401k Plan data: VAN DE POL ENTERPRISES, INC. 401(K) PLAN plan

VAN DE POL ENTERPRISES, INC. 401(K) PLAN 401k Plan overview

Plan Name	VAN DE POL ENTERPRISES, INC. 401(K) PLAN
Plan identification number	101

VAN DE POL ENTERPRISES, INC. 401(K) PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Profit-sharing
ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.
Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

VAN DE POL ENTERPRISES has sponsored the creation of one or more 401k plans.

Company Name: VAN DE POL ENTERPRISES

Employer identification number (EIN): 942428381

NAIC Classification: 324110
NAIC Description: Petroleum Refineries

Additional information about VAN DE POL ENTERPRISES

Jurisdiction of Incorporation: California Department of State

Incorporation Date: 1977-07-01

Company Identification Number: C0819422

Legal Registered Office Address: 5602 Pintail Ct

Stockton
United States of America (USA)
95207

More information about VAN DE POL ENTERPRISES

Form 5500 Filing Information

Submission information for form 5500 for 401k plan VAN DE POL ENTERPRISES, INC. 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
101 2022-01-01
101 2021-01-01
101 2020-01-01
101 2019-01-01
101 2019-01-01
101 2018-01-01
101 2017-01-01 PHIL TISUE

Plan Statistics for VAN DE POL ENTERPRISES, INC. 401(K) PLAN

401k plan membership statisitcs for VAN DE POL ENTERPRISES, INC. 401(K) PLAN

Measure Date Value
2022: VAN DE POL ENTERPRISES, INC. 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 429
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 375
Number of retired or separated participants receiving benefits 2022-01-01 2
Number of other retired or separated participants entitled to future benefits 2022-01-01 54
Total of all active and inactive participants 2022-01-01 431
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 0
Total participants 2022-01-01 431
Number of participants with account balances 2022-01-01 288
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 0
2021: VAN DE POL ENTERPRISES, INC. 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 460
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 376
Number of retired or separated participants receiving benefits 2021-01-01 7
Number of other retired or separated participants entitled to future benefits 2021-01-01 43
Total of all active and inactive participants 2021-01-01 426
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 426
Number of participants with account balances 2021-01-01 274
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 0
2020: VAN DE POL ENTERPRISES, INC. 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 387
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 344
Number of retired or separated participants receiving benefits 2020-01-01 1
Number of other retired or separated participants entitled to future benefits 2020-01-01 48
Total of all active and inactive participants 2020-01-01 393
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 393
Number of participants with account balances 2020-01-01 257
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 0
2019: VAN DE POL ENTERPRISES, INC. 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 348
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 310
Number of retired or separated participants receiving benefits 2019-01-01 2
Number of other retired or separated participants entitled to future benefits 2019-01-01 45
Total of all active and inactive participants 2019-01-01 357
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 357
Number of participants with account balances 2019-01-01 245
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 0
2018: VAN DE POL ENTERPRISES, INC. 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 340
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 286
Number of retired or separated participants receiving benefits 2018-01-01 2
Number of other retired or separated participants entitled to future benefits 2018-01-01 33
Total of all active and inactive participants 2018-01-01 321
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 321
Number of participants with account balances 2018-01-01 220
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 0
2017: VAN DE POL ENTERPRISES, INC. 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 279
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 273
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 39
Total of all active and inactive participants 2017-01-01 312
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 312
Number of participants with account balances 2017-01-01 216
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 0

