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FORM 5500 DATA

Savings Plan for Employees of Douglas County Incorporated

Overview

Plan Information

  • Plan Year01/01/2006 — 12/31/2006
  • Date of Plan01/01/1993
  • Net Assets as of 12/31/2006 $1,860,256
  • 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
  • Plan Benefit ArrangementInsurance

Participant Information as of 12/31/2006

  • Active (Eligible) Participants139
  • Retired or separated participants receiving benefits0
  • Other retired or separated participants entitled to future benefits13
  • Subtotal152
  • Deceased participants whose beneficiaries are receiving or are entitled to receive benefits0
  • Total152
  • Total number of participants as of 01/01/2006127
  • Number of participants with account balances123
  • Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested8
  • Number of participants required to be reported on Schedule SSA6

Expenses

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

Sponsor Information

  • AddressPo Box 848
  • CityWinchester
  • StateOR
  • Zip97495-0848
  • Telephone(541) 672-5711
  • EIN93-0899201
  • Industry Code321110
  • Named AdministratorHal Westbrook
  • Named Plan SponsorRichard Mathews, Employer

Plan Administrator Information

  • Administrator NameSAME
  • Administrator EIN

Audit Information

  • Audit StatusAudited
  • AuditorWicks,Emmett,Hatfield,&Chappell LLP
  • Auditor EIN93-0718861
  • Audit Opinion Disclaimer
  • Audit TypeLimited Scope 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.
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.
3E Prototype plan A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion or notification letter; and under which a separate funding medium (for example, a separate trust or custodial account) is established for the use of each adopting employer.

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 $186,026
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

Financials

Income and Expense Statement

Income $585,966
Contributions $370,332
Cash Contributions $370,332
Cash from Employers $72,804
Cash from Participants $219,502
Others (including rollovers) $78,026
Noncash Contributions $0
Total Earnings on Investments $215,634
Total Interest $3,364
Interest-Bearing Cash $3,364
U.S. Government Securities $0
Corporate Debt Instruments $0
Loans (other than to participants) $0
Participant Loans $0
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 $0
Real Estate $0
Other $0
Net investment gain (loss) from common/collective trusts $0
Net investment gain (loss) from pooled separate accounts $212,270
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 $96,521
Total Benefit Payments $85,000
Directly to participants or beneficiaries, including direct rollovers $85,000
To insurance carriers for the provision of benefits $0
Other Benefit Payment Fees $0
Corrective Distributions $1,596
Certain deemed distributions of participant loans $0
Interest expense $0
Total Administrative Expenses $9,925
Professional Fees $0
Contract Administrator Fees $9,925
Investment Advisory and management fees $0
Other Administrative Fees $0
Net Income $489,445
Transfers of Assets to this Plan $0
Transfers of Assets from this Plan $0

Asset and Liability Statement

12/31/2006 12/31/2005 Change YOY
Total Assets $1,860,256 $1,370,811 35.70%
Total noninterest-bearing cash $0 $46 -100.00%
Receivables $-112 $-137 -18.25%
Employer Contributions $0 $0 0.0%
Participant Contributions $0 $0 0.0%
Other Contributions $-112 $-137 -18.25%
General Investments $27,425 $5,593 390.35%
Interest-bearing cash $27,425 $5,593 390.35%
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 $0 $0 0.0%
Value of interest in common/collective trusts $0 $0 0.0%
Value of interest in pooled separate accounts $1,703,137 $1,249,671 36.29%
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 $129,806 $115,638 12.25%
Other Investments $0 $0 0.0%
Employer-related Investments $0 $0 0.0%
Employer Securities $0 $0 0.0%
Employer Real Property $0 $0 0.0%
Buildings and other property used in plan operation $0 $0 0.0%
Total Liabilities $0 $0 0.0%
Benefit Claims Payable (1) $0 $0 0.0%
Operating Payables (1) $0 $0 0.0%
Acquisition Indebtedness (1) $0 $0 0.0%
Other liabilities (1) $0 $0 0.0%
Net Assets $1,860,256 $1,370,811 35.70%

Service Providers

Service Providers

Name Nature of Service Relationship to Plan Sponsor Gross Salary or Allowances Paid by Plan Fees and Commissions Paid by Plan Total Salary/Fees
John Hancock USA Contract Administrator $0 $9,925 $9,925
Total $0 $9,925 $9,925

Investments

Investments

Name of Investment Investment Manager Type of Investment Dollar Value
John Hancock (USA) John Hancock Life Insurance Co USA DFE: Pooled Separate Account $1,730,562
Total $1,730,562

Insurance Information

Insurance Information

Insurance Carrier Summary Persons Covered
John Hancock Life Insurance Company U.S.A. 128
EIN 01-0233346
Industry Code 65838
Contract Number 61913
Contract Year 01/01/2006 — 12/31/2006
Value in General Account at Year End $129,806
Value in Separate Accounts at Year End $1,730,562
Insurance Fees and Commissions $5,137
Persons Receiving Commissions and Fees
Agent/Broker Organization Code Commissions Paid Fees Paid Purpose of Fees Paid
Kms Financial Services, Inc. 869 NW Wall Street, Suite 204 BEND, OR 97701 Insurance Agent or Broker $4,323 $0
Pension Planners Northwest 71 Centennial Loop,Suite G Eugene, OR 97401 Insurance Agent or Broker $0 $814 THIRD PARTY ADMINISTRATOR
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 Guaranteed Investment
Balance at the end of the previous year $115,638
Additions $14,930
Contributions Deposited during the year $12,123
Dividends and credits $0
Interest credited during the year $2,807
Transferred from separate account $0
Other $0
Total of Balance and Additions $130,568
Deductions $762
Disbursed from fund to pay benefits or purchase annuities during the year $0
Administration charge made by carrier $762
Transferred to Separate Account $0
Other $0
Balance at the end of the current year $129,806