401k Plan data: FOAM MOLDERS & SPECIALTIES, INC EMPLOYEES SAVINGS & PROFIT SHARING PLAN plan

FOAM MOLDERS & SPECIALTIES, INC EMPLOYEES SAVINGS & PROFIT SHARING PLAN 401k Plan overview

Plan Name	FOAM MOLDERS & SPECIALTIES, INC EMPLOYEES SAVINGS & PROFIT SHARING PLAN
Plan identification number	001

FOAM MOLDERS & SPECIALTIES, INC EMPLOYEES SAVINGS & PROFIT SHARING 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

FOAM MOLDERS & SPECIALTIES has sponsored the creation of one or more 401k plans.

Company Name: FOAM MOLDERS & SPECIALTIES

Employer identification number (EIN): 952868023

NAIC Classification: 326100

Form 5500 Filing Information

Submission information for form 5500 for 401k plan FOAM MOLDERS & SPECIALTIES, INC EMPLOYEES SAVINGS & PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2023-01-01 PAM A TSUJIOKA 2024-05-30 PAM A TSUJIOKA 2024-05-30
001 2022-01-01 PAM TSUJIOKA 2023-07-28
001 2021-01-01 NORMAN L. HIMEL III 2022-07-14 NORMAN L. HIMEL III 2022-07-14
001 2020-01-01 NORMAN L. HIMEL III 2021-07-08 NORMAN L. HIMEL III 2021-07-08
001 2019-01-01 NORMAN L HIMEL III 2020-08-19 NORMAN L HIMEL III 2020-08-19
001 2018-01-01 NORMAN L. HIMEL III 2019-08-23 NORMAN L. HIMEL III 2019-08-23
001 2017-01-01 NORMAN L. HIMEL III 2018-08-27 NORMAN L. HIMEL III 2018-08-27
001 2016-01-01 NORMAN L. HIMEL III 2017-10-03 NORMAN L. HIMEL III 2017-10-03
001 2015-01-01 NORMAN L HIMEL III 2016-09-29 NORMAN L HIMEL III 2016-09-29
001 2014-01-01 NORMAN L. HIMEL III NORMAN L. HIMEL III 2015-10-09
001 2013-01-01 NORMAN HIMEL NORMAN HIMEL 2014-09-26
001 2012-01-01 NORMAN L. HIMEL III NORMAN L. HIMEL III 2013-10-11
001 2011-01-01 NORMAN L. HIMEL III NORMAN L. HIMEL III 2012-10-11
001 2009-01-01 NORMAN L. HIMEL, III NORMAN L. HIMEL, III 2010-10-13

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2023-01-01	PAM A TSUJIOKA	2024-05-30	PAM A TSUJIOKA	2024-05-30
001	2022-01-01	PAM TSUJIOKA	2023-07-28
001	2021-01-01	NORMAN L. HIMEL III	2022-07-14	NORMAN L. HIMEL III	2022-07-14
001	2020-01-01	NORMAN L. HIMEL III	2021-07-08	NORMAN L. HIMEL III	2021-07-08
001	2019-01-01	NORMAN L HIMEL III	2020-08-19	NORMAN L HIMEL III	2020-08-19
001	2018-01-01	NORMAN L. HIMEL III	2019-08-23	NORMAN L. HIMEL III	2019-08-23
001	2017-01-01	NORMAN L. HIMEL III	2018-08-27	NORMAN L. HIMEL III	2018-08-27
001	2016-01-01	NORMAN L. HIMEL III	2017-10-03	NORMAN L. HIMEL III	2017-10-03
001	2015-01-01	NORMAN L HIMEL III	2016-09-29	NORMAN L HIMEL III	2016-09-29
001	2014-01-01	NORMAN L. HIMEL III		NORMAN L. HIMEL III	2015-10-09
001	2013-01-01	NORMAN HIMEL		NORMAN HIMEL	2014-09-26
001	2012-01-01	NORMAN L. HIMEL III		NORMAN L. HIMEL III	2013-10-11
001	2011-01-01	NORMAN L. HIMEL III		NORMAN L. HIMEL III	2012-10-11
001	2009-01-01	NORMAN L. HIMEL, III		NORMAN L. HIMEL, III	2010-10-13

Plan Statistics for FOAM MOLDERS & SPECIALTIES, INC EMPLOYEES SAVINGS & PROFIT SHARING PLAN

