401k Plan data: CNI-UTI 401(K) PLAN & TRUST plan

CNI-UTI 401(K) PLAN & TRUST 401k Plan overview

Plan Name	CNI-UTI 401(K) PLAN & TRUST
Plan identification number	001

CNI-UTI 401(K) PLAN & TRUST 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.
Partial participant-directed account plan - Participants have the opportunity to direct the investment of a portion of 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.
Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

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

Company Name: CNI ENTERPRISES, INC.

Employer identification number (EIN): 382555708

NAIC Classification: 316110
NAIC Description: Leather and Hide Tanning and Finishing

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CNI-UTI 401(K) PLAN & TRUST

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2017-01-01 CHRISTINE PATTEN 2020-03-24
001 2016-01-01
001 2015-01-01 STEVEN DEYOUB 2016-10-03
001 2014-01-01 WILLIAM K. PETERSON 2015-07-29 WILLIAM K. PETERSON 2015-07-29
001 2013-01-01 WILLIAM K. PETERSON 2014-07-29 WILLIAM K. PETERSON 2014-07-29
001 2012-01-01 WILLIAM K. PETERSON
001 2011-01-01 WILLIAM K. PETERSON
001 2009-01-01 WILLIAM PETERSON
001 2009-01-01 WILLIAM K. PETERSON

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2017-01-01	CHRISTINE PATTEN	2020-03-24
001	2016-01-01
001	2015-01-01	STEVEN DEYOUB	2016-10-03
001	2014-01-01	WILLIAM K. PETERSON	2015-07-29	WILLIAM K. PETERSON	2015-07-29
001	2013-01-01	WILLIAM K. PETERSON	2014-07-29	WILLIAM K. PETERSON	2014-07-29
001	2012-01-01	WILLIAM K. PETERSON
001	2011-01-01	WILLIAM K. PETERSON
001	2009-01-01	WILLIAM PETERSON
001	2009-01-01	WILLIAM K. PETERSON

Plan Statistics for CNI-UTI 401(K) PLAN & TRUST

401k plan membership statisitcs for CNI-UTI 401(K) PLAN & TRUST

Measure Date Value
2012: CNI-UTI 401(K) PLAN & TRUST 2012 401k membership
Total participants, beginning-of-year 2012-01-01 171
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 69
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 26
Total of all active and inactive participants 2012-01-01 95
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 95
Number of participants with account balances 2012-01-01 60
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: CNI-UTI 401(K) PLAN & TRUST 2011 401k membership
Total participants, beginning-of-year 2011-01-01 162
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 94
Number of retired or separated participants receiving benefits 2011-01-01 1
Number of other retired or separated participants entitled to future benefits 2011-01-01 29
Total of all active and inactive participants 2011-01-01 124
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 124
Number of participants with account balances 2011-01-01 64
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2009: CNI-UTI 401(K) PLAN & TRUST 2009 401k membership
Total participants, beginning-of-year 2009-01-01 231
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 188
Number of retired or separated participants receiving benefits 2009-01-01 5
Number of other retired or separated participants entitled to future benefits 2009-01-01 51
Total of all active and inactive participants 2009-01-01 244
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 244
Number of participants with account balances 2009-01-01 112
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 0

Measure	Date	Value
2012: CNI-UTI 401(K) PLAN & TRUST 2012 401k membership
Total participants, beginning-of-year	2012-01-01	171
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	69
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	26
Total of all active and inactive participants	2012-01-01	95
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	95
Number of participants with account balances	2012-01-01	60
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: CNI-UTI 401(K) PLAN & TRUST 2011 401k membership
Total participants, beginning-of-year	2011-01-01	162
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	94
Number of retired or separated participants receiving benefits	2011-01-01	1
Number of other retired or separated participants entitled to future benefits	2011-01-01	29
Total of all active and inactive participants	2011-01-01	124
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	124
Number of participants with account balances	2011-01-01	64
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2009: CNI-UTI 401(K) PLAN & TRUST 2009 401k membership
Total participants, beginning-of-year	2009-01-01	231
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	188
Number of retired or separated participants receiving benefits	2009-01-01	5
Number of other retired or separated participants entitled to future benefits	2009-01-01	51
Total of all active and inactive participants	2009-01-01	244
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	244
Number of participants with account balances	2009-01-01	112
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	0

