Annual Return/Report of Employee Benefit Plan

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1 Form 5500 Department of the Treasury Internal Revenue Servie Department of Labor Employee Benefits Seurity Administration Pension Benefit Guaranty Corporation Annual Return/Report of Employee Benefit Plan This form is required to be filed for employee benefit plans under setions 104 and 4065 of the Employee Retirement Inome Seurity At of 1974 (ERISA) and setions 6057(b) and 6058(a) of the Internal Revenue Code (the Code). Complete all entries in aordane with the instrutions to the Form OMB Nos This Form is Open to Publi Inspetion Part I Annual Report Identifiation Information For alendar plan year 2016 or fisal plan year beginning 02/01/2016 and ending 01/31/2017 A X a multiemployer plan X a multiple-employer plan (Filers heking this box must attah a list of This return/report is for: partiipating employer information in aordane with the form instrutions.) X a single-employer plan X a DFE (speify) _C_ B This return/report is: X the first return/report X the final return/report X an amended return/report X a short plan year return/report (less than 12 months) C If the plan is a olletively-bargained plan, hek here X D Chek box if filing under: X Form 5558 X automati extension X the DFVC program X speial extension (enter desription) ABCDE Part II Basi Plan Information enter all requested information 1a Name of plan CENTRAL PENSION FUND OF THE IUOE & PARTICIPATING EMPLOYERS 2a Plan sponsor s name (employer, if for a single-employer plan) Mailing address (inlude room, apt., suite no. and street, or P.O. Box) City or town, state or provine, ountry, and ZIP or foreign postal ode (if foreign, see instrutions) BOARD OF TRUSTEES OF THE CPF OF THE IUOE AND PARTICIPATING EMPLOYERS D/B/A 4115 /o CHESAPEAKE STREET, NW WASHINGTON, DC ABCDE ABCDE CITYEFGHI AB, ST UK Caution: A penalty for the late or inomplete filing of this return/report will be assessed unless reasonable ause is established. 1b Three-digit plan number (PN) Effetive date of plan YYYY-MM-DD 09/07/1960 2b Employer Identifiation Number (EIN) Plan Sponsor s telephone number d Business ode (see instrutions) Under penalties of perjury and other penalties set forth in the instrutions, I delare that I have examined this return/report, inluding aompanying shedules, statements and attahments, as well as the eletroni version of this return/report, and to the best of my knowledge and belief, it is true, orret, and omplete. SIGN HERE Filed with authorized/valid eletroni signature. YYYY-MM-DD 10/11/2017 JAMES T. CALLAHAN-UNION TRUSTEE ABCDE Signature of plan administrator Date Enter name of individual signing as plan administrator SIGN HERE YYYY-MM-DD ABCDE Signature of employer/ Date Enter name of individual signing as employer or SIGN YYYY-MM-DD ABCDE HERE Signature of DFE Date Enter name of individual signing as DFE Preparer s name (inluding firm name, if appliable) and address (inlude room or suite number) Preparer s telephone number For Paperwork Redution At Notie, see the Instrutions for Form Form 5500 (2016) v

