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FORM 5500 DATA

A&M Supply Holdings, Inc. & Affiliates Employee Stock Ownership and Savings Plan

Overview

Plan Information

  • Plan Year10/01/2010 — 09/30/2011
  • Date of Plan02/01/2001
  • Net Assets as of 09/30/2011 $5,881,508
  • Plan Number1
  • Plan Type Single Employer
  • Is the plan collectively bargained? No
  • Did the plan file for an extension of time or the DFVC Program?Yes
  • Plan Funding ArrangementInsurance Trust
  • Plan Benefit ArrangementInsurance Trust

Participant Information as of 09/30/2011

  • Active (Eligible) Participants155
  • Retired or separated participants receiving benefits53
  • Other retired or separated participants entitled to future benefits133
  • Subtotal341
  • Deceased participants whose beneficiaries are receiving or are entitled to receive benefits5
  • Total346
  • Total number of participants as of 10/01/2010342
  • Number of participants with account balances328
  • Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested18

Expenses

  • Total Benefit Payments$0
  • Corrective Distributions$0
  • Administrative Service Providers$0
  • Other Expenses$0
  • Total Expenses$0
  • Total Transfers$0

Sponsor Information

  • Address6701 90th Ave
  • CityPinellas Park
  • StateFL
  • Zip33782-4535
  • Telephone(727) 541-6631
  • EIN54-1598875
  • Industry Code423300
  • Named AdministratorJeffrey Dooly
  • Named Plan SponsorJeffrey Dooly

Plan Administrator Information

  • Administrator NameA & M Supply Holdings, Inc.
  • Address6701 90th Ave
  • CityPinellas Park
  • StateFL
  • Zip33782-4535
  • Telephone(727) 541-6631
  • Administrator EIN54-1598875

Audit Information

  • Audit StatusAudited
  • AuditorMcgladrey LLP
  • Auditor EIN42-0714325
  • Audit OpinionUnqualified
  • Audit Type Full Audit

Benefits Provided Under the Plan

Code Benefit Description
2E Profit-sharing A defined contribution plan that allows employer discretionary contributions. These plans often contain a 401(k) feature.
2F ERISA section 404(c) Plan This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
2G 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.
2I Stock bonus A stock bonus plan is a type of profit-sharing by which a corporation uses its own stock to make contributions and distributions.
2J 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.
2K 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 contributions 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.
2O ESOP other than a leveraged ESOP An Employee Stock Ownership Plan (ESOP) is a type of employee benefit plan designed to invest primarily in employer stock.
3H Controlled Group Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

Questions and Answers

Question Answer Amount
During the plan year did the employer fail to transmit to the plan any participant contributions within the time period described in 29 CFT 2510.3-102? Yes $102,886
Were any loans by the plan or fixed income obligations due the plan in default as of the close of plan year or classified during the year as uncollectible? Disregard participant loans secured by participant's account balance. No
Were any leases to which the plan was a party in default or classified during the year as uncollectible? No
Were there any nonexempt transactions with any party-in-interest? No
Was this plan covered by a fidelity bond? Yes $1,000,000
Did the plan have a loss, whether or not reimbursed by the plan's fidelity bond, that was caused by fraud or dishonesty? No
Did the plan hold any assets whose current value was neither readily determinable on an established market nor set by an independent third party appraiser? No
Did the plan receive any noncash contributions whose value was neither readily determinable on an established market nor set by an independent third party appraiser? No
Did the plan have assets held for investment? Yes
Were any plan transactions or series of transactions in excess of 5% of the current value of plan assets? No
Were all the plan assets either distributed to participants or beneficiaries, transferred to another plan, or brought under the control of the PBGC? No
Has the plan failed to provide any benefit when due under the plan? No
If this is an individual account plan, was there a blackout period? No
If there was a blackout period, have you either provided the required notice or one of the exceptions to providing the notice applied under 29 CFR 2520.101-3? No

