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FORM 5500 DATA

A-1 Chipseal Co. 401k Profit Sharing Plan and Trust

Overview

Plan Information

  • Plan Year01/01/2008 — 12/31/2008
  • Date of Plan01/01/1998
  • Net Assets as of 12/31/2008 $524,792
  • 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? No
  • Plan Funding ArrangementInsurance Trust
  • Plan Benefit ArrangementInsurance Trust

Participant Information as of 12/31/2008

  • Active (Eligible) Participants13
  • Retired or separated participants receiving benefits0
  • Other retired or separated participants entitled to future benefits7
  • Subtotal20
  • Deceased participants whose beneficiaries are receiving or are entitled to receive benefits0
  • Total20
  • Total number of participants as of 01/01/200817
  • Number of participants with account balances19
  • Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested0
  • Number of participants required to be reported on Schedule SSA2

Expenses

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

Sponsor Information

  • Address2001 West 64th Lane
  • CityDenver
  • StateCO
  • Zip80221-2345
  • Telephone(303) 464-9267
  • EIN84-1216817
  • Industry Code237310
  • Named Administrator-Fivia) Bcvtot
  • Named Plan Sponsor-Daviol'I Eyv-7,Wwou

Plan Administrator Information

  • Administrator NameSAME
  • Administrator EIN

Benefits Provided Under the Plan

Code Benefit Description
2A Age/Service Weighted or New Comparability or Similar Plan Age/Service Weighted Plan: Allocations are based on age, service, or age and service. New Comparability or Similar Plan: Allocations are based on participant classifications and a classification(s) consists entirely or predominantly of highly compensated employees; or the plan provides an additional allocation rate on compensation above a specified threshold, and the threshold or additional rate allowed under the permitted disparity rules of section 401(l)
2E Profit-sharing A defined contribution plan that allows employer discretionary contributions. These plans often contain a 401(k) feature.
2H Partial participant-directed account plan Participants have the opportunity to direct the investment of a portion of the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
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.

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? No
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 $195,000
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 at any time hold 20% or more of its assets in any single security, debt, mortgage, parcel of real estate, or partnership/joint venture interest? No $0
Are you claiming a waiver of the annual examination and report of an independent qualified public accountant (IQPA) under 29 CFR 2520.104-46? Yes
Were all the plan assets either distributed to participants or beneficiaries, transferred to another plan, or brought under the control of the PBGC? No

Financials

Income and Expense Statement

Income $-145,420
Contributions $0
Cash Contributions $70,991
Cash from Employers $0
Cash from Participants $29,080
Others (including rollovers) $41,911
Noncash Contributions $0
Other Income $-216,411
Expenses $5,882
Total Benefit Payments $0
Corrective Distributions $0
Certain deemed distributions of participant loans $0
Other Expenses $5,882
Net Income $-151,302
Transfers of Assets to (from) this Plan $0

Asset and Liability Statement

12/31/2008 12/31/2007 Change YOY
Total Assets $524,792 $684,262 -23.31%
Total Liabilities $0 $8,168 -100.00%
Net Assets $524,792 $676,094 -22.38%

Specific Assets Statement

Held? Amount
Total Specific Assets Yes $0
Partnership/joint venture interests Yes $0
Employer Real Property Yes $0
Real Estate Yes $0
Employer Securities Yes $0
Participant Loans Yes $0
Loans (other than to participants) Yes $0
Tangible Personal Property Yes $0

Service Providers

Service Providers

There are no service providers listed for this plan.