401k plan membership statisitcs for FOAM MOLDERS & SPECIALTIES, INC EMPLOYEES SAVINGS & PROFIT SHARING PLAN

Measure Date Value
2014: FOAM MOLDERS & SPECIALTIES, INC EMPLOYEES SAVINGS & PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 102
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 73
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 82
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 82
Number of participants with account balances 2014-01-01 35
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0
2013: FOAM MOLDERS & SPECIALTIES, INC EMPLOYEES SAVINGS & PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 115
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 95
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 7
Total of all active and inactive participants 2013-01-01 102
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 102
Number of participants with account balances 2013-01-01 35
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0
2012: FOAM MOLDERS & SPECIALTIES, INC EMPLOYEES SAVINGS & PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 100
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 105
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 9
Total of all active and inactive participants 2012-01-01 114
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 114
Number of participants with account balances 2012-01-01 39
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: FOAM MOLDERS & SPECIALTIES, INC EMPLOYEES SAVINGS & PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 139
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 89
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 10
Total of all active and inactive participants 2011-01-01 99
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 99
Number of participants with account balances 2011-01-01 40
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2009: FOAM MOLDERS & SPECIALTIES, INC EMPLOYEES SAVINGS & PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 170
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 135
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 12
Total of all active and inactive participants 2009-01-01 147
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 147
Number of participants with account balances 2009-01-01 61
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 2

Measure	Date	Value
2014: FOAM MOLDERS & SPECIALTIES, INC EMPLOYEES SAVINGS & PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	102
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	73
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	82
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	82
Number of participants with account balances	2014-01-01	35
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2013: FOAM MOLDERS & SPECIALTIES, INC EMPLOYEES SAVINGS & PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	115
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	95
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	7
Total of all active and inactive participants	2013-01-01	102
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	102
Number of participants with account balances	2013-01-01	35
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0
2012: FOAM MOLDERS & SPECIALTIES, INC EMPLOYEES SAVINGS & PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	100
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	105
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	9
Total of all active and inactive participants	2012-01-01	114
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	114
Number of participants with account balances	2012-01-01	39
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: FOAM MOLDERS & SPECIALTIES, INC EMPLOYEES SAVINGS & PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	139
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	89
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	10
Total of all active and inactive participants	2011-01-01	99
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	99
Number of participants with account balances	2011-01-01	40
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2009: FOAM MOLDERS & SPECIALTIES, INC EMPLOYEES SAVINGS & PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	170
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	135
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	12
Total of all active and inactive participants	2009-01-01	147
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	147
Number of participants with account balances	2009-01-01	61
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	2