Measure	Date	Value
2022: VAN DE POL ENTERPRISES, INC. 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	429
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	375
Number of retired or separated participants receiving benefits	2022-01-01	2
Number of other retired or separated participants entitled to future benefits	2022-01-01	54
Total of all active and inactive participants	2022-01-01	431
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	0
Total participants	2022-01-01	431
Number of participants with account balances	2022-01-01	288
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	0
2021: VAN DE POL ENTERPRISES, INC. 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	460
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	376
Number of retired or separated participants receiving benefits	2021-01-01	7
Number of other retired or separated participants entitled to future benefits	2021-01-01	43
Total of all active and inactive participants	2021-01-01	426
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	426
Number of participants with account balances	2021-01-01	274
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	0
2020: VAN DE POL ENTERPRISES, INC. 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	387
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	344
Number of retired or separated participants receiving benefits	2020-01-01	1
Number of other retired or separated participants entitled to future benefits	2020-01-01	48
Total of all active and inactive participants	2020-01-01	393
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	393
Number of participants with account balances	2020-01-01	257
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	0
2019: VAN DE POL ENTERPRISES, INC. 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	348
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	310
Number of retired or separated participants receiving benefits	2019-01-01	2
Number of other retired or separated participants entitled to future benefits	2019-01-01	45
Total of all active and inactive participants	2019-01-01	357
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	357
Number of participants with account balances	2019-01-01	245
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	0
2018: VAN DE POL ENTERPRISES, INC. 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	340
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	286
Number of retired or separated participants receiving benefits	2018-01-01	2
Number of other retired or separated participants entitled to future benefits	2018-01-01	33
Total of all active and inactive participants	2018-01-01	321
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	321
Number of participants with account balances	2018-01-01	220
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	0
2017: VAN DE POL ENTERPRISES, INC. 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	279
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	273
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	39
Total of all active and inactive participants	2017-01-01	312
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	312
Number of participants with account balances	2017-01-01	216
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	0

