401k Plan data: TABER FOOD SERVICES, INC. SAVINGS INCENTIVE PLAN plan

TABER FOOD SERVICES, INC. SAVINGS INCENTIVE PLAN 401k Plan overview

Plan Name	TABER FOOD SERVICES, INC. SAVINGS INCENTIVE PLAN
Plan identification number	001

TABER FOOD SERVICES, INC. SAVINGS INCENTIVE 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

TABER FOOD SERVICES, INC. has sponsored the creation of one or more 401k plans.

Company Name: TABER FOOD SERVICES, INC.

Employer identification number (EIN): 942373234

NAIC Classification: 722300
NAIC Description: Special Food Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan TABER FOOD SERVICES, INC. SAVINGS INCENTIVE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2018-01-01 EDWARD FIKE 2018-10-19
001 2017-01-01 EDWARD FIKE 2018-08-28
001 2016-01-01 PETER TABER 2017-08-31
001 2015-01-01 EDWARD GERARD FIKE
001 2014-01-01 PETER TABER
001 2013-01-01 EDWARD FIKE
001 2012-01-01 PETER TABER EDWARD FIKE 2013-10-07
001 2011-01-01 PETER TABER EDWARD FIKE 2012-10-10
001 2010-01-01 PETER TABER EDWARD GERARD FIKE 2011-10-14
001 2009-01-01 EDWARD GERARD FIKE

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2018-01-01	EDWARD FIKE	2018-10-19
001	2017-01-01	EDWARD FIKE	2018-08-28
001	2016-01-01	PETER TABER	2017-08-31
001	2015-01-01	EDWARD GERARD FIKE
001	2014-01-01	PETER TABER
001	2013-01-01	EDWARD FIKE
001	2012-01-01	PETER TABER		EDWARD FIKE	2013-10-07
001	2011-01-01	PETER TABER		EDWARD FIKE	2012-10-10
001	2010-01-01	PETER TABER		EDWARD GERARD FIKE	2011-10-14
001	2009-01-01	EDWARD GERARD FIKE

Plan Statistics for TABER FOOD SERVICES, INC. SAVINGS INCENTIVE PLAN

401k plan membership statisitcs for TABER FOOD SERVICES, INC. SAVINGS INCENTIVE PLAN

Measure Date Value
2015: TABER FOOD SERVICES, INC. SAVINGS INCENTIVE PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 117
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 95
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 6
Total of all active and inactive participants 2015-01-01 101
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 101
Number of participants with account balances 2015-01-01 40
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0
2014: TABER FOOD SERVICES, INC. SAVINGS INCENTIVE PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 115
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 104
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 9
Total of all active and inactive participants 2014-01-01 113
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 113
Number of participants with account balances 2014-01-01 51
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0
2013: TABER FOOD SERVICES, INC. SAVINGS INCENTIVE PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 136
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 99
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 15
Total of all active and inactive participants 2013-01-01 114
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 114
Number of participants with account balances 2013-01-01 52
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 1
2012: TABER FOOD SERVICES, INC. SAVINGS INCENTIVE PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 154
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 106
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 14
Total of all active and inactive participants 2012-01-01 120
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 120
Number of participants with account balances 2012-01-01 54
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 1
2011: TABER FOOD SERVICES, INC. SAVINGS INCENTIVE PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 171
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 128
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 14
Total of all active and inactive participants 2011-01-01 142
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 142
Number of participants with account balances 2011-01-01 56
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2010: TABER FOOD SERVICES, INC. SAVINGS INCENTIVE PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 187
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 156
Number of retired or separated participants receiving benefits 2010-01-01 0
Number of other retired or separated participants entitled to future benefits 2010-01-01 8
Total of all active and inactive participants 2010-01-01 164
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 164
Number of participants with account balances 2010-01-01 56
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 0
2009: TABER FOOD SERVICES, INC. SAVINGS INCENTIVE PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 166
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 145
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 10
Total of all active and inactive participants 2009-01-01 155
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 155
Number of participants with account balances 2009-01-01 54
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 0