2 Form 5500 (2016) Page 2 3a Plan administrator s name and address X Same as Plan Sponsor /o ABCDE ABCDE CITYEFGHI AB, ST UK 4 If the name and/or EIN of the has hanged sine the last return/report filed for this plan, enter the name, EIN and the plan number from the last return/report: a Sponsor s name 3b Administrator s EIN Administrator s telephone number b EIN PN Total number of partiipants at the beginning of the plan year Number of partiipants as of the end of the plan year unless otherwise stated (welfare plans omplete only lines 6a(1), 6a(2), 6b, 6, and 6d). a(1) Total number of ative partiipants at the beginning of the plan year... 6a(1) a(2) Total number of ative partiipants at the end of the plan year... 6a(2) b Retired or separated partiipants reeiving benefits... 6b Other retired or separated partiipants entitled to future benefits d Subtotal. Add lines 6a(2), 6b, and d e Deeased partiipants whose benefiiaries are reeiving or are entitled to reeive benefits.... 6e f Total. Add lines 6d and 6e.... 6f g Number of partiipants with aount balanes as of the end of the plan year (only defined ontribution plans omplete this item)... 6g h Number of partiipants that terminated employment during the plan year with arued benefits that were less than 100% vested... 6h Enter the total number of employers obligated to ontribute to the plan (only multiemployer plans omplete this item) a If the plan provides pension benefits, enter the appliable pension feature odes from the List of Plan Charateristis Codes in the instrutions: 1A b If the plan provides welfare benefits, enter the appliable welfare feature odes from the List of Plan Charateristis Codes in the instrutions: 9a Plan funding arrangement (hek all that apply) 9b Plan benefit arrangement (hek all that apply) (1) X Insurane (1) X Insurane (2) X Code setion 412(e)(3) insurane ontrats (2) X Code setion 412(e)(3) insurane ontrats (3) X Trust (3) X Trust (4) X General assets of the sponsor (4) X General assets of the sponsor 10 Chek all appliable boxes in 10a and 10b to indiate whih shedules are attahed, and, where indiated, enter the number attahed. (See instrutions) a Pension Shedules (1) X R (Retirement Plan Information) (2) X MB (Multiemployer Defined Benefit Plan and Certain Money Purhase Plan Atuarial Information) - signed by the plan atuary (3) X SB (Single-Employer Defined Benefit Plan Atuarial Information) - signed by the plan atuary b General Shedules (1) X H (Finanial Information) (2) X I (Finanial Information Small Plan) (3) X 1 A (Insurane Information) (4) X C (Servie Provider Information) (5) X D (DFE/Partiipating Plan Information) (6) X G (Finanial Transation Shedules)

3 Form 5500 (2016) Page 3 Part III Form M-1 Compliane Information (to be ompleted by welfare benefit plans) 11a If the plan provides welfare benefits, was the plan subjet to the Form M-1 filing requirements during the plan year? (See instrutions and 29 CFR ) X Yes X No If Yes is heked, omplete lines 11b and b Is the plan urrently in ompliane with the Form M-1 filing requirements? (See instrutions and 29 CFR )... X Yes 11 Enter the Reeipt Confirmation Code for the 2016 Form M-1 annual report. If the plan was not required to file the 2016 Form M-1 annual report, enter the Reeipt Confirmation Code for the most reent Form M-1 that was required to be filed under the Form M-1 filing requirements. (Failure to enter a valid Reeipt Confirmation Code will subjet the Form 5500 filing to rejetion as inomplete.) Reeipt Confirmation Code X No

4 SCHEDULE MB (Form 5500) Department of the Treasury Internal Revenue Servie Department of Labor Employee Benefits Seurity Administration Pension Benefit Guaranty Corporation Multiemployer Defined Benefit Plan and Certain Money Purhase Plan Atuarial Information This shedule is required to be filed under setion 104 of the Employee Retirement Inome Seurity At of 1974 (ERISA) and setion 6059 of the Internal Revenue Code (the Code). File as an attahment to Form 5500 or 5500-SF. For alendar plan year 2016 or fisal plan year beginning 02/01/2016 and ending 01/31/2017 Round off amounts to nearest dollar. OMB No This Form is Open to Publi Inspetion Caution: A penalty of $1,000 will be assessed for late filing of this report unless reasonable ause is established. A Name of plan B Three-digit CENTRAL PENSION FUND OF THE IUOE & PARTICIPATING EMPLOYERS plan number (PN) C Plan sponsor s name as shown on line 2a of Form 5500 or 5500-SF BOARD OF TRUSTEES OF THE CPF OF THE IUOE AND PARTICIPATING EMPLOYERS D Employer Identifiation Number (EIN) E Type of plan: (1) X Multiemployer Defined Benefit (2) X Money Purhase (see instrutions) 1a Enter the valuation date: Month 02 Day 01 Year 2016 b Assets (1) Current value of assets... 1b(1) (2) Atuarial value of assets for funding standard aount... 1b(2) (1) Arued liability for plan using immediate gain methods... 1(1) (2) Information for plans using spread gain methods: (a) Unfunded liability for methods with bases... 1(2)(a) (b) Arued liability under entry age normal method... 1(2)(b) () Normal ost under entry age normal method... 1(2)() (3) Arued liability under unit redit ost method... 1(3) d Information on urrent liabilities of the plan: (1) Amount exluded from urrent liability attributable to pre-partiipation servie (see instrutions)... 1d(1) (2) RPA 94 information: (a) Current liability... 1d(2)(a) (b) Expeted inrease in urrent liability due to benefits aruing during the plan year... 1d(2)(b) () Expeted release from RPA 94 urrent liability for the plan year... 1d(2)() (3) Expeted plan disbursements for the plan year... 1d(3) Statement by Enrolled Atuary To the best of my knowledge, the information supplied in this shedule and aompanying shedules, statements and attahments, if any, is omplete and aurate. Eah presribed assumption was applied in aordane with appliable law and regulations. In my opinion, eah other assumption is reasonable (taking into aount the experiene of the plan and reasonable expetations) and suh other assumptions, in ombination, offer my best estimate of antiipated experiene under the plan. SIGN HERE JONATHAN M. FELDMAN HORIZON ACTUARIAL SERVICES, LLC Signature of atuary Type or print name of atuary Firm name GEORGIA AVENUE, SUITE 700, SILVER SPRING, ABCDE MD ABCDE UK Address of the firm Date Most reent enrollment number /10/2017 Telephone number (inluding area ode) If the atuary has not fully refleted any regulation or ruling promulgated under the statute in ompleting this shedule, hek the box and see X instrutions For Paperwork Redution At Notie, see the Instrutions for Form 5500 or 5500-SF. Shedule MB (Form 5500) 2016 v