Financial Data on VAN DE POL ENTERPRISES, INC. 401(K) PLAN

Measure	Date	Value
2022 : VAN DE POL ENTERPRISES, INC. 401(K) PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets	2022-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$0
Total income from all sources (including contributions)	2022-12-31	$32,038
Total loss/gain on sale of assets	2022-12-31	$0
Total of all expenses incurred	2022-12-31	$859,033
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-31	$687,586
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-12-31	$2,665,025
Value of total assets at end of year	2022-12-31	$17,003,789
Value of total assets at beginning of year	2022-12-31	$17,830,784
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-12-31	$171,447
Total interest from all sources	2022-12-31	$49,663
Total dividends received (eg from common stock, registered investment company shares)	2022-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2022-12-31	No
Was this plan covered by a fidelity bond	2022-12-31	Yes
Value of fidelity bond cover	2022-12-31	$500,000
If this is an individual account plan, was there a blackout period	2022-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2022-12-31	No
Contributions received from participants	2022-12-31	$1,749,947
Participant contributions at end of year	2022-12-31	$553,433
Participant contributions at beginning of year	2022-12-31	$419,258
Participant contributions at end of year	2022-12-31	$66,040
Participant contributions at beginning of year	2022-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2022-12-31	$41,697
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-12-31	No
Value of net income/loss	2022-12-31	$-826,995
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$17,003,789
Value of net assets at beginning of year (total assets less liabilities)	2022-12-31	$17,830,784
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2022-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2022-12-31	No
Were any leases to which the plan was party in default or uncollectible	2022-12-31	No
Value of interest in pooled separate accounts at end of year	2022-12-31	$14,338,872
Value of interest in pooled separate accounts at beginning of year	2022-12-31	$15,461,029
Interest on participant loans	2022-12-31	$18,993
Interest earned on other investments	2022-12-31	$30,670
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2022-12-31	$2,011,119
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2022-12-31	$1,950,497
Net investment gain/loss from pooled separate accounts	2022-12-31	$-2,682,650
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2022-12-31	No
Was there a failure to transmit to the plan any participant contributions	2022-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2022-12-31	No
Contributions received in cash from employer	2022-12-31	$873,381
Employer contributions (assets) at end of year	2022-12-31	$34,325
Employer contributions (assets) at beginning of year	2022-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-12-31	$687,586
Contract administrator fees	2022-12-31	$171,447
Did the plan have assets held for investment	2022-12-31	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	2022-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2022-12-31	No
Opinion of an independent qualified public accountant for this plan	2022-12-31	Unqualified
Accountancy firm name	2022-12-31	COULTER & JUSTUS
Accountancy firm EIN	2022-12-31	621532536
2021 : VAN DE POL ENTERPRISES, INC. 401(K) PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets	2021-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$0
Total income from all sources (including contributions)	2021-12-31	$4,448,512
Total loss/gain on sale of assets	2021-12-31	$0
Total of all expenses incurred	2021-12-31	$1,964,069
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$1,835,815
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$2,626,539
Value of total assets at end of year	2021-12-31	$17,830,784
Value of total assets at beginning of year	2021-12-31	$15,346,341
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$128,254
Total interest from all sources	2021-12-31	$54,840
Total dividends received (eg from common stock, registered investment company shares)	2021-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2021-12-31	No
Was this plan covered by a fidelity bond	2021-12-31	Yes
Value of fidelity bond cover	2021-12-31	$500,000
If this is an individual account plan, was there a blackout period	2021-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2021-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2021-12-31	No
Contributions received from participants	2021-12-31	$1,504,550
Participant contributions at end of year	2021-12-31	$419,258
Participant contributions at beginning of year	2021-12-31	$518,330
Income. Received or receivable in cash from other sources (including rollovers)	2021-12-31	$344,212
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Value of net income/loss	2021-12-31	$2,484,443
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$17,830,784
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$15,346,341
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2021-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2021-12-31	No
Were any leases to which the plan was party in default or uncollectible	2021-12-31	No
Value of interest in pooled separate accounts at end of year	2021-12-31	$15,461,029
Value of interest in pooled separate accounts at beginning of year	2021-12-31	$13,021,768
Interest on participant loans	2021-12-31	$27,944
Interest earned on other investments	2021-12-31	$26,896
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2021-12-31	$1,950,497
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2021-12-31	$1,806,243
Net investment gain/loss from pooled separate accounts	2021-12-31	$1,767,133
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2021-12-31	No
Was there a failure to transmit to the plan any participant contributions	2021-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2021-12-31	No
Contributions received in cash from employer	2021-12-31	$777,777
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$1,835,815
Contract administrator fees	2021-12-31	$128,254
Did the plan have assets held for investment	2021-12-31	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	2021-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2021-12-31	No
Opinion of an independent qualified public accountant for this plan	2021-12-31	Unqualified
Accountancy firm name	2021-12-31	COULTER & JUSTUS
Accountancy firm EIN	2021-12-31	621532536
2020 : VAN DE POL ENTERPRISES, INC. 401(K) PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets	2020-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total income from all sources (including contributions)	2020-12-31	$3,698,482
Total loss/gain on sale of assets	2020-12-31	$0
Total of all expenses incurred	2020-12-31	$1,160,603
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$1,098,664
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$1,775,245
Value of total assets at end of year	2020-12-31	$15,346,341
Value of total assets at beginning of year	2020-12-31	$12,808,462
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$61,939
Total interest from all sources	2020-12-31	$51,501
Total dividends received (eg from common stock, registered investment company shares)	2020-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2020-12-31	No
Was this plan covered by a fidelity bond	2020-12-31	Yes
Value of fidelity bond cover	2020-12-31	$500,000
If this is an individual account plan, was there a blackout period	2020-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2020-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2020-12-31	No
Contributions received from participants	2020-12-31	$1,128,647
Participant contributions at end of year	2020-12-31	$518,330
Participant contributions at beginning of year	2020-12-31	$463,921
Participant contributions at end of year	2020-12-31	$0
Participant contributions at beginning of year	2020-12-31	$10,910
Income. Received or receivable in cash from other sources (including rollovers)	2020-12-31	$33,820
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Value of net income/loss	2020-12-31	$2,537,879
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$15,346,341
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$12,808,462
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2020-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2020-12-31	No
Were any leases to which the plan was party in default or uncollectible	2020-12-31	No