Measure	Date	Value
2015: TABER FOOD SERVICES, INC. SAVINGS INCENTIVE PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	117
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	95
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	6
Total of all active and inactive participants	2015-01-01	101
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	101
Number of participants with account balances	2015-01-01	40
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0
2014: TABER FOOD SERVICES, INC. SAVINGS INCENTIVE PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	115
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	104
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	9
Total of all active and inactive participants	2014-01-01	113
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	113
Number of participants with account balances	2014-01-01	51
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2013: TABER FOOD SERVICES, INC. SAVINGS INCENTIVE PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	136
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	99
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	15
Total of all active and inactive participants	2013-01-01	114
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	114
Number of participants with account balances	2013-01-01	52
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	1
2012: TABER FOOD SERVICES, INC. SAVINGS INCENTIVE PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	154
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	106
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	14
Total of all active and inactive participants	2012-01-01	120
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	120
Number of participants with account balances	2012-01-01	54
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	1
2011: TABER FOOD SERVICES, INC. SAVINGS INCENTIVE PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	171
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	128
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	14
Total of all active and inactive participants	2011-01-01	142
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	142
Number of participants with account balances	2011-01-01	56
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2010: TABER FOOD SERVICES, INC. SAVINGS INCENTIVE PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	187
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	156
Number of retired or separated participants receiving benefits	2010-01-01	0
Number of other retired or separated participants entitled to future benefits	2010-01-01	8
Total of all active and inactive participants	2010-01-01	164
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	164
Number of participants with account balances	2010-01-01	56
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	0
2009: TABER FOOD SERVICES, INC. SAVINGS INCENTIVE PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	166
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	145
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	10
Total of all active and inactive participants	2009-01-01	155
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	155
Number of participants with account balances	2009-01-01	54
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	0

