401k Plan data: PE FACILITY SOLUTIONS, LLC 401(K) PLAN plan

PE FACILITY SOLUTIONS, LLC 401(K) PLAN 401k Plan overview

Plan Name	PE FACILITY SOLUTIONS, LLC 401(K) PLAN
Plan identification number	001

PE FACILITY SOLUTIONS, LLC 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.
Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

PE FACILITY SOLUTIONS, LLC has sponsored the creation of one or more 401k plans.

Company Name: PE FACILITY SOLUTIONS, LLC

Employer identification number (EIN): 815241663

NAIC Classification: 561720
NAIC Description: Janitorial Services

Additional information about PE FACILITY SOLUTIONS, LLC

Jurisdiction of Incorporation: Texas Secretary of State

Incorporation Date: 2017-02-23

Company Identification Number: 0802657645

Legal Registered Office Address: 19680 MARINO LAKES CIRCLE #2403

MIROMAR
United States of America (USA)
33931

More information about PE FACILITY SOLUTIONS, LLC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PE FACILITY SOLUTIONS, LLC 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2019-01-01
001 2019-01-01
001 2018-01-01 MICHAEL FERGUS O CONNELL
001 2017-01-01 MICHAEL FERGUS O CONNELL

Plan Statistics for PE FACILITY SOLUTIONS, LLC 401(K) PLAN

401k plan membership statisitcs for PE FACILITY SOLUTIONS, LLC 401(K) PLAN

Measure Date Value
2019: PE FACILITY SOLUTIONS, LLC 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 878
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 0
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 0
Total of all active and inactive participants 2019-01-01 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 0
Number of participants with account balances 2019-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 0
2018: PE FACILITY SOLUTIONS, LLC 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 867
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 864
Number of retired or separated participants receiving benefits 2018-01-01 5
Number of other retired or separated participants entitled to future benefits 2018-01-01 9
Total of all active and inactive participants 2018-01-01 878
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 878
Number of participants with account balances 2018-01-01 69
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 0
2017: PE FACILITY SOLUTIONS, LLC 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 1,081
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 962
Number of retired or separated participants receiving benefits 2017-01-01 6
Number of other retired or separated participants entitled to future benefits 2017-01-01 10
Total of all active and inactive participants 2017-01-01 978
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 978
Number of participants with account balances 2017-01-01 51
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 1

Measure	Date	Value
2019: PE FACILITY SOLUTIONS, LLC 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	878
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	0
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	0
Total of all active and inactive participants	2019-01-01	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	0
Number of participants with account balances	2019-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	0
2018: PE FACILITY SOLUTIONS, LLC 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	867
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	864
Number of retired or separated participants receiving benefits	2018-01-01	5
Number of other retired or separated participants entitled to future benefits	2018-01-01	9
Total of all active and inactive participants	2018-01-01	878
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	878
Number of participants with account balances	2018-01-01	69
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	0
2017: PE FACILITY SOLUTIONS, LLC 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	1,081
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	962
Number of retired or separated participants receiving benefits	2017-01-01	6
Number of other retired or separated participants entitled to future benefits	2017-01-01	10
Total of all active and inactive participants	2017-01-01	978
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	978
Number of participants with account balances	2017-01-01	51
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	1