Value of interest in pooled separate accounts at end of year	2020-12-31	$13,021,768
Value of interest in pooled separate accounts at beginning of year	2020-12-31	$10,730,158
Interest on participant loans	2020-12-31	$25,207
Interest earned on other investments	2020-12-31	$26,294
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2020-12-31	$1,806,243
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2020-12-31	$1,602,187
Net investment gain/loss from pooled separate accounts	2020-12-31	$1,871,736
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2020-12-31	No
Was there a failure to transmit to the plan any participant contributions	2020-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2020-12-31	No
Contributions received in cash from employer	2020-12-31	$612,778
Employer contributions (assets) at end of year	2020-12-31	$0
Employer contributions (assets) at beginning of year	2020-12-31	$1,286
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$1,098,664
Contract administrator fees	2020-12-31	$61,939
Did the plan have assets held for investment	2020-12-31	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	2020-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2020-12-31	No
Opinion of an independent qualified public accountant for this plan	2020-12-31	Unqualified
Accountancy firm name	2020-12-31	COULTER & JUSTUS
Accountancy firm EIN	2020-12-31	621532536
2019 : VAN DE POL ENTERPRISES, INC. 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	$3,800,915
Total loss/gain on sale of assets	2019-12-31	$0
Total of all expenses incurred	2019-12-31	$1,045,747
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$992,156
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$1,927,848
Value of total assets at end of year	2019-12-31	$12,808,462
Value of total assets at beginning of year	2019-12-31	$10,053,294
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$53,591
Total interest from all sources	2019-12-31	$47,721
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	No
Was this plan covered by a fidelity bond	2019-12-31	Yes
Value of fidelity bond cover	2019-12-31	$500,000
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	$1,102,851
Participant contributions at end of year	2019-12-31	$463,921
Participant contributions at beginning of year	2019-12-31	$433,163
Participant contributions at end of year	2019-12-31	$10,910
Participant contributions at beginning of year	2019-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$229,871
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	$2,755,168
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$12,808,462
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$10,053,294
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	$10,730,158
Value of interest in pooled separate accounts at beginning of year	2019-12-31	$8,032,843
Interest on participant loans	2019-12-31	$22,289
Interest earned on other investments	2019-12-31	$25,432
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$1,602,187
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$1,587,288
Net investment gain/loss from pooled separate accounts	2019-12-31	$1,825,346
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	Yes
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	$595,126
Employer contributions (assets) at end of year	2019-12-31	$1,286
Employer contributions (assets) at beginning of year	2019-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$992,156
Contract administrator fees	2019-12-31	$53,591
Did the plan have assets held for investment	2019-12-31	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	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	No
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	COULTER & JUSTUS
Accountancy firm EIN	2019-12-31	621532536
2018 : VAN DE POL ENTERPRISES, INC. 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	$18,550
Total income from all sources (including contributions)	2018-12-31	$963,187
Total loss/gain on sale of assets	2018-12-31	$0
Total of all expenses incurred	2018-12-31	$890,751
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$834,160
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$1,532,581
Value of total assets at end of year	2018-12-31	$10,053,294
Value of total assets at beginning of year	2018-12-31	$9,999,408
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$56,591
Total interest from all sources	2018-12-31	$38,019
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	$500,000
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	$964,773
Participant contributions at end of year	2018-12-31	$433,163
Participant contributions at beginning of year	2018-12-31	$356,887
Participant contributions at end of year	2018-12-31	$0
Participant contributions at beginning of year	2018-12-31	$650
Income. Received or receivable in cash from other sources (including rollovers)	2018-12-31	$16,479
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2018-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2018-12-31	$18,550
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	$72,436
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$10,053,294
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$9,980,858
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	$8,032,843
Value of interest in pooled separate accounts at beginning of year	2018-12-31	$7,968,199
Interest on participant loans	2018-12-31	$17,474
Interest earned on other investments	2018-12-31	$20,545
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2018-12-31	$1,587,288
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2018-12-31	$1,673,272
Net investment gain/loss from pooled separate accounts	2018-12-31	$-607,413
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	Yes
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	$551,329
Employer contributions (assets) at end of year	2018-12-31	$0
Employer contributions (assets) at beginning of year	2018-12-31	$400
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$834,160
Contract administrator fees	2018-12-31	$56,591
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	COULTER & JUSTUS
Accountancy firm EIN	2018-12-31	621532536
2017 : VAN DE POL ENTERPRISES, INC. 401(K) PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets	2017-12-31	$0
Total transfer of assets to this plan	2017-12-31	$8,310,779
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$18,550
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	$2,547,825
Total loss/gain on sale of assets	2017-12-31	$0
Total of all expenses incurred	2017-12-31	$877,746
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$840,959
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$1,403,646
Value of total assets at end of year	2017-12-31	$9,999,408
Value of total assets at beginning of year	2017-12-31	$0
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$36,787
Total interest from all sources	2017-12-31	$35,791
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	$500,000
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	$899,350
Participant contributions at end of year	2017-12-31	$356,887
Participant contributions at beginning of year	2017-12-31	$0
Participant contributions at end of year	2017-12-31	$650
Participant contributions at beginning of year	2017-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2017-12-31	$18,550
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2017-12-31	$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	2017-12-31	No
Value of net income/loss	2017-12-31	$1,670,079
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$9,980,858
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$0
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	$7,968,199
Value of interest in pooled separate accounts at beginning of year	2017-12-31	$0
Interest on participant loans	2017-12-31	$14,872
Interest earned on other investments	2017-12-31	$20,919
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2017-12-31	$1,673,272
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-12-31	$0
Net investment gain/loss from pooled separate accounts	2017-12-31	$1,108,388
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	Yes
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	$504,296
Employer contributions (assets) at end of year	2017-12-31	$400
Employer contributions (assets) at beginning of year	2017-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$840,959
Contract administrator fees	2017-12-31	$36,787
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	COULTER & JUSTUS
Accountancy firm EIN	2017-12-31	621532536