Financial Data on FOAM MOLDERS & SPECIALTIES, INC EMPLOYEES SAVINGS & PROFIT SHARING PLAN

Measure	Date	Value
2014 : FOAM MOLDERS & SPECIALTIES, INC EMPLOYEES SAVINGS & PROFIT SHARING PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets	2014-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Total income from all sources (including contributions)	2014-12-31	$83,488
Total loss/gain on sale of assets	2014-12-31	$0
Total of all expenses incurred	2014-12-31	$14,107
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$8,443
Value of total corrective distributions	2014-12-31	$863
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$74,491
Value of total assets at end of year	2014-12-31	$823,701
Value of total assets at beginning of year	2014-12-31	$754,320
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$4,801
Total interest from all sources	2014-12-31	$1,318
Total dividends received (eg from common stock, registered investment company shares)	2014-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-12-31	No
Was this plan covered by a fidelity bond	2014-12-31	Yes
Value of fidelity bond cover	2014-12-31	$1,000,000
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	$62,309
Participant contributions at end of year	2014-12-31	$31,632
Participant contributions at beginning of year	2014-12-31	$34,157
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	$69,381
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$823,701
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$754,320
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
Investment advisory and management fees	2014-12-31	$4,326
Value of interest in pooled separate accounts at end of year	2014-12-31	$710,422
Value of interest in pooled separate accounts at beginning of year	2014-12-31	$638,250
Interest on participant loans	2014-12-31	$1,029
Interest earned on other investments	2014-12-31	$289
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-12-31	$81,647
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-12-31	$81,913
Net investment gain/loss from pooled separate accounts	2014-12-31	$7,679
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	$12,182
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$8,443
Contract administrator fees	2014-12-31	$475
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	KHO & PATEL, CPA
Accountancy firm EIN	2014-12-31	330381007
2013 : FOAM MOLDERS & SPECIALTIES, INC EMPLOYEES SAVINGS & PROFIT SHARING PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets	2013-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
Total income from all sources (including contributions)	2013-12-31	$173,473
Total loss/gain on sale of assets	2013-12-31	$0
Total of all expenses incurred	2013-12-31	$42,118
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$34,302
Value of total corrective distributions	2013-12-31	$3,130
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$83,387
Value of total assets at end of year	2013-12-31	$754,320
Value of total assets at beginning of year	2013-12-31	$622,965
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$4,686
Total interest from all sources	2013-12-31	$1,334
Total dividends received (eg from common stock, registered investment company shares)	2013-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-12-31	No
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$1,000,000
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	$57,333
Participant contributions at end of year	2013-12-31	$34,157
Participant contributions at beginning of year	2013-12-31	$27,282
Income. Received or receivable in cash from other sources (including rollovers)	2013-12-31	$14,731
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	$131,355
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$754,320
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$622,965
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
Investment advisory and management fees	2013-12-31	$3,886
Value of interest in pooled separate accounts at end of year	2013-12-31	$638,250
Value of interest in pooled separate accounts at beginning of year	2013-12-31	$533,678
Interest on participant loans	2013-12-31	$1,049
Interest earned on other investments	2013-12-31	$285
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2013-12-31	$81,913
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-12-31	$62,005
Net investment gain/loss from pooled separate accounts	2013-12-31	$88,752
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	$11,323
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$34,302
Contract administrator fees	2013-12-31	$800
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	No
Opinion of an independent qualified public accountant for this plan	2013-12-31	Unqualified
Accountancy firm name	2013-12-31	KHO & PATEL, CPA
Accountancy firm EIN	2013-12-31	330381007
2012 : FOAM MOLDERS & SPECIALTIES, INC EMPLOYEES SAVINGS & PROFIT SHARING 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	$124,833
Total loss/gain on sale of assets	2012-12-31	$0
Total of all expenses incurred	2012-12-31	$10,965
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$4,043
Value of total corrective distributions	2012-12-31	$3,231
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$64,861
Value of total assets at end of year	2012-12-31	$622,965
Value of total assets at beginning of year	2012-12-31	$509,097
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$3,691
Total interest from all sources	2012-12-31	$692
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
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$1,000,000
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	$54,091
Participant contributions at end of year	2012-12-31	$27,282
Participant contributions at beginning of year	2012-12-31	$7,154
Other income not declared elsewhere	2012-12-31	$246
Total non interest bearing cash at beginning of year	2012-12-31	$1,225
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	$113,868
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$622,965
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$509,097
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
Investment advisory and management fees	2012-12-31	$3,266
Value of interest in pooled separate accounts at end of year	2012-12-31	$533,678
Value of interest in pooled separate accounts at beginning of year	2012-12-31	$444,624
Interest on participant loans	2012-12-31	$692
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-12-31	$62,005
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-12-31	$56,094
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2012-12-31	$-5
Net investment gain/loss from pooled separate accounts	2012-12-31	$59,039
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	$10,770
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$4,043
Contract administrator fees	2012-12-31	$425
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	No
Opinion of an independent qualified public accountant for this plan	2012-12-31	Unqualified
Accountancy firm name	2012-12-31	KHO AND PATEL, CPA
Accountancy firm EIN	2012-12-31	330381007
2011 : FOAM MOLDERS & SPECIALTIES, INC EMPLOYEES SAVINGS & PROFIT SHARING PLAN 2011 401k financial data
Total unrealized appreciation/depreciation of assets	2011-12-31	$0
Total transfer of assets from this plan	2011-12-31	$333,934
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	$47,029
Total loss/gain on sale of assets	2011-12-31	$0
Total of all expenses incurred	2011-12-31	$14,748
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$13,633
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$60,638
Value of total assets at end of year	2011-12-31	$509,097
Value of total assets at beginning of year	2011-12-31	$810,750
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$1,115
Total interest from all sources	2011-12-31	$110
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	$250,000
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	$50,422
Participant contributions at end of year	2011-12-31	$7,154
Other income not declared elsewhere	2011-12-31	$39
Total non interest bearing cash at end of year	2011-12-31	$1,225
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	$32,281
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$509,097
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$810,750
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	$444,624
Interest on participant loans	2011-12-31	$110
Value of interest in common/collective trusts at beginning of year	2011-12-31	$748,042
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2011-12-31	$62,708
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2011-12-31	$62,708
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-12-31	$56,094
Net investment gain/loss from pooled separate accounts	2011-12-31	$-31,054
Net investment gain or loss from common/collective trusts	2011-12-31	$17,296
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	$10,216
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$13,633
Contract administrator fees	2011-12-31	$1,115
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	No
Opinion of an independent qualified public accountant for this plan	2011-12-31	Unqualified
Accountancy firm name	2011-12-31	KHO AND PATEL, CPA
Accountancy firm EIN	2011-12-31	330381007
2010 : FOAM MOLDERS & SPECIALTIES, INC EMPLOYEES SAVINGS & PROFIT SHARING 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	$167,869
Total loss/gain on sale of assets	2010-12-31	$0
Total of all expenses incurred	2010-12-31	$23,564
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$15,017
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$70,517
Value of total assets at end of year	2010-12-31	$810,750
Value of total assets at beginning of year	2010-12-31	$666,445
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$8,547
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	$1,000,000
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	$58,446
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	$144,305
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$810,750
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$666,445
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
Investment advisory and management fees	2010-12-31	$394
Value of interest in common/collective trusts at end of year	2010-12-31	$748,042
Value of interest in common/collective trusts at beginning of year	2010-12-31	$604,972
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2010-12-31	$62,708
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2010-12-31	$61,473
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2010-12-31	$61,473
Net investment gain or loss from common/collective trusts	2010-12-31	$97,352
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	$12,071
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$15,017
Contract administrator fees	2010-12-31	$8,153
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	No
Opinion of an independent qualified public accountant for this plan	2010-12-31	Unqualified
Accountancy firm name	2010-12-31	KHO & PATEL, CPA
Accountancy firm EIN	2010-12-31	330381007
2009 : FOAM MOLDERS & SPECIALTIES, INC EMPLOYEES SAVINGS & PROFIT SHARING 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 FOAM MOLDERS & SPECIALTIES, INC EMPLOYEES SAVINGS & PROFIT SHARING PLAN