5 Shedule MB (Form 5500) 2016 Page x 2 Operational information as of beginning of this plan year: a Current value of assets (see instrutions) 2a b RPA 94 urrent liability/partiipant ount breakdown: (1) Number of partiipants (2) Current liability (1) For retired partiipants and benefiiaries reeiving payment (2) For terminated vested partiipants (3) For ative partiipants: (a) Non-vested benefits (b) Vested benefits () Total ative (4) Total If the perentage resulting from dividing line 2a by line 2b(4), olumn (2), is less than 70%, enter suh 2 perentage % Contributions made to the plan for the plan year by employer(s) and employees: (a) Date (MM-DD-YYYY) (b) Amount paid by employer(s) () Amount paid by employees (a) Date (MM-DD-YYYY) (b) Amount paid by employer(s) ) Amount paid by employees Totals 3(b) () 4 Information on plan status: a Funded perentage for monitoring plan s status (line 1b(2) divided by line 1(3))... 4a 94.0% b Enter ode to indiate plan s status (see instrutions for attahment of supporting evidene of plan s status). If ode is N, go to line 5.. 4b N Is the plan making the sheduled progress under any appliable funding improvement or rehabilitation plan?... X Yes X No d If the plan is in ritial status or ritial and delining status, were any benefits redued (see instrutions)?... X Yes X No e If line d is Yes, enter the redution in liability resulting from the redution in benefits (see instrutions), measured as of the valuation date... 4e f If the rehabilitation plan projets emergene from ritial status or ritial and delining status, enter the plan year in whih it is projeted to emerge. If the rehabilitation plan is based on forestalling possible insolveny, enter the plan year in whih insolveny is expeted and hek here... 4f 5 Atuarial ost method used as the basis for this plan year s funding standard aount omputations (hek all that apply): a e X Attained age normal X Frozen initial liability b f X Entry age normal X Individual level premium g X Arued benefit (unit redit) X Individual aggregate d h X Aggregate X Shortfall i X Other (speify): j If box h is heked, enter period of use of shortfall method... 5j YYYY-MM-DD k Has a hange been made in funding method for this plan year?... X Yes X No l If line k is Yes, was the hange made pursuant to Revenue Proedure or other automati approval?... X Yes X No m If line k is Yes, and line l is No, enter the date (MM-DD-YYYY) of the ruling letter (individual or lass) approving the hange in funding method... 5m YYYY-MM-DD

