401k Plan data: FOWLER ELEVATOR, INC. 401(K) PLAN plan

FOWLER ELEVATOR, INC. 401(K) PLAN 401k Plan overview

Plan Name	FOWLER ELEVATOR, INC. 401(K) PLAN
Plan identification number	001

FOWLER ELEVATOR, INC. 401(K) 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.
Participant-directed brokerage accounts provided as an investment option under the plan.
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

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

Company Name: FOWLER ELEVATOR, INC.

Employer identification number (EIN): 431034317

NAIC Classification: 115110

Form 5500 Filing Information

Submission information for form 5500 for 401k plan FOWLER ELEVATOR, INC. 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2019-10-01 AMANDA GUTHRIE 2021-04-09
001 2018-10-01 AMANDA GUTHRIE 2020-04-23
001 2017-10-01 AMANDA GUTHRIE 2019-04-16
001 2016-10-01 AMANDA GUTHRIE 2018-05-10
001 2015-10-01 AMANDA GUTHRIE 2017-04-20
001 2014-10-01 AMANDA GUTHRIE
001 2013-10-01 AMANDA GUTHRIE
001 2012-10-01 AMANDA GUTHRIE
001 2011-10-01 AMANDA GUTHRIE
001 2009-10-01 AMANDA GUTHRIE
001 2008-10-01 AMANDA GUTHRIE

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
001	2019-10-01	AMANDA GUTHRIE	2021-04-09
001	2018-10-01	AMANDA GUTHRIE	2020-04-23
001	2017-10-01	AMANDA GUTHRIE	2019-04-16
001	2016-10-01	AMANDA GUTHRIE	2018-05-10
001	2015-10-01	AMANDA GUTHRIE	2017-04-20
001	2014-10-01	AMANDA GUTHRIE
001	2013-10-01	AMANDA GUTHRIE
001	2012-10-01	AMANDA GUTHRIE
001	2011-10-01	AMANDA GUTHRIE
001	2009-10-01	AMANDA GUTHRIE
001	2008-10-01	AMANDA GUTHRIE

Plan Statistics for FOWLER ELEVATOR, INC. 401(K) PLAN

401k plan membership statisitcs for FOWLER ELEVATOR, INC. 401(K) PLAN

Measure Date Value
2014: FOWLER ELEVATOR, INC. 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year 2014-10-01 20
Total number of active participants reported on line 7a of the Form 5500 2014-10-01 20
Number of retired or separated participants receiving benefits 2014-10-01 0
Number of other retired or separated participants entitled to future benefits 2014-10-01 0
Total of all active and inactive participants 2014-10-01 20
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-10-01 0
Total participants 2014-10-01 20
Number of participants with account balances 2014-10-01 3
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-10-01 0
2013: FOWLER ELEVATOR, INC. 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year 2013-10-01 22
Total number of active participants reported on line 7a of the Form 5500 2013-10-01 20
Number of retired or separated participants receiving benefits 2013-10-01 0
Number of other retired or separated participants entitled to future benefits 2013-10-01 0
Total of all active and inactive participants 2013-10-01 20
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-10-01 0
Total participants 2013-10-01 20
Number of participants with account balances 2013-10-01 4
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-10-01 0
2012: FOWLER ELEVATOR, INC. 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year 2012-10-01 26
Total number of active participants reported on line 7a of the Form 5500 2012-10-01 22
Number of retired or separated participants receiving benefits 2012-10-01 2
Number of other retired or separated participants entitled to future benefits 2012-10-01 0
Total of all active and inactive participants 2012-10-01 24
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-10-01 0
Total participants 2012-10-01 24
Number of participants with account balances 2012-10-01 10
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-10-01 0
2011: FOWLER ELEVATOR, INC. 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year 2011-10-01 28
Total number of active participants reported on line 7a of the Form 5500 2011-10-01 23
Number of retired or separated participants receiving benefits 2011-10-01 2
Number of other retired or separated participants entitled to future benefits 2011-10-01 1
Total of all active and inactive participants 2011-10-01 26
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-10-01 0
Total participants 2011-10-01 26
Number of participants with account balances 2011-10-01 23
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-10-01 0
2009: FOWLER ELEVATOR, INC. 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year 2009-10-01 26
Total number of active participants reported on line 7a of the Form 5500 2009-10-01 25
Number of retired or separated participants receiving benefits 2009-10-01 1
Number of other retired or separated participants entitled to future benefits 2009-10-01 0
Total of all active and inactive participants 2009-10-01 26
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-10-01 0
Total participants 2009-10-01 26
Number of participants with account balances 2009-10-01 23
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-10-01 0
2008: FOWLER ELEVATOR, INC. 401(K) PLAN 2008 401k membership
Total participants, beginning-of-year 2008-10-01 25
Total number of active participants reported on line 7a of the Form 5500 2008-10-01 24
Number of retired or separated participants receiving benefits 2008-10-01 0
Number of other retired or separated participants entitled to future benefits 2008-10-01 0
Total of all active and inactive participants 2008-10-01 24
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2008-10-01 0
Total participants 2008-10-01 24
Number of participants with account balances 2008-10-01 21
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2008-10-01 0

