisory and management fees	2012-09-30	$22,639
Value of interest in registered invesment companies (eg mutual funds) at end of year	2012-09-30	$8,576,235
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-09-30	$7,363,269
Interest on participant loans	2012-09-30	$6,997
Value of interest in common/collective trusts at end of year	2012-09-30	$999,356
Value of interest in common/collective trusts at beginning of year	2012-09-30	$1,110,534
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2012-09-30	$3,275
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2012-09-30	$248
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2012-09-30	$248
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2012-09-30	$6
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-09-30	$322,420
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-09-30	$317,504
Expenses. Payments to insurance carriers foe the provision of benefits	2012-09-30	$14,548
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2012-09-30	$1,321,461
Net investment gain or loss from common/collective trusts	2012-09-30	$2,559
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-09-30	No
Was there a failure to transmit to the plan any participant contributions	2012-09-30	Yes
Has the plan failed to provide any benefit when due under the plan	2012-09-30	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-09-30	$636,112
Contract administrator fees	2012-09-30	$7,417
Did the plan have assets held for investment	2012-09-30	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	2012-09-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-09-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-09-30	Yes
Opinion of an independent qualified public accountant for this plan	2012-09-30	Disclaimer
Accountancy firm name	2012-09-30	PRITCHARD, BIELER, GRUVER, WILLISON
Accountancy firm EIN	2012-09-30	233019016
2011 : SHELLY ENTERPRISES, INC. 401(K) SAVINGS PLAN 2011 401k financial data
Total unrealized appreciation/depreciation of assets	2011-09-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-09-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-09-30	$0
Total income from all sources (including contributions)	2011-09-30	$48,893
Total loss/gain on sale of assets	2011-09-30	$0
Total of all expenses incurred	2011-09-30	$1,356,721
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-09-30	$1,308,217
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-09-30	$168,501
Value of total assets at end of year	2011-09-30	$8,973,632
Value of total assets at beginning of year	2011-09-30	$10,281,460
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-09-30	$48,504
Total interest from all sources	2011-09-30	$9,408
Total dividends received (eg from common stock, registered investment company shares)	2011-09-30	$374,063
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-09-30	No
Total dividends received from registered investment company shares (eg mutual funds)	2011-09-30	$374,063
Was this plan covered by a fidelity bond	2011-09-30	Yes
Value of fidelity bond cover	2011-09-30	$1,000,000
If this is an individual account plan, was there a blackout period	2011-09-30	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-09-30	$0
Were there any nonexempt tranactions with any party-in-interest	2011-09-30	No
Contributions received from participants	2011-09-30	$168,501
Participant contributions at end of year	2011-09-30	$182,077
Participant contributions at beginning of year	2011-09-30	$218,317
Administrative expenses (other) incurred	2011-09-30	$48,504
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-09-30	No
Value of net income/loss	2011-09-30	$-1,307,828
Value of net assets at end of year (total assets less liabilities)	2011-09-30	$8,973,632
Value of net assets at beginning of year (total assets less liabilities)	2011-09-30	$10,281,460
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2011-09-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2011-09-30	No
Were any leases to which the plan was party in default or uncollectible	2011-09-30	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2011-09-30	$7,363,269
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-09-30	$8,177,210
Interest on participant loans	2011-09-30	$9,406
Value of interest in common/collective trusts at end of year	2011-09-30	$1,110,534
Value of interest in common/collective trusts at beginning of year	2011-09-30	$1,501,688
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2011-09-30	$248
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2011-09-30	$12,883
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2011-09-30	$12,883
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2011-09-30	$2
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-09-30	$317,504
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-09-30	$371,362
Expenses. Payments to insurance carriers foe the provision of benefits	2011-09-30	$14,725
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2011-09-30	$-508,100
Net investment gain or loss from common/collective trusts	2011-09-30	$5,021
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-09-30	No
Was there a failure to transmit to the plan any participant contributions	2011-09-30	No
Has the plan failed to provide any benefit when due under the plan	2011-09-30	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-09-30	$1,293,492
Did the plan have assets held for investment	2011-09-30	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	2011-09-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2011-09-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-09-30	Yes
Opinion of an independent qualified public accountant for this plan	2011-09-30	Disclaimer
Accountancy firm name	2011-09-30	PARENTE BEARD LLC
Accountancy firm EIN	2011-09-30	232932984
2010 : SHELLY ENTERPRISES, INC. 401(K) SAVINGS PLAN 2010 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-09-30	$0