6 Shedule MB (Form 5500) 2016 Page x 6 Cheklist of ertain atuarial assumptions: a Interest rate for RPA 94 urrent liability.... 6a % 3.27 Pre-retirement Post-retirement b Rates speified in insurane or annuity ontrats... X Yes X No X N/A X Yes X No X N/A Mortality table ode for valuation purposes: (1) Males... 6(1) (2) Females... 6(2) d Valuation liability interest rate... 6d % % 7.75 e Expense loading... 6e % 5.0 X N/A % X N/A f Salary sale... 6f % X N/A g Estimated investment return on atuarial value of assets for year ending on the valuation date... 6g % 4.0 h Estimated investment return on urrent value of assets for year ending on the valuation date... 6h % New amortization bases established in the urrent plan year: (1) Type of base (2) Initial balane (3) Amortization Charge/Credit A A A 8 Misellaneous information: a If a waiver of a funding defiieny has been approved for this plan year, enter the date (MM-DD-YYYY) of 8a the ruling letter granting the approval... b(1) Is the plan required to provide a projetion of expeted benefit payments? (See the instrutions.) If Yes, attah a shedule.... b(2) Is the plan required to provide a Shedule of Ative Partiipant Data? (See the instrutions.) If Yes, attah a shedule.... Are any of the plan s amortization bases operating under an extension of time under setion 412(e) (as in effet prior to 2008) or setion 431(d) of the Code?... d If line is Yes, provide the following additional information: YYYY-MM-DD X Yes X No X Yes X No X Yes X No (1) Was an extension granted automati approval under setion 431(d)(1) of the Code?... X Yes X No (2) If line 8d(1) is Yes, enter the number of years by whih the amortization period was extended... 8d(2) 12 (3) Was an extension approved by the Internal Revenue Servie under setion 412(e) (as in effet prior to 2008) or 431(d)(2) of the Code?... X Yes X No (4) If line 8d(3) is Yes, enter number of years by whih the amortization period was extended (not inluding the number of years in line (2))... 8d(4) 12 (5) If line 8d(3) is Yes, enter the date of the ruling letter approving the extension... 8d(5) YYYY-MM-DD (6) If line 8d(3) is Yes, is the amortization base eligible for amortization using interest rates appliable under X Yes X No setion 6621(b) of the Code for years beginning after 2007?... e If box 5h is heked or line 8 is Yes, enter the differene between the minimum required ontribution for the year and the minimum that would have been required without using the shortfall method or 8e extending the amortization base(s)... 9 Funding standard aount statement for this plan year: Charges to funding standard aount: a Prior year funding defiieny, if any... 9a b Employer s normal ost for plan year as of valuation date... 9b Amortization harges as of valuation date: (1) All bases exept funding waivers and ertain bases for whih the amortization period has been extended... Outstanding balane 9(1) (2) Funding waivers... 9(2) (3) Certain bases for whih the amortization period has been extended... 9(3) d Interest as appliable on lines 9a, 9b, and d e Total harges. Add lines 9a through 9d... 9e F 6 6F

7 Shedule MB (Form 5500) 2016 Page 4 Credits to funding standard aount: f Prior year redit balane, if any... 9f g Employer ontributions. Total from olumn (b) of line g Outstanding balane h Amortization redits as of valuation date... 9h i Interest as appliable to end of plan year on lines 9f, 9g, and 9h... 9i j Full funding limitation (FFL) and redits: (1) ERISA FFL (arued liability FFL)... 9j(1) (2) RPA 94 override (90% urrent liability FFL)... 9j(2) (3) FFL redit... 9j(3) k (1) Waived funding defiieny... 9k(1) (2) Other redits... 9k(2) l Total redits. Add lines 9f through 9i, 9j(3), 9k(1), and 9k(2)... 9l m Credit balane: If line 9l is greater than line 9e, enter the differene... 9m n Funding defiieny: If line 9e is greater than line 9l, enter the differene... 9n 9 o Current year s aumulated reoniliation aount: (1) Due to waived funding defiieny aumulated prior to the 2016 plan year... 9o(1) (2) Due to amortization bases extended and amortized using the interest rate under setion 6621(b) of the Code: (a) Reoniliation outstanding balane as of valuation date... 9o(2)(a) (b) Reoniliation amount (line 9(3) balane minus line 9o(2)(a))... 9o(2)(b) (3) Total as of valuation date... 9o(3) 10 Contribution neessary to avoid an aumulated funding defiieny. (See instrutions.) Has a hange been made in the atuarial assumptions for the urrent plan year? If Yes, see instrutions..... X Yes X No