Financials

Income and Expense Statement

Income $388,136
Contributions $199,908
Cash Contributions $199,908
Cash from Employers $0
Cash from Participants $163,782
Others (including rollovers) $36,126
Noncash Contributions $0
Total Earnings on Investments $188,228
Total Interest $6,577
Interest-Bearing Cash $7
U.S. Government Securities $0
Corporate Debt Instruments $0
Loans (other than to participants) $0
Participant Loans $6,570
Interest from Other Investments $0
Total Dividends $0
Preferred Stock $0
Common Stock $0
Rents $0
Net gain (loss) on sale of assets $0
Aggregate Proceeds $0
Aggregate Carrying Amount $0
Total Unrealized Appreciation (depreciation) of assets $143,394
Real Estate $0
Other $143,394
Net investment gain (loss) from common/collective trusts $0
Net investment gain (loss) from pooled separate accounts $38,257
Net investment gain (loss) from master trust investment accounts $0
Net investment gain (loss) from 103-12 investment entities $0
Net investment gain (loss) from registered investment companies $0
Other Income $0
Expenses $379,318
Total Benefit Payments $377,501
Directly to participants or beneficiaries, including direct rollovers $377,501
To insurance carriers for the provision of benefits $0
Other Benefit Payment Fees $0
Corrective Distributions $0
Certain deemed distributions of participant loans $0
Interest expense $0
Total Administrative Expenses $1,817
Professional Fees $0
Contract Administrator Fees $1,817
Investment Advisory and management fees $0
Other Administrative Fees $0
Net Income $8,818
Transfers of Assets to this Plan $0
Transfers of Assets from this Plan $0

Asset and Liability Statement

09/30/2011 09/30/2010 Change YOY
Total Assets $5,881,531 $5,873,937 0.13%
Total noninterest-bearing cash $0 $0 0.0%
Receivables $0 $0 0.0%
Employer Contributions $0 $0 0.0%
Participant Contributions $0 $0 0.0%
Other Contributions $0 $0 0.0%
General Investments $26,531 $27,770 -4.46%
Interest-bearing cash $26,531 $27,770 -4.46%
U.S. Government Securities $0 $0 0.0%
Corporate Debt Instruments $0 $0 0.0%
Preferred $0 $0 0.0%
All Other $0 $0 0.0%
Corporate Stocks $0 $0 0.0%
Preferred $0 $0 0.0%
Common $0 $0 0.0%
Partnership/joint venture interests $0 $0 0.0%
Real estate (other than employer real property) $0 $0 0.0%
Loans (other than to participants) $0 $0 0.0%
Participants Loans $137,729 $114,061 20.75%
Value of interest in common/collective trusts $0 $0 0.0%
Value of interest in pooled separate accounts $1,723,447 $1,663,407 3.61%
Value of interest in master trust investment accounts $0 $0 0.0%
Value of interest in 103-12 investment entities $0 $0 0.0%
Value of interest in registered investment companies $0 $0 0.0%
Value of funds held in insurance co. general account $0 $0 0.0%
Other Investments $0 $0 0.0%
Employer-related Investments $3,993,824 $4,068,699 -1.84%
Employer Securities $3,993,824 $4,068,699 -1.84%
Employer Real Property $0 $0 0.0%
Buildings and other property used in plan operation $0 $0 0.0%
Total Liabilities $23 $1,247 -98.16%
Benefit Claims Payable (1) $23 $1,247 -98.16%
Operating Payables (1) $0 $0 0.0%
Acquisition Indebtedness (1) $0 $0 0.0%
Other liabilities (1) $0 $0 0.0%
Net Assets $5,881,508 $5,872,690 0.15%

Service Providers

Persons Receiving Only Eligible Indirect Compensation

There is no information on eligible indirect compensation for this plan.

Other Service Providers Receiving Direct or Indirect Compensation

Name Nature of Service Relationship to Plan Sponsor Direct Compensation Paid by Plan Indirect Compensation Paid by Plan Total Compensation
Principal Life Insurance Company Contract Administrator, Participant loan processing, Direct payment from the plan, Recordkeeping fees Contract Administrator $1,816 $0 $1,816
Total $1,816 $0 $1,816

Indirect Compensation

There are no service providers with indirect compensation listed for this plan.

Service Providers Who Fail or Refuse to Provide Information

There are no service providers who failed or refused to provide information.

Termination Information on Accountants and Enrolled Actuaries

There is no termination information for this plan.

