401k Plan data: VANTAGE HOSPITALITY GROUP, INC. 401(K) PLAN plan

VANTAGE HOSPITALITY GROUP, INC. 401(K) PLAN 401k Plan overview

Plan Name	VANTAGE HOSPITALITY GROUP, INC. 401(K) PLAN
Plan identification number	001

VANTAGE HOSPITALITY GROUP, 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.
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

VANTAGE HOSPITALITY GROUP, INC. has sponsored the creation of one or more 401k plans.

Company Name: VANTAGE HOSPITALITY GROUP, INC.

Employer identification number (EIN): 650930583

NAIC Classification: 721110
NAIC Description: Hotels (except Casino Hotels) and Motels

Form 5500 Filing Information

Submission information for form 5500 for 401k plan VANTAGE HOSPITALITY GROUP, INC. 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2017-01-01 TIM LISTON
001 2016-01-01 TIM LISTON
001 2016-01-01 TIM LISTON
001 2015-01-01 TIM LISTON
001 2015-01-01 TIM LISTON
001 2014-01-01 TIM LISTON 2015-07-13 TIM LISTON 2015-07-13
001 2013-01-01 TIM LISTON 2014-07-10 TIM LISTON 2014-07-10
001 2012-01-01 TIM LISTON 2013-07-23 TIM LISTON 2013-07-23
001 2011-01-01 TIM LISTON 2012-06-21 TIM LISTON 2012-06-21
001 2010-01-01 TIM LISTON 2011-07-22 TIM LISTON 2011-07-22

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2017-01-01	TIM LISTON
001	2016-01-01	TIM LISTON
001	2016-01-01	TIM LISTON
001	2015-01-01	TIM LISTON
001	2015-01-01	TIM LISTON
001	2014-01-01	TIM LISTON	2015-07-13	TIM LISTON	2015-07-13
001	2013-01-01	TIM LISTON	2014-07-10	TIM LISTON	2014-07-10
001	2012-01-01	TIM LISTON	2013-07-23	TIM LISTON	2013-07-23
001	2011-01-01	TIM LISTON	2012-06-21	TIM LISTON	2012-06-21
001	2010-01-01	TIM LISTON	2011-07-22	TIM LISTON	2011-07-22

Plan Statistics for VANTAGE HOSPITALITY GROUP, INC. 401(K) PLAN

401k plan membership statisitcs for VANTAGE HOSPITALITY GROUP, INC. 401(K) PLAN

Measure Date Value
2017: VANTAGE HOSPITALITY GROUP, INC. 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 108
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 0
Number of retired or separated participants receiving benefits 2017-01-01 0
Number of other retired or separated participants entitled to future benefits 2017-01-01 0
Total of all active and inactive participants 2017-01-01 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 0
Number of participants with account balances 2017-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 0
2016: VANTAGE HOSPITALITY GROUP, INC. 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 145
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 3
Number of retired or separated participants receiving benefits 2016-01-01 13
Number of other retired or separated participants entitled to future benefits 2016-01-01 92
Total of all active and inactive participants 2016-01-01 108
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 108
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 0
Number of participants with account balances 2016-01-01 0
2015: VANTAGE HOSPITALITY GROUP, INC. 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 131
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 126
Number of retired or separated participants receiving benefits 2015-01-01 4
Number of other retired or separated participants entitled to future benefits 2015-01-01 18
Total of all active and inactive participants 2015-01-01 148
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 148
Number of participants with account balances 2015-01-01 108
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 1

Measure	Date	Value
2017: VANTAGE HOSPITALITY GROUP, INC. 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	108
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	0
Number of retired or separated participants receiving benefits	2017-01-01	0
Number of other retired or separated participants entitled to future benefits	2017-01-01	0
Total of all active and inactive participants	2017-01-01	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	0
Number of participants with account balances	2017-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	0
2016: VANTAGE HOSPITALITY GROUP, INC. 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	145
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	3
Number of retired or separated participants receiving benefits	2016-01-01	13
Number of other retired or separated participants entitled to future benefits	2016-01-01	92
Total of all active and inactive participants	2016-01-01	108
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	108
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	0
Number of participants with account balances	2016-01-01	0
2015: VANTAGE HOSPITALITY GROUP, INC. 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	131
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	126
Number of retired or separated participants receiving benefits	2015-01-01	4
Number of other retired or separated participants entitled to future benefits	2015-01-01	18
Total of all active and inactive participants	2015-01-01	148
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	148
Number of participants with account balances	2015-01-01	108
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	1