Financial Data on CNI-UTI 401(K) PLAN & TRUST

Measure	Date	Value
2012 : CNI-UTI 401(K) PLAN & TRUST 2012 401k financial data
Total unrealized appreciation/depreciation of assets	2012-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$0
Total income from all sources (including contributions)	2012-12-31	$487,287
Total loss/gain on sale of assets	2012-12-31	$0
Total of all expenses incurred	2012-12-31	$70,162
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$44,969
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$264,302
Value of total assets at end of year	2012-12-31	$1,835,608
Value of total assets at beginning of year	2012-12-31	$1,418,483
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$25,193
Total interest from all sources	2012-12-31	$2,022
Total dividends received (eg from common stock, registered investment company shares)	2012-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-12-31	No
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$250,000
If this is an individual account plan, was there a blackout period	2012-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2012-12-31	No
Contributions received from participants	2012-12-31	$153,823
Participant contributions at end of year	2012-12-31	$48,608
Participant contributions at beginning of year	2012-12-31	$67,500
Participant contributions at end of year	2012-12-31	$5,238
Income. Received or receivable in cash from other sources (including rollovers)	2012-12-31	$110,479
Other income not declared elsewhere	2012-12-31	$-487
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Value of net income/loss	2012-12-31	$417,125
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$1,835,608
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$1,418,483
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-12-31	No
Were any leases to which the plan was party in default or uncollectible	2012-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2012-12-31	$1,704,990
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-12-31	$1,285,855
Interest on participant loans	2012-12-31	$2,022
Value of interest in common/collective trusts at end of year	2012-12-31	$62,125
Value of interest in common/collective trusts at beginning of year	2012-12-31	$48,385
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2012-12-31	$6,499
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2012-12-31	$8,108
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2012-12-31	$8,108
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-12-31	$8,148
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-12-31	$8,635
Expenses. Payments to insurance carriers foe the provision of benefits	2012-12-31	$192
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2012-12-31	$220,467
Net investment gain or loss from common/collective trusts	2012-12-31	$983
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-12-31	No
Was there a failure to transmit to the plan any participant contributions	2012-12-31	No
Has the plan failed to provide any benefit when due under the plan	2012-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$44,777
Contract administrator fees	2012-12-31	$25,193
Did the plan have assets held for investment	2012-12-31	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	2012-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-12-31	No
Opinion of an independent qualified public accountant for this plan	2012-12-31	Unqualified
Accountancy firm name	2012-12-31	DOEREN MAYHEW
Accountancy firm EIN	2012-12-31	382492570
2011 : CNI-UTI 401(K) PLAN & TRUST 2011 401k financial data
Total unrealized appreciation/depreciation of assets	2011-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$0
Total income from all sources (including contributions)	2011-12-31	$88,555
Total loss/gain on sale of assets	2011-12-31	$0
Total of all expenses incurred	2011-12-31	$152,046
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$128,736
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$106,665
Value of total assets at end of year	2011-12-31	$1,418,483
Value of total assets at beginning of year	2011-12-31	$1,481,974
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$23,310
Total interest from all sources	2011-12-31	$2,256
Total dividends received (eg from common stock, registered investment company shares)	2011-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-12-31	No
Was this plan covered by a fidelity bond	2011-12-31	Yes
Value of fidelity bond cover	2011-12-31	$250,000
If this is an individual account plan, was there a blackout period	2011-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2011-12-31	No
Contributions received from participants	2011-12-31	$106,665
Participant contributions at end of year	2011-12-31	$67,500
Participant contributions at beginning of year	2011-12-31	$64,842
Participant contributions at beginning of year	2011-12-31	$3,722
Other income not declared elsewhere	2011-12-31	$-218
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Value of net income/loss	2011-12-31	$-63,491
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$1,418,483
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$1,481,974
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2011-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2011-12-31	No
Were any leases to which the plan was party in default or uncollectible	2011-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2011-12-31	$1,285,855
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-12-31	$1,332,388
Interest on participant loans	2011-12-31	$2,256
Value of interest in common/collective trusts at end of year	2011-12-31	$48,385
Value of interest in common/collective trusts at beginning of year	2011-12-31	$65,323
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2011-12-31	$8,108
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2011-12-31	$6,846
