401k Plan data: LA MESA VETERINARY ASSOCIATES DEFINED BENEFIT PLAN plan

LA MESA VETERINARY ASSOCIATES DEFINED BENEFIT PLAN 401k Plan overview

Plan Name	LA MESA VETERINARY ASSOCIATES DEFINED BENEFIT PLAN
Plan identification number	001

LA MESA VETERINARY ASSOCIATES DEFINED BENEFIT PLAN Benefits

401k Plan Type	Defined Benefit Pension
Plan Features/Benefits	Benefits are primarily pay related 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

MENDOTA EQUINE SPORTS MEDICINE has sponsored the creation of one or more 401k plans.

Company Name: MENDOTA EQUINE SPORTS MEDICINE

Employer identification number (EIN): 752577951

NAIC Classification: 541940
NAIC Description: Veterinary Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan LA MESA VETERINARY ASSOCIATES DEFINED BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2020-01-01 ALAN DONNELL 2021-07-29 ALAN DONNELL 2021-07-29
001 2019-01-01 ALAN DONNELL 2020-07-10 ALAN DONNELL 2020-07-10
001 2018-01-01 ALAN DONNELL 2019-09-11 ALAN DONNELL 2019-09-11
001 2017-01-01
001 2016-01-01
001 2015-01-01
001 2014-01-01
001 2013-01-01
001 2012-01-01 ALAN D. DONNELL, DVM ALAN D. DONNELL, DVM 2013-09-17
001 2011-01-01 ALAN D. DONNELL, DVM ALAN D. DONNELL, DVM 2012-10-05
001 2009-01-01 ALAN D. DONNELL ALAN D. DONNELL 2010-07-28

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2020-01-01	ALAN DONNELL	2021-07-29	ALAN DONNELL	2021-07-29
001	2019-01-01	ALAN DONNELL	2020-07-10	ALAN DONNELL	2020-07-10
001	2018-01-01	ALAN DONNELL	2019-09-11	ALAN DONNELL	2019-09-11
001	2017-01-01
001	2016-01-01
001	2015-01-01
001	2014-01-01
001	2013-01-01
001	2012-01-01	ALAN D. DONNELL, DVM		ALAN D. DONNELL, DVM	2013-09-17
001	2011-01-01	ALAN D. DONNELL, DVM		ALAN D. DONNELL, DVM	2012-10-05
001	2009-01-01	ALAN D. DONNELL		ALAN D. DONNELL	2010-07-28

Plan Statistics for LA MESA VETERINARY ASSOCIATES DEFINED BENEFIT PLAN

401k plan membership statisitcs for LA MESA VETERINARY ASSOCIATES DEFINED BENEFIT PLAN

Measure Date Value
2020: LA MESA VETERINARY ASSOCIATES DEFINED BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 7
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 0
Number of retired or separated participants receiving benefits 2020-01-01 0
Number of other retired or separated participants entitled to future benefits 2020-01-01 0
Total of all active and inactive participants 2020-01-01 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 0
2019: LA MESA VETERINARY ASSOCIATES DEFINED BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 7
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 6
Number of retired or separated participants receiving benefits 2019-01-01 0
Number of other retired or separated participants entitled to future benefits 2019-01-01 1
Total of all active and inactive participants 2019-01-01 7
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 7
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 0
2018: LA MESA VETERINARY ASSOCIATES DEFINED BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 7
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 6
Number of retired or separated participants receiving benefits 2018-01-01 0
Number of other retired or separated participants entitled to future benefits 2018-01-01 1
Total of all active and inactive participants 2018-01-01 7
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 7
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 0
2017: LA MESA VETERINARY ASSOCIATES DEFINED BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 6
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 6
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 1
Total of all active and inactive participants 2017-01-01 7
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 7
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 0
2016: LA MESA VETERINARY ASSOCIATES DEFINED BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 7
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 6
Number of retired or separated participants receiving benefits 2016-01-01 0
Number of other retired or separated participants entitled to future benefits 2016-01-01 1
Total of all active and inactive participants 2016-01-01 7
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 7
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 0
2015: LA MESA VETERINARY ASSOCIATES DEFINED BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 8
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 6
Number of retired or separated participants receiving benefits 2015-01-01 0
Number of other retired or separated participants entitled to future benefits 2015-01-01 2
Total of all active and inactive participants 2015-01-01 8
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 8
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0
2014: LA MESA VETERINARY ASSOCIATES DEFINED BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 8
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 6
Number of retired or separated participants receiving benefits 2014-01-01 0
Number of other retired or separated participants entitled to future benefits 2014-01-01 2
Total of all active and inactive participants 2014-01-01 8
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 8
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0
2013: LA MESA VETERINARY ASSOCIATES DEFINED BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 9
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 7
Number of retired or separated participants receiving benefits 2013-01-01 0
Number of other retired or separated participants entitled to future benefits 2013-01-01 2
Total of all active and inactive participants 2013-01-01 9
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 9
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0
2012: LA MESA VETERINARY ASSOCIATES DEFINED BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 8
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 7
Number of other retired or separated participants entitled to future benefits 2012-01-01 2
Total of all active and inactive participants 2012-01-01 9
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 9
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: LA MESA VETERINARY ASSOCIATES DEFINED BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 8
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 8
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 0
Total of all active and inactive participants 2011-01-01 8
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 8
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2009: LA MESA VETERINARY ASSOCIATES DEFINED BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 8
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 8
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 0
Total of all active and inactive participants 2009-01-01 8
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 8
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 0