Financial Data on TABER FOOD SERVICES, INC. SAVINGS INCENTIVE PLAN

Measure	Date	Value
2015 : TABER FOOD SERVICES, INC. SAVINGS INCENTIVE PLAN 2015 401k financial data
Unrealized appreciation/depreciation of real estate assets	2015-12-31	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2015-12-31	$0
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	$1,749
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Expenses. Interest paid	2015-12-31	$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2015-12-31	$0
Total income from all sources (including contributions)	2015-12-31	$62,199
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$47,688
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$32,703
Expenses. Certain deemed distributions of participant loans	2015-12-31	$0
Value of total corrective distributions	2015-12-31	$1,749
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$54,673
Value of total assets at end of year	2015-12-31	$960,468
Value of total assets at beginning of year	2015-12-31	$944,208
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$13,236
Total income from rents	2015-12-31	$0
Total interest from all sources	2015-12-31	$565
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2015-12-31	$0
Assets. Real estate other than employer real property at end of year	2015-12-31	$0
Assets. Real estate other than employer real property at beginning of year	2015-12-31	$0
Administrative expenses professional fees incurred	2015-12-31	$2,000
Assets. Corporate prefeered stocks other than exployer securities at end of year	2015-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year	2015-12-31	$0
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$96,000
If this is an individual account plan, was there a blackout period	2015-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2015-12-31	No
Contributions received from participants	2015-12-31	$52,276
Participant contributions at end of year	2015-12-31	$9,385
Participant contributions at beginning of year	2015-12-31	$17,245
Participant contributions at end of year	2015-12-31	$2,254
Participant contributions at beginning of year	2015-12-31	$2,185
Assets. Other investments not covered elsewhere at end of year	2015-12-31	$0
Assets. Other investments not covered elsewhere at beginning of year	2015-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2015-12-31	$0
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2015-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2015-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2015-12-31	$0
Assets. Loans (other than to participants) at end of year	2015-12-31	$0
Assets. Loans (other than to participants) at beginning of year	2015-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2015-12-31	$1,749
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2015-12-31	$0
Other income not declared elsewhere	2015-12-31	$291
Administrative expenses (other) incurred	2015-12-31	$11,236
Liabilities. Value of operating payables at end of year	2015-12-31	$0
Liabilities. Value of operating payables at beginning of year	2015-12-31	$0
Total non interest bearing cash at end of year	2015-12-31	$0
Total non interest bearing cash at beginning of year	2015-12-31	$0
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	$14,511
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$958,719
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$944,208
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
Assets. partnership/joint venture interests at end of year	2015-12-31	$0
Assets. partnership/joint venture interests at beginning of year	2015-12-31	$0
Investment advisory and management fees	2015-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2015-12-31	$0
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	$948,732
Value of interest in pooled separate accounts at beginning of year	2015-12-31	$924,644
Interest on participant loans	2015-12-31	$565
Income. Interest from loans (other than to participants)	2015-12-31	$0
Interest earned on other investments	2015-12-31	$0
Income. Interest from US Government securities	2015-12-31	$0
Income. Interest from corporate debt instruments	2015-12-31	$0
Value of interest in master investment trust accounts at end of year	2015-12-31	$0
Value of interest in master investment trust accounts at beginning of year	2015-12-31	$0
Value of interest in common/collective trusts at end of year	2015-12-31	$0
Value of interest in common/collective trusts at beginning of year	2015-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2015-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2015-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2015-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2015-12-31	$0
Assets. Value of investments in 103.12 investment entities at end of year	2015-12-31	$0
Assets. Value of investments in 103.12 investment entities at beginning of year	2015-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-12-31	$0
Expenses. Payments to insurance carriers foe the provision of benefits	2015-12-31	$0
Asset value of US Government securities at end of year	2015-12-31	$0
Asset value of US Government securities at beginning of year	2015-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2015-12-31	$0
Net investment gain/loss from pooled separate accounts	2015-12-31	$6,670
Net investment gain or loss from common/collective trusts	2015-12-31	$0
Net gain/loss from 103.12 investment entities	2015-12-31	$0
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
Assets. Invements in employer securities at end of year	2015-12-31	$0
Assets. Invements in employer securities at beginning of year	2015-12-31	$0
Assets. Value of employer real property at end of year	2015-12-31	$0
Assets. Value of employer real property at beginning of year	2015-12-31	$0
Contributions received in cash from employer	2015-12-31	$2,397
Employer contributions (assets) at end of year	2015-12-31	$97
Employer contributions (assets) at beginning of year	2015-12-31	$134
Income. Dividends from preferred stock	2015-12-31	$0
Income. Dividends from common stock	2015-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$32,703
Asset. Corporate debt instrument preferred debt at end of year	2015-12-31	$0
Asset. Corporate debt instrument preferred debt at beginning of year	2015-12-31	$0
Asset. Corporate debt instrument debt (other) at end of year	2015-12-31	$0
Asset. Corporate debt instrument debt (other) at beginning of year	2015-12-31	$0
Assets. Corporate common stocks other than exployer securities at end of year	2015-12-31	$0
Assets. Corporate common stocks other than exployer securities at beginning of year	2015-12-31	$0
Liabilities. Value of benefit claims payable at end of year	2015-12-31	$0
Liabilities. Value of benefit claims payable at beginning of year	2015-12-31	$0
Assets. Value of buildings and other operty used in plan operation at end of year	2015-12-31	$0
Assets. Value of buildings and other operty used in plan operation at beginning of year	2015-12-31	$0
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
Aggregate proceeds on sale of assets	2015-12-31	$0
Aggregate carrying amount (costs) on sale of assets	2015-12-31	$0
Liabilities. Value of acquisition indebtedness at end of year	2015-12-31	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2015-12-31	$0
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	JDGLENN & ASSOCIATES, PC
Accountancy firm EIN	2015-12-31	870628064
2014 : TABER FOOD SERVICES, INC. SAVINGS INCENTIVE PLAN 2014 401k financial data
Total income from all sources (including contributions)	2014-12-31	$116,622
Total of all expenses incurred	2014-12-31	$126,299
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$113,929
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$63,579
Value of total assets at end of year	2014-12-31	$944,208
Value of total assets at beginning of year	2014-12-31	$953,885
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$12,370
Total interest from all sources	2014-12-31	$898
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-12-31	No
Administrative expenses professional fees incurred	2014-12-31	$2,200
Was this plan covered by a fidelity bond	2014-12-31	Yes
Value of fidelity bond cover	2014-12-31	$95,000
If this is an individual account plan, was there a blackout period	2014-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2014-12-31	No
Contributions received from participants	2014-12-31	$61,084
Participant contributions at end of year	2014-12-31	$17,245
Participant contributions at beginning of year	2014-12-31	$24,790
Participant contributions at end of year	2014-12-31	$2,185
Participant contributions at beginning of year	2014-12-31	$3,134
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Value of net income/loss	2014-12-31	$-9,677
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$944,208
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$953,885
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2014-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2014-12-31	No
Were any leases to which the plan was party in default or uncollectible	2014-12-31	No
Value of interest in pooled separate accounts at end of year	2014-12-31	$924,644
Value of interest in pooled separate accounts at beginning of year	2014-12-31	$925,860
Interest on participant loans	2014-12-31	$898
Net investment gain/loss from pooled separate accounts	2014-12-31	$52,145
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2014-12-31	No
Was there a failure to transmit to the plan any participant contributions	2014-12-31	No
Has the plan failed to provide any benefit when due under the plan	2014-12-31	No
Contributions received in cash from employer	2014-12-31	$2,495
Employer contributions (assets) at end of year	2014-12-31	$134