Financial Data on VANTAGE HOSPITALITY GROUP, INC. 401(K) PLAN

Measure	Date	Value
2017 : VANTAGE HOSPITALITY GROUP, INC. 401(K) PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets	2017-09-06	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-09-06	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-09-06	$0
Total income from all sources (including contributions)	2017-09-06	$354,595
Total loss/gain on sale of assets	2017-09-06	$0
Total of all expenses incurred	2017-09-06	$4,157,759
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-09-06	$4,091,854
Expenses. Certain deemed distributions of participant loans	2017-09-06	$51,416
Value of total corrective distributions	2017-09-06	$1,968
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-09-06	$17,331
Value of total assets at end of year	2017-09-06	$0
Value of total assets at beginning of year	2017-09-06	$3,803,164
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-09-06	$12,521
Total interest from all sources	2017-09-06	$1,737
Total dividends received (eg from common stock, registered investment company shares)	2017-09-06	$0
Administrative expenses professional fees incurred	2017-09-06	$3,602
Was this plan covered by a fidelity bond	2017-09-06	Yes
Value of fidelity bond cover	2017-09-06	$500,000
If this is an individual account plan, was there a blackout period	2017-09-06	No
Were there any nonexempt tranactions with any party-in-interest	2017-09-06	No
Contributions received from participants	2017-09-06	$1,742
Participant contributions at end of year	2017-09-06	$0
Participant contributions at beginning of year	2017-09-06	$73,126
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-09-06	No
Value of net income/loss	2017-09-06	$-3,803,164
Value of net assets at end of year (total assets less liabilities)	2017-09-06	$0
Value of net assets at beginning of year (total assets less liabilities)	2017-09-06	$3,803,164
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2017-09-06	No
Were any loans by the plan or fixed income obligations due to the plan in default	2017-09-06	No
Were any leases to which the plan was party in default or uncollectible	2017-09-06	No
Investment advisory and management fees	2017-09-06	$4,364
Value of interest in registered invesment companies (eg mutual funds) at end of year	2017-09-06	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-09-06	$3,671,653
Interest on participant loans	2017-09-06	$1,518
Interest earned on other investments	2017-09-06	$219
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2017-09-06	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-09-06	$58,385
Net investment gain/loss from pooled separate accounts	2017-09-06	$335,527
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2017-09-06	No
Was there a failure to transmit to the plan any participant contributions	2017-09-06	No
Has the plan failed to provide any benefit when due under the plan	2017-09-06	No
Contributions received in cash from employer	2017-09-06	$15,589
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-09-06	$4,091,854
Contract administrator fees	2017-09-06	$4,555
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2017-09-06	No
Did the plan have assets held for investment	2017-09-06	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	2017-09-06	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2017-09-06	Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2017-09-06	Yes
Opinion of an independent qualified public accountant for this plan	2017-09-06	Disclaimer
Accountancy firm name	2017-09-06	BDO USA, LLP
Accountancy firm EIN	2017-09-06	135381590
2016 : VANTAGE HOSPITALITY GROUP, INC. 401(K) PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets	2016-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total income from all sources (including contributions)	2016-12-31	$808,717
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$140,487
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$128,426
Value of total corrective distributions	2016-12-31	$1,944
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$571,872
Value of total assets at end of year	2016-12-31	$3,803,164
Value of total assets at beginning of year	2016-12-31	$3,134,934
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$10,117
Total interest from all sources	2016-12-31	$3,041
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$0
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$500,000
If this is an individual account plan, was there a blackout period	2016-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Contributions received from participants	2016-12-31	$365,104
Participant contributions at end of year	2016-12-31	$73,126
Participant contributions at beginning of year	2016-12-31	$78,467
Income. Received or receivable in cash from other sources (including rollovers)	2016-12-31	$50,541
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Value of net income/loss	2016-12-31	$668,230
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$3,803,164
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$3,134,934
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2016-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2016-12-31	No
Were any leases to which the plan was party in default or uncollectible	2016-12-31	No
Investment advisory and management fees	2016-12-31	$9,317
Value of interest in registered invesment companies (eg mutual funds) at end of year	2016-12-31	$3,671,653
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-12-31	$3,010,820
Interest on participant loans	2016-12-31	$3,032
Interest earned on other investments	2016-12-31	$9
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-12-31	$58,385
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-12-31	$45,647
Net investment gain/loss from pooled separate accounts	2016-12-31	$233,804
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2016-12-31	No
Was there a failure to transmit to the plan any participant contributions	2016-12-31	No
Has the plan failed to provide any benefit when due under the plan	2016-12-31	No
Contributions received in cash from employer	2016-12-31	$156,227
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$128,426
Contract administrator fees	2016-12-31	$800
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2016-12-31	No
Did the plan have assets held for investment	2016-12-31	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	2016-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2016-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2016-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2016-12-31	Disclaimer
Accountancy firm name	2016-12-31	BDO USA, LLP
Accountancy firm EIN	2016-12-31	135381590
2015 : VANTAGE HOSPITALITY GROUP, INC. 401(K) PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets	2015-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Total income from all sources (including contributions)	2015-12-31	$657,781
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$235,800
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$217,981
Expenses. Certain deemed distributions of participant loans	2015-12-31	$7,884
Value of total corrective distributions	2015-12-31	$104
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$670,849
Value of total assets at end of year	2015-12-31	$3,134,934
Value of total assets at beginning of year	2015-12-31	$2,712,953
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$9,831
Total interest from all sources	2015-12-31	$4,096
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$0
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$500,000
If this is an individual account plan, was there a blackout period	2015-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2015-12-31	No
Contributions received from participants	2015-12-31	$400,806
Participant contributions at end of year	2015-12-31	$78,467
Participant contributions at beginning of year	2015-12-31	$93,693
Income. Received or receivable in cash from other sources (including rollovers)	2015-12-31	$100,324
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Value of net income/loss	2015-12-31	$421,981
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$3,134,934
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$2,712,953
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2015-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2015-12-31	No
Were any leases to which the plan was party in default or uncollectible	2015-12-31	No
Investment advisory and management fees	2015-12-31	$8,776
Value of interest in registered invesment companies (eg mutual funds) at end of year	2015-12-31	$3,010,820
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-12-31	$0
Value of interest in pooled separate accounts at end of year	2015-12-31	$0
Value of interest in pooled separate accounts at beginning of year	2015-12-31	$2,583,095
Interest on participant loans	2015-12-31	$3,446
Interest earned on other investments	2015-12-31	$650
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-12-31	$45,647
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-12-31	$36,165
Net investment gain/loss from pooled separate accounts	2015-12-31	$-17,164
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2015-12-31	No
Was there a failure to transmit to the plan any participant contributions	2015-12-31	No
Has the plan failed to provide any benefit when due under the plan	2015-12-31	No
Contributions received in cash from employer	2015-12-31	$169,719
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$217,981
Contract administrator fees	2015-12-31	$1,055
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2015-12-31	No
Did the plan have assets held for investment	2015-12-31	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	2015-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2015-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2015-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2015-12-31	Disclaimer
Accountancy firm name	2015-12-31	BDO USA, LLP
Accountancy firm EIN	2015-12-31	135381590