Measure	Date	Value
2020: LA MESA VETERINARY ASSOCIATES DEFINED BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	7
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	0
Number of retired or separated participants receiving benefits	2020-01-01	0
Number of other retired or separated participants entitled to future benefits	2020-01-01	0
Total of all active and inactive participants	2020-01-01	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	0
2019: LA MESA VETERINARY ASSOCIATES DEFINED BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	7
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	6
Number of retired or separated participants receiving benefits	2019-01-01	0
Number of other retired or separated participants entitled to future benefits	2019-01-01	1
Total of all active and inactive participants	2019-01-01	7
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	7
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	0
2018: LA MESA VETERINARY ASSOCIATES DEFINED BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	7
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	6
Number of retired or separated participants receiving benefits	2018-01-01	0
Number of other retired or separated participants entitled to future benefits	2018-01-01	1
Total of all active and inactive participants	2018-01-01	7
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	7
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	0
2017: LA MESA VETERINARY ASSOCIATES DEFINED BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	6
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	6
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	1
Total of all active and inactive participants	2017-01-01	7
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	7
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	0
2016: LA MESA VETERINARY ASSOCIATES DEFINED BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	7
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	6
Number of retired or separated participants receiving benefits	2016-01-01	0
Number of other retired or separated participants entitled to future benefits	2016-01-01	1
Total of all active and inactive participants	2016-01-01	7
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	7
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	0
2015: LA MESA VETERINARY ASSOCIATES DEFINED BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	8
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	6
Number of retired or separated participants receiving benefits	2015-01-01	0
Number of other retired or separated participants entitled to future benefits	2015-01-01	2
Total of all active and inactive participants	2015-01-01	8
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	8
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0
2014: LA MESA VETERINARY ASSOCIATES DEFINED BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	8
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	6
Number of retired or separated participants receiving benefits	2014-01-01	0
Number of other retired or separated participants entitled to future benefits	2014-01-01	2
Total of all active and inactive participants	2014-01-01	8
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	8
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2013: LA MESA VETERINARY ASSOCIATES DEFINED BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	9
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	7
Number of retired or separated participants receiving benefits	2013-01-01	0
Number of other retired or separated participants entitled to future benefits	2013-01-01	2
Total of all active and inactive participants	2013-01-01	9
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	9
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0
2012: LA MESA VETERINARY ASSOCIATES DEFINED BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	8
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	7
Number of other retired or separated participants entitled to future benefits	2012-01-01	2
Total of all active and inactive participants	2012-01-01	9
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	9
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: LA MESA VETERINARY ASSOCIATES DEFINED BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	8
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	8
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	0
Total of all active and inactive participants	2011-01-01	8
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	8
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2009: LA MESA VETERINARY ASSOCIATES DEFINED BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	8
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	8
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	0
Total of all active and inactive participants	2009-01-01	8
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	8
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	0

Financial Data on LA MESA VETERINARY ASSOCIATES DEFINED BENEFIT PLAN

Measure	Date	Value
2010 : LA MESA VETERINARY ASSOCIATES DEFINED BENEFIT PLAN 2010 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-12-31	$0