Measure	Date	Value
2014: FOWLER ELEVATOR, INC. 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year	2014-10-01	20
Total number of active participants reported on line 7a of the Form 5500	2014-10-01	20
Number of retired or separated participants receiving benefits	2014-10-01	0
Number of other retired or separated participants entitled to future benefits	2014-10-01	0
Total of all active and inactive participants	2014-10-01	20
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-10-01	0
Total participants	2014-10-01	20
Number of participants with account balances	2014-10-01	3
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-10-01	0
2013: FOWLER ELEVATOR, INC. 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year	2013-10-01	22
Total number of active participants reported on line 7a of the Form 5500	2013-10-01	20
Number of retired or separated participants receiving benefits	2013-10-01	0
Number of other retired or separated participants entitled to future benefits	2013-10-01	0
Total of all active and inactive participants	2013-10-01	20
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-10-01	0
Total participants	2013-10-01	20
Number of participants with account balances	2013-10-01	4
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-10-01	0
2012: FOWLER ELEVATOR, INC. 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year	2012-10-01	26
Total number of active participants reported on line 7a of the Form 5500	2012-10-01	22
Number of retired or separated participants receiving benefits	2012-10-01	2
Number of other retired or separated participants entitled to future benefits	2012-10-01	0
Total of all active and inactive participants	2012-10-01	24
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-10-01	0
Total participants	2012-10-01	24
Number of participants with account balances	2012-10-01	10
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-10-01	0
2011: FOWLER ELEVATOR, INC. 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year	2011-10-01	28
Total number of active participants reported on line 7a of the Form 5500	2011-10-01	23
Number of retired or separated participants receiving benefits	2011-10-01	2
Number of other retired or separated participants entitled to future benefits	2011-10-01	1
Total of all active and inactive participants	2011-10-01	26
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-10-01	0
Total participants	2011-10-01	26
Number of participants with account balances	2011-10-01	23
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-10-01	0
2009: FOWLER ELEVATOR, INC. 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year	2009-10-01	26
Total number of active participants reported on line 7a of the Form 5500	2009-10-01	25
Number of retired or separated participants receiving benefits	2009-10-01	1
Number of other retired or separated participants entitled to future benefits	2009-10-01	0
Total of all active and inactive participants	2009-10-01	26
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-10-01	0
Total participants	2009-10-01	26
Number of participants with account balances	2009-10-01	23
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-10-01	0
2008: FOWLER ELEVATOR, INC. 401(K) PLAN 2008 401k membership
Total participants, beginning-of-year	2008-10-01	25
Total number of active participants reported on line 7a of the Form 5500	2008-10-01	24
Number of retired or separated participants receiving benefits	2008-10-01	0
Number of other retired or separated participants entitled to future benefits	2008-10-01	0
Total of all active and inactive participants	2008-10-01	24
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2008-10-01	0
Total participants	2008-10-01	24
Number of participants with account balances	2008-10-01	21
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2008-10-01	0