Financial Data on PE FACILITY SOLUTIONS, LLC 401(K) PLAN

Measure	Date	Value
2019 : PE FACILITY SOLUTIONS, LLC 401(K) PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets	2019-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total income from all sources (including contributions)	2019-12-31	$543,416
Total loss/gain on sale of assets	2019-12-31	$0
Total of all expenses incurred	2019-12-31	$1,629,476
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$1,620,785
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$349,038
Value of total assets at end of year	2019-12-31	$0
Value of total assets at beginning of year	2019-12-31	$1,086,060
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$8,691
Total interest from all sources	2019-12-31	$514
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2019-12-31	$0
Was this plan covered by a fidelity bond	2019-12-31	Yes
Value of fidelity bond cover	2019-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2019-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2019-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Contributions received from participants	2019-12-31	$217,690
Participant contributions at end of year	2019-12-31	$0
Participant contributions at beginning of year	2019-12-31	$10,056
Administrative expenses (other) incurred	2019-12-31	$3,585
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Value of net income/loss	2019-12-31	$-1,086,060
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$0
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$1,086,060
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-12-31	No
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Value of interest in pooled separate accounts at end of year	2019-12-31	$0
Value of interest in pooled separate accounts at beginning of year	2019-12-31	$1,064,100
Interest on participant loans	2019-12-31	$516
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2019-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2019-12-31	$1,344
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2019-12-31	$1,344
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2019-12-31	$-2
Net investment gain/loss from pooled separate accounts	2019-12-31	$193,864
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-12-31	No
Was there a failure to transmit to the plan any participant contributions	2019-12-31	No
Has the plan failed to provide any benefit when due under the plan	2019-12-31	No
Contributions received in cash from employer	2019-12-31	$131,348
Employer contributions (assets) at end of year	2019-12-31	$0
Employer contributions (assets) at beginning of year	2019-12-31	$10,560
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$1,620,785
Contract administrator fees	2019-12-31	$5,106
Did the plan have assets held for investment	2019-12-31	No
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	2019-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-12-31	Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2019-12-31	Disclaimer
Accountancy firm name	2019-12-31	ALRICH CPAS AND ADVISORS LLP
Accountancy firm EIN	2019-12-31	930623286
2018 : PE FACILITY SOLUTIONS, LLC 401(K) PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets	2018-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$0
Total income from all sources (including contributions)	2018-12-31	$353,101
Total loss/gain on sale of assets	2018-12-31	$0
Total of all expenses incurred	2018-12-31	$766,467
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$761,553
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$407,408
Value of total assets at end of year	2018-12-31	$1,086,060
Value of total assets at beginning of year	2018-12-31	$1,499,426
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$4,914
Total interest from all sources	2018-12-31	$1,553
Total dividends received (eg from common stock, registered investment company shares)	2018-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-12-31	No
Was this plan covered by a fidelity bond	2018-12-31	Yes
Value of fidelity bond cover	2018-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2018-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2018-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2018-12-31	No
Contributions received from participants	2018-12-31	$231,239
Participant contributions at end of year	2018-12-31	$10,056
Participant contributions at beginning of year	2018-12-31	$40,894
Income. Received or receivable in cash from other sources (including rollovers)	2018-12-31	$33,281
Administrative expenses (other) incurred	2018-12-31	$4,914
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Value of net income/loss	2018-12-31	$-413,366
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$1,086,060
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$1,499,426
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2018-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2018-12-31	No
Were any leases to which the plan was party in default or uncollectible	2018-12-31	No
Value of interest in pooled separate accounts at end of year	2018-12-31	$1,064,100
Value of interest in pooled separate accounts at beginning of year	2018-12-31	$1,452,191
Interest on participant loans	2018-12-31	$1,539
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2018-12-31	$1,344
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2018-12-31	$1,349
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2018-12-31	$1,349
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2018-12-31	$14
Net investment gain/loss from pooled separate accounts	2018-12-31	$-55,860
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2018-12-31	No
Was there a failure to transmit to the plan any participant contributions	2018-12-31	No
Has the plan failed to provide any benefit when due under the plan	2018-12-31	No
Contributions received in cash from employer	2018-12-31	$142,888
Employer contributions (assets) at end of year	2018-12-31	$10,560
Employer contributions (assets) at beginning of year	2018-12-31	$4,992
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$761,553
Did the plan have assets held for investment	2018-12-31	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	2018-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2018-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2018-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2018-12-31	Disclaimer
Accountancy firm name	2018-12-31	ALRICH CPAS AND ADVISORS LLP
Accountancy firm EIN	2018-12-31	930623286
2017 : PE FACILITY SOLUTIONS, LLC 401(K) PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets	2017-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$0
Total income from all sources (including contributions)	2017-12-31	$538,981
Total loss/gain on sale of assets	2017-12-31	$0
Total of all expenses incurred	2017-12-31	$609,060
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$602,973
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$274,421
Value of total assets at end of year	2017-12-31	$1,499,426
Value of total assets at beginning of year	2017-12-31	$1,569,505
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$6,087
Total interest from all sources	2017-12-31	$940
Total dividends received (eg from common stock, registered investment company shares)	2017-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-12-31	No
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2017-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2017-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2017-12-31	No
Contributions received from participants	2017-12-31	$176,485
Participant contributions at end of year	2017-12-31	$40,894
Participant contributions at beginning of year	2017-12-31	$19,933
Participant contributions at end of year	2017-12-31	$0
Participant contributions at beginning of year	2017-12-31	$3,409
Income. Received or receivable in cash from other sources (including rollovers)	2017-12-31	$346
Administrative expenses (other) incurred	2017-12-31	$985
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Value of net income/loss	2017-12-31	$-70,079
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$1,499,426
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$1,569,505
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2017-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2017-12-31	No
Were any leases to which the plan was party in default or uncollectible	2017-12-31	No
Value of interest in pooled separate accounts at end of year	2017-12-31	$1,452,191
Value of interest in pooled separate accounts at beginning of year	2017-12-31	$1,521,544
Interest on participant loans	2017-12-31	$938
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2017-12-31	$1,349
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2017-12-31	$1,351
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2017-12-31	$1,351
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2017-12-31	$2
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2017-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-12-31	$7,746
Net investment gain/loss from pooled separate accounts	2017-12-31	$263,620
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2017-12-31	No
Was there a failure to transmit to the plan any participant contributions	2017-12-31	No
Has the plan failed to provide any benefit when due under the plan	2017-12-31	No
Contributions received in cash from employer	2017-12-31	$97,590
Employer contributions (assets) at end of year	2017-12-31	$4,992
Employer contributions (assets) at beginning of year	2017-12-31	$15,522
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$602,973
Contract administrator fees	2017-12-31	$5,102
Did the plan have assets held for investment	2017-12-31	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	2017-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2017-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2017-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2017-12-31	Disclaimer
Accountancy firm name	2017-12-31	ALRICH CPAS AND ADVISORS LLP
Accountancy firm EIN	2017-12-31	930623286

