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| Plan Name | CAFE CONCEPTS 401(K) PLAN |
| Plan identification number | 001 |
| 401k Plan Type | Defined Contribution Pension |
| Plan Features/Benefits |
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| Company Name: | CAFE CONCEPTS |
| Employer identification number (EIN): | 330984855 |
| NAIC Classification: | 423400 |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 001 | 2016-01-01 | VENESSA ROWE | 2017-06-15 | VENESSA ROWE | 2017-06-15 |
| 001 | 2015-01-01 | JILL WALSH | 2016-06-22 | ||
| 001 | 2012-01-01 | JILL WALSH |
| Measure | Date | Value |
|---|---|---|
| 2012: CAFE CONCEPTS 401(K) PLAN 2012 401k membership | ||
| Total participants, beginning-of-year | 2012-01-01 | 4 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 3 |
| Number of retired or separated participants receiving benefits | 2012-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2012-01-01 | 1 |
| Total of all active and inactive participants | 2012-01-01 | 4 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2012-01-01 | 0 |
| Total participants | 2012-01-01 | 4 |
| Number of participants with account balances | 2012-01-01 | 3 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2012-01-01 | 0 |
| Measure | Date | Value |
|---|---|---|
| 2012 : CAFE CONCEPTS 401(K) PLAN 2012 401k financial data | ||
| Transfers to/from the plan | 2012-12-31 | $0 |
| Total income from all sources | 2012-12-31 | $9,218 |
| Expenses. Total of all expenses incurred | 2012-12-31 | $644 |
| Benefits paid (including direct rollovers) | 2012-12-31 | $0 |
| Total plan assets at end of year | 2012-12-31 | $120,258 |
| Total plan assets at beginning of year | 2012-12-31 | $111,684 |
| Value of fidelity bond covering the plan | 2012-12-31 | $20,000 |
| Total contributions received or receivable from participants | 2012-12-31 | $202 |
| Expenses. Other expenses not covered elsewhere | 2012-12-31 | $644 |
| Contributions received from other sources (not participants or employers) | 2012-12-31 | $0 |
| Other income received | 2012-12-31 | $506 |
| Net income (gross income less expenses) | 2012-12-31 | $8,574 |
| Net plan assets at end of year (total assets less liabilities) | 2012-12-31 | $120,258 |
| Net plan assets at beginning of year (total assets less liabilities) | 2012-12-31 | $111,684 |
| Assets. Value of participant loans | 2012-12-31 | $30,969 |
| Total contributions received or receivable from employer(s) | 2012-12-31 | $8,510 |
| Value of certain deemed distributions of participant loans | 2012-12-31 | $0 |
| Value of corrective distributions | 2012-12-31 | $0 |
| 2012: CAFE CONCEPTS 401(K) PLAN 2012 form 5500 responses | ||
|---|---|---|
| 2012-01-01 | Type of plan entity | Single employer plan |
| 2012-01-01 | Submission has been amended | No |
| 2012-01-01 | This submission is the final filing | No |
| 2012-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2012-01-01 | Plan is a collectively bargained plan | No |
| 2012-01-01 | Plan funding arrangement – Insurance | Yes |
| 2012-01-01 | Plan funding arrangement – Trust | Yes |
| 2012-01-01 | Plan benefit arrangement – Insurance | Yes |
| HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | GA-824257 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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