Financial Data on FOWLER ELEVATOR, INC. 401(K) PLAN

Measure	Date	Value
2015 : FOWLER ELEVATOR, INC. 401(K) PLAN 2015 401k financial data
Total income from all sources	2015-09-30	$-3,163
Expenses. Total of all expenses incurred	2015-09-30	$47,431
Benefits paid (including direct rollovers)	2015-09-30	$47,381
Total plan assets at end of year	2015-09-30	$59,057
Total plan assets at beginning of year	2015-09-30	$109,651
Value of fidelity bond covering the plan	2015-09-30	$500,000
Other income received	2015-09-30	$-3,163
Net income (gross income less expenses)	2015-09-30	$-50,594
Net plan assets at end of year (total assets less liabilities)	2015-09-30	$59,057
Net plan assets at beginning of year (total assets less liabilities)	2015-09-30	$109,651
Assets. Value of assets in partnership/joint-venture interests	2015-09-30	$2,400
Expenses. Administrative service providers (salaries,fees and commissions)	2015-09-30	$50
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-09-30	$0
2014 : FOWLER ELEVATOR, INC. 401(K) PLAN 2014 401k financial data
Total income from all sources	2014-09-30	$-25,285
Expenses. Total of all expenses incurred	2014-09-30	$50,258
Benefits paid (including direct rollovers)	2014-09-30	$50,153
Total plan assets at end of year	2014-09-30	$109,651
Total plan assets at beginning of year	2014-09-30	$185,194
Value of fidelity bond covering the plan	2014-09-30	$500,000
Total contributions received or receivable from participants	2014-09-30	$0
Other income received	2014-09-30	$-25,285
Net income (gross income less expenses)	2014-09-30	$-75,543
Net plan assets at end of year (total assets less liabilities)	2014-09-30	$109,651
Net plan assets at beginning of year (total assets less liabilities)	2014-09-30	$185,194
Assets. Value of assets in partnership/joint-venture interests	2014-09-30	$28,409
Total contributions received or receivable from employer(s)	2014-09-30	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2014-09-30	$105
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-09-30	$0
2013 : FOWLER ELEVATOR, INC. 401(K) PLAN 2013 401k financial data
Total income from all sources	2013-09-30	$7,875
Expenses. Total of all expenses incurred	2013-09-30	$902,362
Benefits paid (including direct rollovers)	2013-09-30	$901,562
Total plan assets at end of year	2013-09-30	$185,194
Total plan assets at beginning of year	2013-09-30	$1,079,681
Value of fidelity bond covering the plan	2013-09-30	$500,000
Total contributions received or receivable from participants	2013-09-30	$1,106
Other income received	2013-09-30	$6,050
Net income (gross income less expenses)	2013-09-30	$-894,487
Net plan assets at end of year (total assets less liabilities)	2013-09-30	$185,194
Net plan assets at beginning of year (total assets less liabilities)	2013-09-30	$1,079,681
Assets. Value of assets in partnership/joint-venture interests	2013-09-30	$83,378
Total contributions received or receivable from employer(s)	2013-09-30	$719
Expenses. Administrative service providers (salaries,fees and commissions)	2013-09-30	$800
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-09-30	$0
2012 : FOWLER ELEVATOR, INC. 401(K) PLAN 2012 401k financial data
Total income from all sources	2012-09-30	$218,181
Expenses. Total of all expenses incurred	2012-09-30	$119,454
Benefits paid (including direct rollovers)	2012-09-30	$119,304
Total plan assets at end of year	2012-09-30	$1,079,681
Total plan assets at beginning of year	2012-09-30	$980,954
Value of fidelity bond covering the plan	2012-09-30	$500,000
Total contributions received or receivable from participants	2012-09-30	$45,601
Other income received	2012-09-30	$145,328
Net income (gross income less expenses)	2012-09-30	$98,727
Net plan assets at end of year (total assets less liabilities)	2012-09-30	$1,079,681
Net plan assets at beginning of year (total assets less liabilities)	2012-09-30	$980,954
Assets. Value of assets in partnership/joint-venture interests	2012-09-30	$138,914
Total contributions received or receivable from employer(s)	2012-09-30	$27,252
Expenses. Administrative service providers (salaries,fees and commissions)	2012-09-30	$150
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-09-30	$0
2011 : FOWLER ELEVATOR, INC. 401(K) PLAN 2011 401k financial data
Total income from all sources	2011-09-30	$53,089
Expenses. Total of all expenses incurred	2011-09-30	$0
Total plan assets at end of year	2011-09-30	$980,954
Total plan assets at beginning of year	2011-09-30	$927,865
Value of fidelity bond covering the plan	2011-09-30	$84,000
Total contributions received or receivable from participants	2011-09-30	$45,109
Other income received	2011-09-30	$-18,639
Net income (gross income less expenses)	2011-09-30	$53,089
Net plan assets at end of year (total assets less liabilities)	2011-09-30	$980,954
Net plan assets at beginning of year (total assets less liabilities)	2011-09-30	$927,865
Assets. Value of assets in partnership/joint-venture interests	2011-09-30	$158,830
Total contributions received or receivable from employer(s)	2011-09-30	$26,619
2010 : FOWLER ELEVATOR, INC. 401(K) PLAN 2010 401k financial data
Total income from all sources	2010-09-30	$149,217
Expenses. Total of all expenses incurred	2010-09-30	$0
Total plan assets at end of year	2010-09-30	$927,865
Total plan assets at beginning of year	2010-09-30	$778,648
Value of fidelity bond covering the plan	2010-09-30	$84,000
Total contributions received or receivable from participants	2010-09-30	$41,101
Other income received	2010-09-30	$84,308
Net income (gross income less expenses)	2010-09-30	$149,217
Net plan assets at end of year (total assets less liabilities)	2010-09-30	$927,865
Net plan assets at beginning of year (total assets less liabilities)	2010-09-30	$778,648
Assets. Value of assets in partnership/joint-venture interests	2010-09-30	$200,492
Total contributions received or receivable from employer(s)	2010-09-30	$23,808