Form 5500 Responses for SHELLY ENTERPRISES, INC. 401(K) SAVINGS PLAN

2012: SHELLY ENTERPRISES, INC. 401(K) SAVINGS PLAN 2012 form 5500 responses
2012-10-01	Type of plan entity	Single employer plan
2012-10-01	Submission has been amended	No
2012-10-01	This submission is the final filing	No
2012-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-10-01	Plan is a collectively bargained plan	No
2012-10-01	Plan funding arrangement – Insurance	Yes
2012-10-01	Plan funding arrangement – Trust	Yes
2012-10-01	Plan benefit arrangement – Insurance	Yes
2012-10-01	Plan benefit arrangement - Trust	Yes
2011: SHELLY ENTERPRISES, INC. 401(K) SAVINGS PLAN 2011 form 5500 responses
2011-10-01	Type of plan entity	Single employer plan
2011-10-01	Submission has been amended	Yes
2011-10-01	This submission is the final filing	No
2011-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-10-01	Plan is a collectively bargained plan	No
2011-10-01	Plan funding arrangement – Insurance	Yes
2011-10-01	Plan funding arrangement – Trust	Yes
2011-10-01	Plan benefit arrangement – Insurance	Yes
2011-10-01	Plan benefit arrangement - Trust	Yes
2009: SHELLY ENTERPRISES, INC. 401(K) SAVINGS PLAN 2009 form 5500 responses
2009-10-01	Type of plan entity	Single employer plan
2009-10-01	Submission has been amended	No
2009-10-01	This submission is the final filing	No
2009-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-10-01	Plan is a collectively bargained plan	No
2009-10-01	Plan funding arrangement – Insurance	Yes
2009-10-01	Plan funding arrangement – Trust	Yes
2009-10-01	Plan benefit arrangement – Insurance	Yes
2009-10-01	Plan benefit arrangement - Trust	Yes
2008: SHELLY ENTERPRISES, INC. 401(K) SAVINGS PLAN 2008 form 5500 responses
2008-10-01	Type of plan entity	Single employer plan
2008-10-01	Submission has been amended	No
2008-10-01	This submission is the final filing	No
2008-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2008-10-01	Plan is a collectively bargained plan	No

Insurance Providers Used on plan

NATIONWIDE LIFE AND ANNUITY COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 70750 )

Policy contract number

0067L

Policy instance

Insurance contract or identification number	0067L
Number of Individuals Covered	2
Insurance policy start date	2012-10-01
Insurance policy end date	2013-09-30
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	Yes
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?	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

THE LAFAYETTE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65242 )

Policy contract number

ULCP0996

Policy instance

Insurance contract or identification number	ULCP0996
Number of Individuals Covered	0
Insurance policy start date	2012-10-01
Insurance policy end date	2013-09-30
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	Yes
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?	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

THE LAFAYETTE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65242 )

Policy contract number

ULCP0996

Policy instance

Insurance contract or identification number	ULCP0996
Number of Individuals Covered	19
Insurance policy start date	2011-10-01
Insurance policy end date	2012-09-30
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	Yes
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?	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

NATIONWIDE LIFE AND ANNUITY COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 70750 )

Policy contract number

0067L

Policy instance

Insurance contract or identification number	0067L
Number of Individuals Covered	2
Insurance policy start date	2011-10-01
Insurance policy end date	2012-09-30
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	Yes
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?	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

THE LAFAYETTE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65242 )

Policy contract number

ULCP0996

Policy instance

Insurance contract or identification number	ULCP0996
Number of Individuals Covered	21
Insurance policy start date	2010-10-01
Insurance policy end date	2011-09-30
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	Yes
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?	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

NATIONWIDE LIFE AND ANNUITY COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 70750 )

Policy contract number

0067L

Policy instance

Insurance contract or identification number	0067L
Number of Individuals Covered	2
Insurance policy start date	2010-10-01
Insurance policy end date	2011-09-30
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	Yes
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?	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

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Company Name:	SHELLY ENTERPRISES, INC.
Employer identification number (EIN):	231286527
NAIC Classification:	444190
NAIC Description:	Other Building Material Dealers