Employer contributions (assets) at beginning of year	2014-12-31	$101
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$113,929
Contract administrator fees	2014-12-31	$10,170
Did the plan have assets held for investment	2014-12-31	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	2014-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2014-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2014-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2014-12-31	Disclaimer
Accountancy firm name	2014-12-31	JDGLENN & ASSOCIATES, PC
Accountancy firm EIN	2014-12-31	870628064
2013 : TABER FOOD SERVICES, INC. SAVINGS INCENTIVE PLAN 2013 401k financial data
Total income from all sources (including contributions)	2013-12-31	$234,907
Total of all expenses incurred	2013-12-31	$50,772
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$37,581
Expenses. Certain deemed distributions of participant loans	2013-12-31	$949
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$67,886
Value of total assets at end of year	2013-12-31	$953,885
Value of total assets at beginning of year	2013-12-31	$769,750
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$12,242
Total interest from all sources	2013-12-31	$1,307
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-12-31	No
Administrative expenses professional fees incurred	2013-12-31	$2,200
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$80,000
If this is an individual account plan, was there a blackout period	2013-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2013-12-31	No
Contributions received from participants	2013-12-31	$65,391
Participant contributions at end of year	2013-12-31	$24,790
Participant contributions at beginning of year	2013-12-31	$44,168
Participant contributions at end of year	2013-12-31	$3,134
Participant contributions at beginning of year	2013-12-31	$2,391
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Value of net income/loss	2013-12-31	$184,135
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$953,885
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$769,750
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2013-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2013-12-31	No
Were any leases to which the plan was party in default or uncollectible	2013-12-31	No
Value of interest in pooled separate accounts at end of year	2013-12-31	$925,860
Value of interest in pooled separate accounts at beginning of year	2013-12-31	$723,067
Interest on participant loans	2013-12-31	$1,307
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-12-31	$0
Net investment gain/loss from pooled separate accounts	2013-12-31	$165,714
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2013-12-31	No
Was there a failure to transmit to the plan any participant contributions	2013-12-31	No
Has the plan failed to provide any benefit when due under the plan	2013-12-31	No
Contributions received in cash from employer	2013-12-31	$2,495
Employer contributions (assets) at end of year	2013-12-31	$101
Employer contributions (assets) at beginning of year	2013-12-31	$124
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$37,581
Contract administrator fees	2013-12-31	$10,042
Did the plan have assets held for investment	2013-12-31	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	2013-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2013-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2013-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2013-12-31	Disclaimer
Accountancy firm name	2013-12-31	JDGLENN & ASSOCIATES, PC
Accountancy firm EIN	2013-12-31	870628064
2012 : TABER FOOD SERVICES, INC. SAVINGS INCENTIVE 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	$139,853
Total loss/gain on sale of assets	2012-12-31	$0
Total of all expenses incurred	2012-12-31	$23,287
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$12,125
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$63,865
Value of total assets at end of year	2012-12-31	$769,750
Value of total assets at beginning of year	2012-12-31	$653,184
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$11,162
Total interest from all sources	2012-12-31	$2,223
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
Administrative expenses professional fees incurred	2012-12-31	$2,200
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$80,000
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	$61,108
Participant contributions at end of year	2012-12-31	$44,168
Participant contributions at beginning of year	2012-12-31	$4,963
Participant contributions at end of year	2012-12-31	$2,391
Participant contributions at beginning of year	2012-12-31	$2,475
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	$116,566
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$769,750
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$653,184
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	$723,067
Value of interest in pooled separate accounts at beginning of year	2012-12-31	$645,621
Interest on participant loans	2012-12-31	$2,223
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-12-31	$15
Net investment gain/loss from pooled separate accounts	2012-12-31	$73,765
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	$2,757
Employer contributions (assets) at end of year	2012-12-31	$124
Employer contributions (assets) at beginning of year	2012-12-31	$110
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$12,125
Contract administrator fees	2012-12-31	$8,962
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	2012-12-31	No
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	JD GLENN & ASSOCIATES, PC
Accountancy firm EIN	2012-12-31	870628064
2011 : TABER FOOD SERVICES, INC. SAVINGS INCENTIVE 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	$47,828
Total loss/gain on sale of assets	2011-12-31	$0
Total of all expenses incurred	2011-12-31	$38,681
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$24,182
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$66,432
Value of total assets at end of year	2011-12-31	$653,184
Value of total assets at beginning of year	2011-12-31	$644,037
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$14,499
Total interest from all sources	2011-12-31	$9
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	$80,000
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	$63,551
Participant contributions at end of year	2011-12-31	$4,963
Participant contributions at end of year	2011-12-31	$2,475
Participant contributions at beginning of year	2011-12-31	$2,481
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	$9,147
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$653,184
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$644,037
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	$645,621
Value of interest in pooled separate accounts at beginning of year	2011-12-31	$641,429
Interest on participant loans	2011-12-31	$9
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-12-31	$15
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-12-31	$15
Net investment gain/loss from pooled separate accounts	2011-12-31	$-18,613
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	$2,881
Employer contributions (assets) at end of year	2011-12-31	$110
Employer contributions (assets) at beginning of year	2011-12-31	$112
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$24,182
Contract administrator fees	2011-12-31	$14,499
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	2011-12-31	No
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	JD GLENN & ASSOCIATES, PC
Accountancy firm EIN	2011-12-31	870628064
2010 : TABER FOOD SERVICES, INC. SAVINGS INCENTIVE 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	$134,949
Total loss/gain on sale of assets	2010-12-31	$0
Total of all expenses incurred	2010-12-31	$44,493
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$32,319
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$64,225
Value of total assets at end of year	2010-12-31	$644,037
Value of total assets at beginning of year	2010-12-31	$553,581
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$12,174
Total interest from all sources	2010-12-31	$0
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
Was this plan covered by a fidelity bond	2010-12-31	Yes
Value of fidelity bond cover	2010-12-31	$80,000
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	$61,431
Participant contributions at end of year	2010-12-31	$2,481
Participant contributions at beginning of year	2010-12-31	$2,443
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	$90,456
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$644,037
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$553,581
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	$641,429
Value of interest in pooled separate accounts at beginning of year	2010-12-31	$551,028
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2010-12-31	$15
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2010-12-31	$0
Net investment gain/loss from pooled separate accounts	2010-12-31	$70,724
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	$2,794
Employer contributions (assets) at end of year	2010-12-31	$112
Employer contributions (assets) at beginning of year	2010-12-31	$110
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$32,319
Contract administrator fees	2010-12-31	$12,174
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	2010-12-31	No
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	JD GLENN & ASSOCIATES, PC
Accountancy firm EIN	2010-12-31	870628064
2009 : TABER FOOD SERVICES, INC. SAVINGS INCENTIVE 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 TABER FOOD SERVICES, INC. SAVINGS INCENTIVE PLAN