2014: FOAM MOLDERS & SPECIALTIES, INC EMPLOYEES SAVINGS & PROFIT SHARING PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – 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: FOAM MOLDERS & SPECIALTIES, INC EMPLOYEES SAVINGS & PROFIT SHARING PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – 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: FOAM MOLDERS & SPECIALTIES, INC EMPLOYEES SAVINGS & PROFIT SHARING 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: FOAM MOLDERS & SPECIALTIES, INC EMPLOYEES SAVINGS & PROFIT SHARING 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
2009: FOAM MOLDERS & SPECIALTIES, INC EMPLOYEES SAVINGS & PROFIT SHARING 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 – Trust	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

15722

Policy instance

Insurance contract or identification number	15722
Number of Individuals Covered	35
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $3,753
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?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,753
Insurance broker organization code?	3
Insurance broker name	CHRISTOPHER FITZSIMMONS

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

15722

Policy instance

Insurance contract or identification number	15722
Number of Individuals Covered	35
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $3,336
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?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,336
Insurance broker organization code?	3
Insurance broker name	CHRISTOPHER FITZSIMMONS

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

15722

Policy instance

Insurance contract or identification number	15722
Number of Individuals Covered	39
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $2,719
Total amount of fees paid to insurance company	USD $200
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?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,719
Insurance broker organization code?	3
Amount paid for insurance broker fees	186
Additional information about fees paid to insurance broker	MRKT. FEES
Insurance broker name	401K COACH

UNITED OF OMAHA (National Association of Insurance Commissioners NAIC id number: )

Policy contract number

15722

Policy instance

Insurance contract or identification number	15722
Number of Individuals Covered	40
Insurance policy start date	2011-04-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $1,106
Total amount of fees paid to insurance company	USD $4,395
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?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

Potentially related plans

FOAM MOLDERS 401(K) PROFIT SHARING PLAN [EIN = 272348298]

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Company Name:	FOAM MOLDERS & SPECIALTIES
Employer identification number (EIN):	952868023
NAIC Classification:	326100