401k Plan data: GRAVES SPRAY SUPPLY VOL. LIFE, LTD, AND STD PLAN plan

GRAVES SPRAY SUPPLY VOL. LIFE, LTD, AND STD PLAN 401k Plan overview

Plan Name	GRAVES SPRAY SUPPLY VOL. LIFE, LTD, AND STD PLAN
Plan identification number	505

GRAVES SPRAY SUPPLY VOL. LIFE, LTD, AND STD PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Life insurance Temporary disability (accident and sickness) Long-term disability cover

401k Sponsoring company profile

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

Company Name: GSSC, INC.

Employer identification number (EIN): 362650388

NAIC Classification: 333900

Form 5500 Filing Information

Submission information for form 5500 for 401k plan GRAVES SPRAY SUPPLY VOL. LIFE, LTD, AND STD PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
505 2006-01-01 ANNIKKA JENKINS 2022-03-17

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
505	2006-01-01	ANNIKKA JENKINS	2022-03-17

Plan Statistics for GRAVES SPRAY SUPPLY VOL. LIFE, LTD, AND STD PLAN

401k plan membership statisitcs for GRAVES SPRAY SUPPLY VOL. LIFE, LTD, AND STD PLAN

Measure Date Value
2006: GRAVES SPRAY SUPPLY VOL. LIFE, LTD, AND STD PLAN 2006 401k membership
Total participants, beginning-of-year 2006-01-01 171
Total number of active participants reported on line 7a of the Form 5500 2006-01-01 0
Number of retired or separated participants receiving benefits 2006-01-01 0
Number of other retired or separated participants entitled to future benefits 2006-01-01 0
Total of all active and inactive participants 2006-01-01 0
Number of employers contributing to the scheme 2006-01-01 0

Measure	Date	Value
2006: GRAVES SPRAY SUPPLY VOL. LIFE, LTD, AND STD PLAN 2006 401k membership
Total participants, beginning-of-year	2006-01-01	171
Total number of active participants reported on line 7a of the Form 5500	2006-01-01	0
Number of retired or separated participants receiving benefits	2006-01-01	0
Number of other retired or separated participants entitled to future benefits	2006-01-01	0
Total of all active and inactive participants	2006-01-01	0
Number of employers contributing to the scheme	2006-01-01	0

Form 5500 Responses for GRAVES SPRAY SUPPLY VOL. LIFE, LTD, AND STD PLAN

2006: GRAVES SPRAY SUPPLY VOL. LIFE, LTD, AND STD PLAN 2006 form 5500 responses
2006-01-01	Type of plan entity	Single employer plan
2006-01-01	Submission has been amended	Yes
2006-01-01	This submission is the final filing	Yes
2006-01-01	Plan funding arrangement – Insurance	Yes
2006-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

JEFFERSON PILOT FINANCIAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70254 )

Policy contract number

40000100004186

Policy instance

Insurance contract or identification number	40000100004186
Number of Individuals Covered	101
Insurance policy start date	2006-01-01
Insurance policy end date	2006-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $295
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $12,897
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $0
Amount paid for insurance broker fees	295
Additional information about fees paid to insurance broker	BROKER FEE
Insurance broker organization code?	3

JEFFERSON PILOT FINANCIAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70254 )

Policy contract number

010067330

Policy instance

Insurance contract or identification number	010067330
Number of Individuals Covered	14
Insurance policy start date	2006-01-01
Insurance policy end date	2006-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $118
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $5,340
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $0
Amount paid for insurance broker fees	118
Additional information about fees paid to insurance broker	BROKER BONUS
Insurance broker organization code?	3

JEFFERSON PILOT FINANCIAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70254 )

Policy contract number

40000200001257

Policy instance

Insurance contract or identification number	40000200001257
Number of Individuals Covered	77
Insurance policy start date	2006-01-01
Insurance policy end date	2006-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $337
Temporary Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $14,421
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $0
Amount paid for insurance broker fees	337
Additional information about fees paid to insurance broker	BROKER BONUS
Insurance broker organization code?	3

JEFFERSON PILOT FINANCIAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70254 )

Policy contract number

400003002012349

Policy instance

Insurance contract or identification number	400003002012349
Number of Individuals Covered	61
Insurance policy start date	2006-01-01
Insurance policy end date	2006-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $613
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $24,594
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $0
Amount paid for insurance broker fees	613
Additional information about fees paid to insurance broker	BROKER BONUS
Insurance broker organization code?	3

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Company Name:	GSSC, INC.
Employer identification number (EIN):	362650388
NAIC Classification:	333900