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2011-12-31	$6,846
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-12-31	$8,635
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-12-31	$8,853
Expenses. Payments to insurance carriers foe the provision of benefits	2011-12-31	$192
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2011-12-31	$-20,903
Net investment gain or loss from common/collective trusts	2011-12-31	$755
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-12-31	No
Was there a failure to transmit to the plan any participant contributions	2011-12-31	No
Has the plan failed to provide any benefit when due under the plan	2011-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$128,544
Contract administrator fees	2011-12-31	$23,310
Did the plan have assets held for investment	2011-12-31	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	2011-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2011-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-12-31	No
Opinion of an independent qualified public accountant for this plan	2011-12-31	Unqualified
Accountancy firm name	2011-12-31	DOEREN MAYHEW
Accountancy firm EIN	2011-12-31	382492570
2010 : CNI-UTI 401(K) PLAN & TRUST 2010 401k financial data
Total unrealized appreciation/depreciation of assets	2010-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$0
Total income from all sources (including contributions)	2010-12-31	$291,976
Total loss/gain on sale of assets	2010-12-31	$0
Total of all expenses incurred	2010-12-31	$322,422
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$296,416
Expenses. Certain deemed distributions of participant loans	2010-12-31	$1,426
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$99,852
Value of total assets at end of year	2010-12-31	$1,481,974
Value of total assets at beginning of year	2010-12-31	$1,512,420
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$24,580
Total interest from all sources	2010-12-31	$1,502
Total dividends received (eg from common stock, registered investment company shares)	2010-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2010-12-31	No
Was this plan covered by a fidelity bond	2010-12-31	Yes
Value of fidelity bond cover	2010-12-31	$250,000
If this is an individual account plan, was there a blackout period	2010-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2010-12-31	No
Contributions received from participants	2010-12-31	$99,852
Participant contributions at end of year	2010-12-31	$64,842
Participant contributions at beginning of year	2010-12-31	$51,586
Participant contributions at end of year	2010-12-31	$3,722
Participant contributions at beginning of year	2010-12-31	$4,068
Other income not declared elsewhere	2010-12-31	$-1,045
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Value of net income/loss	2010-12-31	$-30,446
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$1,481,974
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$1,512,420
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2010-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2010-12-31	No
Were any leases to which the plan was party in default or uncollectible	2010-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2010-12-31	$1,332,388
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2010-12-31	$1,388,151
Interest on participant loans	2010-12-31	$1,502
Value of interest in common/collective trusts at end of year	2010-12-31	$65,323
Value of interest in common/collective trusts at beginning of year	2010-12-31	$54,097
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2010-12-31	$6,846
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2010-12-31	$4,620
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2010-12-31	$4,620
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2010-12-31	$8,853
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2010-12-31	$9,898
Expenses. Payments to insurance carriers foe the provision of benefits	2010-12-31	$192
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2010-12-31	$190,620
Net investment gain or loss from common/collective trusts	2010-12-31	$1,047
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2010-12-31	No
Was there a failure to transmit to the plan any participant contributions	2010-12-31	No
Has the plan failed to provide any benefit when due under the plan	2010-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$296,224
Contract administrator fees	2010-12-31	$24,580
Did the plan have assets held for investment	2010-12-31	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	2010-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2010-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2010-12-31	No
Opinion of an independent qualified public accountant for this plan	2010-12-31	Unqualified
Accountancy firm name	2010-12-31	DOEREN MAYHEW
Accountancy firm EIN	2010-12-31	382492570
2009 : CNI-UTI 401(K) PLAN & TRUST 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2009-12-31	$0

Form 5500 Responses for CNI-UTI 401(K) PLAN & TRUST

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

Insurance Providers Used on plan

ALLIANZ LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 90611 )

Policy contract number

97400024

Policy instance

Insurance contract or identification number	97400024
Number of Individuals Covered	5
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
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

ALLIANZ LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 90611 )

Policy contract number

97400024

Policy instance

Insurance contract or identification number	97400024
Number of Individuals Covered	5
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
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:	CNI ENTERPRISES, INC.
Employer identification number (EIN):	382555708
NAIC Classification:	316110
NAIC Description:	Leather and Hide Tanning and Finishing