Form 5500 Responses for LA MESA VETERINARY ASSOCIATES DEFINED BENEFIT PLAN

2020: LA MESA VETERINARY ASSOCIATES DEFINED BENEFIT PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Submission has been amended	No
2020-01-01	This submission is the final filing	Yes
2020-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-01-01	Plan is a collectively bargained plan	No
2020-01-01	Plan funding arrangement – Section 412(e)(3) insurance Contracts	Yes
2020-01-01	Plan benefit arrangement – Section 412(e)(3) insurance Contracts	Yes
2019: LA MESA VETERINARY ASSOCIATES DEFINED BENEFIT PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Submission has been amended	No
2019-01-01	This submission is the final filing	No
2019-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-01-01	Plan is a collectively bargained plan	No
2019-01-01	Plan funding arrangement – Section 412(e)(3) insurance Contracts	Yes
2019-01-01	Plan benefit arrangement – Section 412(e)(3) insurance Contracts	Yes
2018: LA MESA VETERINARY ASSOCIATES DEFINED BENEFIT PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Submission has been amended	No
2018-01-01	This submission is the final filing	No
2018-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-01-01	Plan is a collectively bargained plan	No
2018-01-01	Plan funding arrangement – Section 412(e)(3) insurance Contracts	Yes
2018-01-01	Plan benefit arrangement – Section 412(e)(3) insurance Contracts	Yes
2017: LA MESA VETERINARY ASSOCIATES DEFINED BENEFIT 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	No
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – Section 412(e)(3) insurance Contracts	Yes
2017-01-01	Plan benefit arrangement – Section 412(e)(3) insurance Contracts	Yes
2016: LA MESA VETERINARY ASSOCIATES DEFINED BENEFIT 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 – Section 412(e)(3) insurance Contracts	Yes
2016-01-01	Plan benefit arrangement – Section 412(e)(3) insurance Contracts	Yes
2015: LA MESA VETERINARY ASSOCIATES DEFINED BENEFIT 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 – Section 412(e)(3) insurance Contracts	Yes
2015-01-01	Plan benefit arrangement – Section 412(e)(3) insurance Contracts	Yes
2014: LA MESA VETERINARY ASSOCIATES DEFINED BENEFIT PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – Section 412(e)(3) insurance Contracts	Yes
2014-01-01	Plan benefit arrangement – Section 412(e)(3) insurance Contracts	Yes
2013: LA MESA VETERINARY ASSOCIATES DEFINED BENEFIT PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Section 412(e)(3) insurance Contracts	Yes
2013-01-01	Plan benefit arrangement – Section 412(e)(3) insurance Contracts	Yes
2012: LA MESA VETERINARY ASSOCIATES DEFINED BENEFIT PLAN 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 – Section 412(e)(3) insurance Contracts	Yes
2012-01-01	Plan benefit arrangement – Section 412(e)(3) insurance Contracts	Yes
2011: LA MESA VETERINARY ASSOCIATES DEFINED BENEFIT PLAN 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 – Section 412(e)(3) insurance Contracts	Yes
2011-01-01	Plan benefit arrangement – Section 412(e)(3) insurance Contracts	Yes
2009: LA MESA VETERINARY ASSOCIATES DEFINED BENEFIT PLAN 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 – Section 412(e)(3) insurance Contracts	Yes
2009-01-01	Plan benefit arrangement – Section 412(e)(3) insurance Contracts	Yes

Insurance Providers Used on plan

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

Policy contract number

Policy instance

Number of Individuals Covered	0
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0

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

Policy contract number

Policy instance

Number of Individuals Covered	7
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0

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

Policy contract number

Policy instance

Number of Individuals Covered	7
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0

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

Policy contract number

Policy instance

Number of Individuals Covered	7
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0

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

Policy contract number

Policy instance

Number of Individuals Covered	8
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0

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

Policy contract number

Policy instance

Number of Individuals Covered	8
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0

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

Policy contract number

Policy instance

Number of Individuals Covered	9
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0

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

Policy contract number

Policy instance

Number of Individuals Covered	9
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0

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

Policy contract number

Policy instance

Number of Individuals Covered	8
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

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

Policy contract number

Policy instance

Number of Individuals Covered	9
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

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Company Name:	MENDOTA EQUINE SPORTS MEDICINE
Employer identification number (EIN):	752577951
NAIC Classification:	541940
NAIC Description:	Veterinary Services