8 SCHEDULE D (Form 5500) Department of the Treasury Internal Revenue Servie Department of Labor Employee Benefits Seurity Administration DFE/Partiipating Plan Information This shedule is required to be filed under setion 104 of the Employee Retirement Inome Seurity At of 1974 (ERISA). File as an attahment to Form OMB No This Form is Open to Publi Inspetion. For alendar plan year 2016 or fisal plan year beginning 02/01/2016 and ending 01/31/2017 A Name of plan B Three-digit CENTRAL PENSION FUND OF THE IUOE & PARTICIPATING EMPLOYERS plan number (PN) C Plan or DFE sponsor s name as shown on line 2a of Form 5500 BOARD OF TRUSTEES OF THE CPF OF THE IUOE AND PARTICIPATING EMPLOYERS D Employer Identifiation Number (EIN) Part I Information on interests in MTIAs, CCTs, PSAs, and IEs (to be ompleted by plans and DFEs) (Complete as many entries as needed to report all interests in DFEs) a Name of MTIA, CCT, PSA, or IE: MSCI ACWI INDEX SL FUND (ZVC5) ABCD STATE STREET BANK AND TRUST COMPANY C ode IE at end of year (see instrutions) a Name of MTIA, CCT, PSA, or IE: INTERMEDIATE US CREDIT INDEX NL FD ABCD STATE STREET BANK AND TRUST COMPANY C ode IE at end of year (see instrutions) a Name of MTIA, CCT, PSA, or IE: US TOTAL MARKET INDEX NL FUND ABCD STATE STREET BANK AND TRUST COMPANY C ode IE at end of year (see instrutions) a Name of MTIA, CCT, PSA, or IE: PRISA ABCD PRUDENTIAL INSURANCE CO P ode IE at end of year (see instrutions) a Name of MTIA, CCT, PSA, or IE: US ASSET BACKED INDEX NL FUND ABCD STATE STREET BANK AND TRUST COMPANY C ode IE at end of year (see instrutions) a Name of MTIA, CCT, PSA, or IE: US COMMERCIAL MORTGAGE BACKED BOND ABCD STATE STREET BANK AND TRUST COMPANY d Entity C e Dollar value of interest in MTIA, CCT, PSA, or ode IE at end of year (see instrutions) a Name of MTIA, CCT, PSA, or IE: US MORTAGE BACKED INDEX NON-LENDIN ABCD STATE STREET BANK AND TRUST COMPANY d Entity C e Dollar value of interest in MTIA, CCT, PSA, or ode IE at end of year (see instrutions) For Paperwork Redution At Notie, see the Instrutions for Form Shedule D (Form 5500) 2016 v

9 Shedule D (Form 5500) 2016 Page 2-11 x a Name of MTIA, CCT, PSA, or IE: INTERMED US GOVT BOND INDEX NL FUND ABCD STATE STREET BANK AND TRUST COMPANY C ode IE at end of year (see instrutions) a Name of MTIA, CCT, PSA, or IE: ABCD ode IE at end of year (see instrutions) a Name of MTIA, CCT, PSA, or IE: ABCD ode IE at end of year (see instrutions) a Name of MTIA, CCT, PSA, or IE: ABCD ode IE at end of year (see instrutions) a Name of MTIA, CCT, PSA, or IE: ABCD ode IE at end of year (see instrutions) a Name of MTIA, CCT, PSA, or IE: ABCD ode IE at end of year (see instrutions) a Name of MTIA, CCT, PSA, or IE: ABCD ode IE at end of year (see instrutions) a Name of MTIA, CCT, PSA, or IE: ABCD ode IE at end of year (see instrutions) a Name of MTIA, CCT, PSA, or IE: ABCD ode IE at end of year (see instrutions) a Name of MTIA, CCT, PSA, or IE: ABCD ode IE at end of year (see instrutions)