Form 5500 Responses for FOWLER ELEVATOR, INC. 401(K) PLAN

2014: FOWLER ELEVATOR, INC. 401(K) PLAN 2014 form 5500 responses
2014-10-01	Type of plan entity	Single employer plan
2014-10-01	Submission has been amended	No
2014-10-01	This submission is the final filing	No
2014-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-10-01	Plan is a collectively bargained plan	No
2014-10-01	Plan funding arrangement – Trust	Yes
2014-10-01	Plan benefit arrangement - Trust	Yes
2013: FOWLER ELEVATOR, INC. 401(K) PLAN 2013 form 5500 responses
2013-10-01	Type of plan entity	Single employer plan
2013-10-01	Submission has been amended	No
2013-10-01	This submission is the final filing	No
2013-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-10-01	Plan is a collectively bargained plan	No
2013-10-01	Plan funding arrangement – Trust	Yes
2013-10-01	Plan benefit arrangement - Trust	Yes
2012: FOWLER ELEVATOR, INC. 401(K) 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 – Trust	Yes
2012-10-01	Plan benefit arrangement - Trust	Yes
2011: FOWLER ELEVATOR, INC. 401(K) PLAN 2011 form 5500 responses
2011-10-01	Type of plan entity	Single employer plan
2011-10-01	Submission has been amended	No
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: FOWLER ELEVATOR, INC. 401(K) 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: FOWLER ELEVATOR, INC. 401(K) 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
2008-10-01	Plan funding arrangement – Insurance	Yes
2008-10-01	Plan funding arrangement – Trust	Yes
2008-10-01	Plan benefit arrangement – Insurance	Yes
2008-10-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

AMERICAN GENERAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 63665 )

Policy contract number

17136

Policy instance

Insurance contract or identification number	17136
Number of Individuals Covered	4
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

AMERICAN GENERAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 63665 )

Policy contract number

17136

Policy instance

Insurance contract or identification number	17136
Number of Individuals Covered	4
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

AMERICAN GENERAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 63665 )

Policy contract number

17136

Policy instance

Insurance contract or identification number	17136
Number of Individuals Covered	5
Insurance policy start date	2009-10-01
Insurance policy end date	2010-09-30
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes

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Company Name:	FOWLER ELEVATOR, INC.
Employer identification number (EIN):	431034317
NAIC Classification:	115110