401k Plan data: HARTSVILLE IGA 401(K) PROFIT-SHARING PLAN plan

HARTSVILLE IGA 401(K) PROFIT-SHARING PLAN 401k Plan overview

Plan Name	HARTSVILLE IGA 401(K) PROFIT-SHARING PLAN
Plan identification number	333

HARTSVILLE IGA 401(K) PROFIT-SHARING 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.
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

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

Company Name: JONES FOODS, INC.

Employer identification number (EIN): 570740870

NAIC Classification: 445110
NAIC Description: Supermarkets and Other Grocery (except Convenience) Stores

Form 5500 Filing Information

Submission information for form 5500 for 401k plan HARTSVILLE IGA 401(K) PROFIT-SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
333 2012-01-01 BILL GARNER
333 2011-01-01 BILL GARNER BILL GARNER 2012-07-26
333 2009-01-01 BILL GARNER BILL GARNER 2010-08-10

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
333	2012-01-01	BILL GARNER
333	2011-01-01	BILL GARNER	BILL GARNER	2012-07-26
333	2009-01-01	BILL GARNER	BILL GARNER	2010-08-10

Plan Statistics for HARTSVILLE IGA 401(K) PROFIT-SHARING PLAN

401k plan membership statisitcs for HARTSVILLE IGA 401(K) PROFIT-SHARING PLAN

Measure Date Value
2012: HARTSVILLE IGA 401(K) PROFIT-SHARING PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 245
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 228
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 8
Total of all active and inactive participants 2012-01-01 236
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 236
Number of participants with account balances 2012-01-01 103
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 7
2011: HARTSVILLE IGA 401(K) PROFIT-SHARING PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 223
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 211
Number of retired or separated participants receiving benefits 2011-01-01 0
Number of other retired or separated participants entitled to future benefits 2011-01-01 11
Total of all active and inactive participants 2011-01-01 222
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 222
Number of participants with account balances 2011-01-01 98
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 11
2009: HARTSVILLE IGA 401(K) PROFIT-SHARING PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 142
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 147
Number of retired or separated participants receiving benefits 2009-01-01 0
Number of other retired or separated participants entitled to future benefits 2009-01-01 2
Total of all active and inactive participants 2009-01-01 149
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 149
Number of participants with account balances 2009-01-01 75
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 3

Measure	Date	Value
2012: HARTSVILLE IGA 401(K) PROFIT-SHARING PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	245
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	228
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	8
Total of all active and inactive participants	2012-01-01	236
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	236
Number of participants with account balances	2012-01-01	103
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	7
2011: HARTSVILLE IGA 401(K) PROFIT-SHARING PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	223
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	211
Number of retired or separated participants receiving benefits	2011-01-01	0
Number of other retired or separated participants entitled to future benefits	2011-01-01	11
Total of all active and inactive participants	2011-01-01	222
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	222
Number of participants with account balances	2011-01-01	98
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	11
2009: HARTSVILLE IGA 401(K) PROFIT-SHARING PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	142
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	147
Number of retired or separated participants receiving benefits	2009-01-01	0
Number of other retired or separated participants entitled to future benefits	2009-01-01	2
Total of all active and inactive participants	2009-01-01	149
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	149
Number of participants with account balances	2009-01-01	75
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	3