Form 5500 Responses for VAN DE POL ENTERPRISES, INC. 401(K) PLAN

2022: VAN DE POL ENTERPRISES, INC. 401(K) PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Submission has been amended	No
2022-01-01	This submission is the final filing	No
2022-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2022-01-01	Plan is a collectively bargained plan	No
2022-01-01	Plan funding arrangement – Insurance	Yes
2022-01-01	Plan funding arrangement – Trust	Yes
2022-01-01	Plan benefit arrangement – Insurance	Yes
2022-01-01	Plan benefit arrangement - Trust	Yes
2021: VAN DE POL ENTERPRISES, INC. 401(K) PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Submission has been amended	No
2021-01-01	This submission is the final filing	No
2021-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-01-01	Plan is a collectively bargained plan	No
2021-01-01	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan funding arrangement – Trust	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes
2021-01-01	Plan benefit arrangement - Trust	Yes
2020: VAN DE POL ENTERPRISES, INC. 401(K) 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	No
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 – Insurance	Yes
2020-01-01	Plan funding arrangement – Trust	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement - Trust	Yes
2019: VAN DE POL ENTERPRISES, INC. 401(K) PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Submission has been amended	Yes
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 – Insurance	Yes
2019-01-01	Plan funding arrangement – Trust	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement - Trust	Yes
2018: VAN DE POL ENTERPRISES, INC. 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 – Insurance	Yes
2018-01-01	Plan benefit arrangement - Trust	Yes
2017: VAN DE POL ENTERPRISES, INC. 401(K) PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	First time form 5500 has been submitted	Yes
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 – Insurance	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

TRANSAMERICA FINANCIAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70688 )

Policy contract number

932393-00067

Policy instance

Insurance contract or identification number	932393-00067
Number of Individuals Covered	431
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $80,526
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $33,953
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	N/A
Insurance broker organization code?	3

TRANSAMERICA FINANCIAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70688 )

Policy contract number

932393-00067

Policy instance

Insurance contract or identification number	932393-00067
Number of Individuals Covered	426
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $99,257
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $33,747
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	N/A
Insurance broker organization code?	3

TRANSAMERICA FINANCIAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70688 )

Policy contract number

932393-00067

Policy instance

Insurance contract or identification number	932393-00067
Number of Individuals Covered	393
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $76,327
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $25,951
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	N/A
Insurance broker organization code?	3

TRANSAMERICA FINANCIAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70688 )

Policy contract number

932393-00067

Policy instance

Insurance contract or identification number	932393-00067
Number of Individuals Covered	357
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $65,131
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $22,145
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	N/A
Insurance broker organization code?	3

TRANSAMERICA FINANCIAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70688 )

Policy contract number

932393-00067

Policy instance

Insurance contract or identification number	932393-00067
Number of Individuals Covered	321
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $59,413
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $20,200
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	N/A
Insurance broker organization code?	3

TRANSAMERICA FINANCIAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70688 )

Policy contract number

932393-00067

Policy instance

Insurance contract or identification number	932393-00067
Number of Individuals Covered	312
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $50,167
Total amount of fees paid to insurance company	USD $3,544
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $18,305
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	0
Insurance broker organization code?	3
Insurance broker name	TAG RESOURCES, LLC

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See full terms and conditions

Company Name:	VAN DE POL ENTERPRISES
Employer identification number (EIN):	942428381
NAIC Classification:	324110
NAIC Description:	Petroleum Refineries

Jurisdiction of Incorporation:	California Department of State
Incorporation Date:	1977-07-01
Company Identification Number:	C0819422
Legal Registered Office Address:	5602 Pintail Ct Stockton United States of America (USA) 95207