Investments

Investments

Name of Investment Investment Manager Type of Investment Dollar Value
Lnl Sa33 Lvip Delaware Social Aware Lincoln National Life Insurance Co. DFE: Pooled Separate Account $156,890
Lnl Sa19 Alliancebernstein Vps Grow Lincoln National Life Insurance Co. DFE: Pooled Separate Account $112,645
Lnl Sa37 Neuberger Berman Amt Mid Lincoln National Life Insurance Co. DFE: Pooled Separate Account $84,598
Lnl Sa24 Small Capitalization Equit Lincoln National Life Insurance Co. DFE: Pooled Separate Account $56,364
Lnl Sa98 Lvip Wilshire Aggressive Lincoln National Life Insurance Co. DFE: Pooled Separate Account $35,804
Lnl Sa17 Medium Capitalization Equi Lincoln National Life Insurance Co. DFE: Pooled Separate Account $25,214
Lnl Sa48 Afis Growth Lincoln National Life Insurance Co. DFE: Pooled Separate Account $9,327
Lnl Sa36 Lvip Ssga Small Cap Index Lincoln National Life Insurance Co. DFE: Pooled Separate Account $8,080
Lnl Sa14 Short Term Lincoln National Life Insurance Co. DFE: Pooled Separate Account $7,832
Lnl Sal1 Lvip Wilshire 2010 Profile Lincoln National Life Insurance Co. DFE: Pooled Separate Account $6,468
Lnl Sa32 Aggressive Balanced Lincoln National Life Insurance Co. DFE: Pooled Separate Account $6,438
Lnl Sa34 Afis Global Growth Lincoln National Life Insurance Co. DFE: Pooled Separate Account $6,397
Lnl Sal4 Lvip Wilshire 2040 Profile Lincoln National Life Insurance Co. DFE: Pooled Separate Account $3,400
Lnl Sa21 Balanced Lincoln National Life Insurance Co. DFE: Pooled Separate Account $2,670
Lnl Sal3 Lvip Wilshire 2030 Profile Lincoln National Life Insurance Co. DFE: Pooled Separate Account $598
Lnl Sa94 Delaware Vip Emerging Mark Lincoln National Life Insurance Co. DFE: Pooled Separate Account $42
Lnl Sa35 Fidelity Vip Contrafund Lincoln National Life Insurance Co. DFE: Pooled Separate Account $0
Lnl Sa23 Large Capitalization Equit Lincoln National Life Insurance Co. DFE: Pooled Separate Account $0
Lnl Sa61 Delaware Vip Value Lincoln National Life Insurance Co. DFE: Pooled Separate Account $0
Total $522,767

Insurance Information

Insurance Information

Insurance Carrier Summary Persons Covered
Lincoln National Life Insurance Company 20
EIN 35-0472300
Industry Code 65676
Contract Number GP81863
Contract Year 01/01/2008 — 12/31/2008
Value in General Account at Year End $0
Value in Separate Accounts at Year End $522,767
Insurance Fees and Commissions $4,691
Persons Receiving Commissions and Fees
Agent/Broker Organization Code Commissions Paid Fees Paid Purpose of Fees Paid
Nfp Securities, Inc 11001 W 120th Avenue Ste 400 Broomkilli), CO 80021 Agent or Broker other than Insurance $3,419 $0
Lafayette Life Insurance Company P.O. Box 7007 Lafayette, IN 47903 -7007 Third Party Administrator $0 $740 THIRD PARTY ADMINISTRATOR
Ronald E. Naff, CLU, ChFC Gemini Group - 789 Sherman St 400 Denver, CO 80203 -3529 Agent or Broker other than Insurance $399 $0
American Buying Retirement Services 19 S. Lasalle St. - Ste. 1500 Chicago, IL 60603 Agent or Broker other than Insurance $133 $0
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
Lafayette Life Insurance Company 20
EIN 35-0457540
Industry Code 65242
Contract Number CP3738
Contract Year —
Value in General Account at Year End $0
Value in Separate Accounts at Year End $0
Insurance Fees and Commissions $1,160
Persons Receiving Commissions and Fees
Agent/Broker Organization Code Commissions Paid Fees Paid Purpose of Fees Paid
Max C. Belcher CLU ChFC 13275 E. Fremont Pl - Ste 315 Centennial, CO 80112 -3917 Agent or Broker other than Insurance $714 $0
American Buying Retirement Service Attn Robert Sheridan - 814 Park Ave River Forest, IL 60305 Agent or Broker other than Insurance $308 $0
Ronald E. Naff, CLU, ChFC Gemini Group - 789 Sherman St 400 Denver, CO 80203 -3529 Agent or Broker other than Insurance $138 $0
Allocated Funds
Type of Contract Individual Policies
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