Financial Data on HARTSVILLE IGA 401(K) PROFIT-SHARING PLAN

Measure	Date	Value
2012 : HARTSVILLE IGA 401(K) PROFIT-SHARING PLAN 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	$264,248
Total loss/gain on sale of assets	2012-12-31	$0
Total of all expenses incurred	2012-12-31	$278,177
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$275,758
Value of total corrective distributions	2012-12-31	$1,654
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$149,214
Value of total assets at end of year	2012-12-31	$982,684
Value of total assets at beginning of year	2012-12-31	$996,613
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$765
Total interest from all sources	2012-12-31	$176
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	$500,000
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	$110,313
Participant contributions at end of year	2012-12-31	$2,086
Participant contributions at beginning of year	2012-12-31	$1,925
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	$-13,929
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$982,684
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$996,613
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 pooled separate accounts at end of year	2012-12-31	$775,696
Value of interest in pooled separate accounts at beginning of year	2012-12-31	$772,795
Interest earned on other investments	2012-12-31	$176
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-12-31	$204,206
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-12-31	$221,174
Net investment gain/loss from pooled separate accounts	2012-12-31	$114,858
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
Contributions received in cash from employer	2012-12-31	$38,901
Employer contributions (assets) at end of year	2012-12-31	$696
Employer contributions (assets) at beginning of year	2012-12-31	$719
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$275,758
Contract administrator fees	2012-12-31	$765
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	Yes
Opinion of an independent qualified public accountant for this plan	2012-12-31	Disclaimer
Accountancy firm name	2012-12-31	ABERNETHY & CO PC
Accountancy firm EIN	2012-12-31	570674209
2011 : HARTSVILLE IGA 401(K) PROFIT-SHARING PLAN 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	$116,722
Total loss/gain on sale of assets	2011-12-31	$0
Total of all expenses incurred	2011-12-31	$110,441
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$109,726
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$142,064
Value of total assets at end of year	2011-12-31	$996,613
Value of total assets at beginning of year	2011-12-31	$990,332
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$715
Total interest from all sources	2011-12-31	$1,276
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	$500,000
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	$107,222
Participant contributions at end of year	2011-12-31	$1,925
Participant contributions at beginning of year	2011-12-31	$1,930
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	$6,281
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$996,613
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$990,332
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 pooled separate accounts at end of year	2011-12-31	$772,795
Value of interest in pooled separate accounts at beginning of year	2011-12-31	$818,216
Interest earned on other investments	2011-12-31	$1,276
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-12-31	$221,174
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-12-31	$169,510
Net investment gain/loss from pooled separate accounts	2011-12-31	$-26,618
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
Contributions received in cash from employer	2011-12-31	$34,842
Employer contributions (assets) at end of year	2011-12-31	$719
Employer contributions (assets) at beginning of year	2011-12-31	$676
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$109,726
Contract administrator fees	2011-12-31	$715
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	Yes
Opinion of an independent qualified public accountant for this plan	2011-12-31	Disclaimer
Accountancy firm name	2011-12-31	ABERNETHY & CO PC
Accountancy firm EIN	2011-12-31	570674209
2010 : HARTSVILLE IGA 401(K) PROFIT-SHARING PLAN 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	$343,629
Total loss/gain on sale of assets	2010-12-31	$0
Total of all expenses incurred	2010-12-31	$67,465
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$67,265
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$243,566
Value of total assets at end of year	2010-12-31	$990,332
Value of total assets at beginning of year	2010-12-31	$714,168
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$200
Total interest from all sources	2010-12-31	$1,932
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
Administrative expenses professional fees incurred	2010-12-31	$200
Was this plan covered by a fidelity bond	2010-12-31	Yes
Value of fidelity bond cover	2010-12-31	$1,000,000
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	$111,287
Participant contributions at end of year	2010-12-31	$1,930
Participant contributions at beginning of year	2010-12-31	$3,225
Income. Received or receivable in cash from other sources (including rollovers)	2010-12-31	$94,882
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	$276,164
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$990,332
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$714,168
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 pooled separate accounts at end of year	2010-12-31	$818,216
Value of interest in pooled separate accounts at beginning of year	2010-12-31	$576,526
Interest earned on other investments	2010-12-31	$1,932
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2010-12-31	$169,510
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2010-12-31	$133,380
Net investment gain/loss from pooled separate accounts	2010-12-31	$98,131
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
Contributions received in cash from employer	2010-12-31	$37,397
Employer contributions (assets) at end of year	2010-12-31	$676
Employer contributions (assets) at beginning of year	2010-12-31	$1,037
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$67,265
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	Yes
Opinion of an independent qualified public accountant for this plan	2010-12-31	Disclaimer
Accountancy firm name	2010-12-31	ABERNETHY & CO PC
Accountancy firm EIN	2010-12-31	570674209
2009 : HARTSVILLE IGA 401(K) PROFIT-SHARING PLAN 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 HARTSVILLE IGA 401(K) PROFIT-SHARING PLAN

2012: HARTSVILLE IGA 401(K) PROFIT-SHARING PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Mulitple 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 benefit arrangement – Insurance	Yes
2011: HARTSVILLE IGA 401(K) PROFIT-SHARING PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Mulitple 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 benefit arrangement – Insurance	Yes
2009: HARTSVILLE IGA 401(K) PROFIT-SHARING PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Mulitple 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 benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )

Policy contract number

GAP-41-K644

Policy instance

Insurance contract or identification number	GAP-41-K644
Number of Individuals Covered	236
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $304
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
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?	Yes
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
Commission paid to Insurance Broker	USD $304
Insurance broker organization code?	3
Insurance broker name	MILESTONE INVESTMENTS, INC.

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )

Policy contract number

GAP-44-K645

Policy instance

Insurance contract or identification number	GAP-44-K645
Number of Individuals Covered	236
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $1,372
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
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
Commission paid to Insurance Broker	USD $1,372
Insurance broker organization code?	3
Insurance broker name	MILESTONE INVESTMENTS, INC.

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )

Policy contract number

GAP-41-K644

Policy instance

Insurance contract or identification number	GAP-41-K644
Number of Individuals Covered	222
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $434
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
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?	Yes
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 INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )

Policy contract number

GAP-44-K645

Policy instance

Insurance contract or identification number	GAP-44-K645
Number of Individuals Covered	222
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $1,298
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
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 INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )

Policy contract number

GAP-41-K644

Policy instance

Insurance contract or identification number	GAP-41-K644
Number of Individuals Covered	213
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $414
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
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?	Yes
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
Commission paid to Insurance Broker	USD $414
Insurance broker organization code?	3
Insurance broker name	MILESTONE INVESTMENTS, INC.

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )

Policy contract number

GAP-44-K645

Policy instance

Insurance contract or identification number	GAP-44-K645
Number of Individuals Covered	213
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $1,084
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
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
Commission paid to Insurance Broker	USD $1,084
Insurance broker organization code?	3
Insurance broker name	MILESTONE INVESTMENTS, INC.

Potentially related plans

HARTSVILLE IGA 401(K) PROFIT-SHARING PLAN [EIN = 571021729]

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Company Name:	JONES FOODS, INC.
Employer identification number (EIN):	570740870
NAIC Classification:	445110
NAIC Description:	Supermarkets and Other Grocery (except Convenience) Stores