10 6 Shedule D (Form 5500) 2016 Page 3-1 x Part II Information on Partiipating Plans (to be ompleted by DFEs) (Complete as many entries as needed to report all partiipating plans)

11 SCHEDULE H (Form 5500) Department of the Treasury Internal Revenue Servie Department of Labor Employee Benefits Seurity Administration Finanial Information This shedule is required to be filed under setion 104 of the Employee Retirement Inome Seurity At of 1974 (ERISA), and setion 6058(a) of the Internal Revenue Code (the Code). OMB No Pension Benefit Guaranty Corporation File as an attahment to Form This Form is Open to Publi Inspetion For alendar plan year 2016 or fisal plan year beginning 02/01/2016 and ending 01/31/2017 A Name of plan B Three-digit CENTRAL PENSION FUND OF THE IUOE & PARTICIPATING EMPLOYERS plan number (PN) C Plan sponsor s name as shown on line 2a of Form 5500 D Employer Identifiation Number (EIN) BOARD OF TRUSTEES OF THE CPF OF THE IUOE AND PARTICIPATING EMPLOYERS Part I Asset and Liability Statement 1 Current value of plan assets and liabilities at the beginning and end of the plan year. Combine the value of plan assets held in more than one trust. Report the value of the plan s interest in a ommingled fund ontaining the assets of more than one plan on a line-by-line basis unless the value is reportable on lines 1(9) through 1(14). Do not enter the value of that portion of an insurane ontrat whih guarantees, during this plan year, to pay a speifi dollar benefit at a future date. Round off amounts to the nearest dollar. MTIAs, CCTs, PSAs, and IEs do not omplete lines 1b(1), 1b(2), 1(8), 1g, 1h, and 1i. CCTs, PSAs, and IEs also do not omplete lines 1d and 1e. See instrutions. Assets (a) Beginning of Year (b) End of Year a Total noninterest-bearing ash... 1a b Reeivables (less allowane for doubtful aounts): (1) Employer ontributions... 1b(1) (2) Partiipant ontributions... 1b(2) (3) Other... 1b(3) General investments: (1) Interest-bearing ash (inlude money market aounts & ertifiates of deposit)... 1(1) (2) U.S. Government seurities... 1(2) (3) Corporate debt instruments (other than employer seurities): (A) Preferred... 1(3)(A) (B) All other... 1(3)(B) (4) Corporate stoks (other than employer seurities): (A) Preferred... 1(4)(A) (B) Common... 1(4)(B) (5) Partnership/joint venture interests... 1(5) (6) Real estate (other than employer real property)... 1(6) (7) Loans (other than to partiipants)... 1(7) (8) Partiipant loans... 1(8) (9) Value of interest in ommon/olletive trusts... 1(9) (10) Value of interest in pooled separate aounts... 1(10) (11) Value of interest in master trust investment aounts... 1(11) (12) Value of interest in investment entities... 1(12) (13) Value of interest in registered investment ompanies (e.g., mutual funds)... 1(13) (14) Value of funds held in insurane ompany general aount (unalloated ontrats)... 1(14) (15) Other... 1(15) For Paperwork Redution At Notie, see the Instrutions for Form Shedule H (Form 5500) 2016 v