Form 5500 Responses for VANTAGE HOSPITALITY GROUP, INC. 401(K) PLAN

2017: VANTAGE HOSPITALITY GROUP, INC. 401(K) PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	No
2017-01-01	This submission is the final filing	Yes
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2017-01-01	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes
2016: VANTAGE HOSPITALITY GROUP, INC. 401(K) PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: VANTAGE HOSPITALITY GROUP, INC. 401(K) PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )

Policy contract number

RM 86182-1

Policy instance

Insurance contract or identification number	RM 86182-1
Number of Individuals Covered	0
Insurance policy start date	2017-01-01
Insurance policy end date	2017-09-06
Total amount of commissions paid to insurance broker	USD $2,280
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	Yes
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?	Yes
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 $2,280
Insurance broker organization code?	3
Insurance broker name	KEITH A DERAS

MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )

Policy contract number

RM 86182-1

Policy instance

Insurance contract or identification number	RM 86182-1
Number of Individuals Covered	108
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $6,178
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?	Yes
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 $6,070
Insurance broker organization code?	3
Insurance broker name	CORBIN LAMBERT

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Company Name:	VANTAGE HOSPITALITY GROUP, INC.
Employer identification number (EIN):	650930583
NAIC Classification:	721110
NAIC Description:	Hotels (except Casino Hotels) and Motels