Form 5500 Responses for PE FACILITY SOLUTIONS, LLC 401(K) PLAN

2019: PE FACILITY SOLUTIONS, LLC 401(K) 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	Yes
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 – Insurance	Yes
2019-01-01	Plan funding arrangement – Trust	Yes
2019-01-01	Plan benefit arrangement - Trust	Yes
2018: PE FACILITY SOLUTIONS, LLC 401(K) 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 – Insurance	Yes
2018-01-01	Plan funding arrangement – Trust	Yes
2018-01-01	Plan benefit arrangement - Trust	Yes
2017: PE FACILITY SOLUTIONS, LLC 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	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 – Insurance	Yes
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

91033

Policy instance

Insurance contract or identification number	91033
Number of Individuals Covered	0
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $3,534
Total amount of fees paid to insurance company	USD $4,175
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?	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 $0
Amount paid for insurance broker fees	4175
Additional information about fees paid to insurance broker	TPA FEES
Insurance broker organization code?	5

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

91033

Policy instance

Insurance contract or identification number	91033
Number of Individuals Covered	70
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $3,739
Total amount of fees paid to insurance company	USD $924
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?	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 $3,739
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	COMMISSION
Insurance broker organization code?	4

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

91033

Policy instance

Insurance contract or identification number	91033
Number of Individuals Covered	53
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $4,713
Total amount of fees paid to insurance company	USD $1,770
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?	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 $4,713
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	COMMISSION
Insurance broker organization code?	4
Insurance broker name	SAN DIEGO PENSION CONSULTANTS

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Company Name:	PE FACILITY SOLUTIONS, LLC
Employer identification number (EIN):	815241663
NAIC Classification:	561720
NAIC Description:	Janitorial Services

Jurisdiction of Incorporation:	Texas Secretary of State
Incorporation Date:	2017-02-23
Company Identification Number:	0802657645
Legal Registered Office Address:	19680 MARINO LAKES CIRCLE #2403 MIROMAR United States of America (USA) 33931