Investments

Investments

Name of Investment Investment Manager Type of Investment Dollar Value
Prin Bond and Mortgage Sa-R6 Principal Life Insurance Company DFE: Pooled Separate Account $331,876
Prin Money Market Sep Acct-R6 Principal Life Insurance Company DFE: Pooled Separate Account $322,290
Prin U.S. Property Sep Acct-R6 Principal Life Insurance Company DFE: Pooled Separate Account $225,730
Prin Midcap S&P 400 Idx Sa-R6 Principal Life Insurance Company DFE: Pooled Separate Account $141,655
Prin Smallcap Value II Sa-R6 Principal Life Insurance Company DFE: Pooled Separate Account $112,536
Prin Largecap Growth II Sa-R6 Principal Life Insurance Company DFE: Pooled Separate Account $100,745
Prin Intl Smallcap Sep Acct-R6 Principal Life Insurance Company DFE: Pooled Separate Account $94,424
Prin Largecap Value III Sa-R6 Principal Life Insurance Company DFE: Pooled Separate Account $71,690
Prin Smallcap Growth I Sa-R6 Principal Life Insurance Company DFE: Pooled Separate Account $64,311
Prin Lifetime 2020 Sep Acct-R6 Principal Life Insurance Company DFE: Pooled Separate Account $47,936
Prin Lifetime 2030 Sep Acct-R6 Principal Life Insurance Company DFE: Pooled Separate Account $45,747
Prin Midcap Value I Sa-R6 Principal Life Insurance Company DFE: Pooled Separate Account $35,327
Prin Lifetime 2040 Sep Acct-R6 Principal Life Insurance Company DFE: Pooled Separate Account $33,633
Prin Lgcap S&P 500 Index Sa-R6 Principal Life Insurance Company DFE: Pooled Separate Account $23,695
Prin Lifetime 2010 Sep Acct-R6 Principal Life Insurance Company DFE: Pooled Separate Account $22,432
Prin Midcap Growth III Sa-R6 Principal Life Insurance Company DFE: Pooled Separate Account $18,050
Prin Lifetime 2050 Sep Acct-R6 Principal Life Insurance Company DFE: Pooled Separate Account $11,986
Prin Diversified Intl Sa-R6 Principal Life Insurance Company DFE: Pooled Separate Account $9,886
Prin Smcap S&P 600 Index Sa-R6 Principal Life Insurance Company DFE: Pooled Separate Account $3,730
Prin Lifetime Strat Inc Sa-R6 Principal Life Insurance Company DFE: Pooled Separate Account $2,916
Prin Intl Emerg Markets Sa-R6 Principal Life Insurance Company DFE: Pooled Separate Account $2,853
Total $1,723,448

Insurance Information

Insurance Information

Insurance Carrier Summary Persons Covered
Principal Life Insurance Company 346
EIN 42-0127290
Industry Code 61271
Contract Number 803310
Contract Year 10/01/2010 — 09/30/2011
Value in General Account at Year End $0
Value in Separate Accounts at Year End $1,723,447
Insurance Fees and Commissions $3,772
Persons Receiving Commissions and Fees
Agent/Broker Organization Code Commissions Paid Fees Paid Purpose of Fees Paid
Stahl & Associates 110 Carillon Pkwy St Petersburg, FL 33716 Insurance Agent or Broker $3,619 $153 REFERRAL/SERVICE FEE
Allocated Funds
Type of Contract Unspecified
Basis of premium rates
Premiums paid to carrier $0
Premiums due but unpaid at the end of the year $0
If the carrier, service, or other organization incurred any specific costs in connection with the acquisition or retention of the contract or policy, enter amount $0
Specify the nature of the costs
Unallocated Funds
Type of Contract Unspecified
Balance at the end of the previous year $0
Additions $0
Contributions Deposited during the year $0
Dividends and credits $0
Interest credited during the year $0
Transferred from separate account $0
Other $0
Total of Balance and Additions $0
Deductions $0
Disbursed from fund to pay benefits or purchase annuities during the year $0
Administration charge made by carrier $0
Transferred to Separate Account $0
Other $0
Balance at the end of the current year $0