2015: TABER FOOD SERVICES, INC. SAVINGS INCENTIVE PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
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
2014: TABER FOOD SERVICES, INC. SAVINGS INCENTIVE PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: TABER FOOD SERVICES, INC. SAVINGS INCENTIVE PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: TABER FOOD SERVICES, INC. SAVINGS INCENTIVE 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 – Insurance	Yes
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: TABER FOOD SERVICES, INC. SAVINGS INCENTIVE 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 – Insurance	Yes
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2010: TABER FOOD SERVICES, INC. SAVINGS INCENTIVE PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Submission has been amended	No
2010-01-01	This submission is the final filing	No
2010-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-01-01	Plan is a collectively bargained plan	No
2010-01-01	Plan funding arrangement – Insurance	Yes
2010-01-01	Plan funding arrangement – Trust	Yes
2010-01-01	Plan benefit arrangement – Insurance	Yes
2010-01-01	Plan benefit arrangement - Trust	Yes
2009: TABER FOOD SERVICES, INC. SAVINGS INCENTIVE 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 – Insurance	Yes
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )

Policy contract number

970419-000

Policy instance

Insurance contract or identification number	970419-000
Number of Individuals Covered	101
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
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes

TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )

Policy contract number

970419-000

Policy instance

Insurance contract or identification number	970419-000
Number of Individuals Covered	51
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )

Policy contract number

970419-000

Policy instance

Insurance contract or identification number	970419-000
Number of Individuals Covered	114
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31

TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )

Policy contract number

970419-000

Policy instance

Insurance contract or identification number	970419-000
Number of Individuals Covered	120
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
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

TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )

Policy contract number

970419-000

Policy instance

Insurance contract or identification number	970419-000
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $1,331
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

TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )

Policy contract number

970419-000

Policy instance

Insurance contract or identification number	970419-000
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $2,019
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

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Company Name:	TABER FOOD SERVICES, INC.
Employer identification number (EIN):	942373234
NAIC Classification:	722300
NAIC Description:	Special Food Services