12 Shedule H (Form 5500) 2016 Page 2 1d Employer-related investments: (a) Beginning of Year (b) End of Year (1) Employer seurities... 1d(1) (2) Employer real property... 1d(2) 1e Buildings and other property used in plan operation... 1e f Total assets (add all amounts in lines 1a through 1e)... 1f Liabilities 1g Benefit laims payable... 1g 1h Operating payables... 1h i Aquisition indebtedness... 1i j Other liabilities... 1j k Total liabilities (add all amounts in lines 1g through1j)... 1k Net Assets 1l Net assets (subtrat line 1k from line 1f)... 1l Part II Inome and Expense Statement 2 Plan inome, expenses, and hanges in net assets for the year. Inlude all inome and expenses of the plan, inluding any trust(s) or separately maintained fund(s) and any payments/reeipts to/from insurane arriers. Round off amounts to the nearest dollar. MTIAs, CCTs, PSAs, and IEs do not omplete lines 2a, 2b(1)(E), 2e, 2f, and 2g. Inome (a) Amount (b) Total a Contributions: (1) Reeived or reeivable in ash from: (A) Employers... 2a(1)(A) (B) Partiipants... 2a(1)(B) (C) Others (inluding rollovers)... 2a(1)(C) (2) Nonash ontributions... 2a(2) (3) Total ontributions. Add lines 2a(1)(A), (B), (C), and line 2a(2)... 2a(3) b Earnings on investments: (1) Interest: (A) Interest-bearing ash (inluding money market aounts and ertifiates of deposit)... 2b(1)(A) (B) U.S. Government seurities... 2b(1)(B) (C) Corporate debt instruments... 2b(1)(C) (D) Loans (other than to partiipants)... 2b(1)(D) (E) Partiipant loans... 2b(1)(E) (F) Other... 2b(1)(F) (G) Total interest. Add lines 2b(1)(A) through (F)... 2b(1)(G) (2) Dividends: (A) Preferred stok... 2b(2)(A) (B) Common stok... 2b(2)(B) (C) Registered investment ompany shares (e.g. mutual funds)... 2b(2)(C) (D) Total dividends. Add lines 2b(2)(A), (B), and (C) 2b(2)(D) (3) Rents... 2b(3) (4) Net gain (loss) on sale of assets: (A) Aggregate proeeds... 2b(4)(A) (B) Aggregate arrying amount (see instrutions)... 2b(4)(B) (C) Subtrat line 2b(4)(B) from line 2b(4)(A) and enter result... 2b(4)(C) (5) Unrealized appreiation (depreiation) of assets: (A) Real estate... 2b(5)(A) (B) Other... 2b(5)(B) (C) Total unrealized appreiation of assets. Add lines 2b(5)(A) and (B)... 2b(5)(C)

13 Shedule H (Form 5500) 2016 Page 3 (a) Amount (b) Total (6) Net investment gain (loss) from ommon/olletive trusts... 2b(6) (7) Net investment gain (loss) from pooled separate aounts... 2b(7) (8) Net investment gain (loss) from master trust investment aounts... 2b(8) (9) Net investment gain (loss) from investment entities... 2b(9) (10) Net investment gain (loss) from registered investment ompanies (e.g., mutual funds)... 2b(10) Other inome d Total inome. Add all inome amounts in olumn (b) and enter total... 2d Expenses e Benefit payment and payments to provide benefits: (1) Diretly to partiipants or benefiiaries, inluding diret rollovers... 2e(1) (2) To insurane arriers for the provision of benefits... 2e(2) (3) Other... 2e(3) (4) Total benefit payments. Add lines 2e(1) through (3)... 2e(4) f Corretive distributions (see instrutions)... 2f g Certain deemed distributions of partiipant loans (see instrutions)... 2g h Interest expense... 2h i Administrative expenses: (1) Professional fees... 2i(1) (2) Contrat administrator fees... 2i(2) (3) Investment advisory and management fees... 2i(3) (4) Other... 2i(4) (5) Total administrative expenses. Add lines 2i(1) through (4)... 2i(5) j Total expenses. Add all expense amounts in olumn (b) and enter total... 2j Net Inome and Reoniliation k Net inome (loss). Subtrat line 2j from line 2d... 2k l Transfers of assets: (1) To this plan... 2l(1) (2) From this plan... 2l(2) Part III Aountant s Opinion 3 Complete lines 3a through 3 if the opinion of an independent qualified publi aountant is attahed to this Form Complete line 3d if an opinion is not attahed. a The attahed opinion of an independent qualified publi aountant for this plan is (see instrutions): (1) X Unqualified (2) X Qualified (3) X Dislaimer (4) X Adverse b Did the aountant perform a limited sope audit pursuant to 29 CFR and/or (d)? X Yes X No Enter the name and EIN of the aountant (or aounting firm) below: (1) Name: CALIBRE CPA GROUP, PLLC ABCD (2) EIN: d The opinion of an independent qualified publi aountant is not attahed beause: (1) X This form is filed for a CCT, PSA, or MTIA. (2) X It will be attahed to the next Form 5500 pursuant to 29 CFR Part IV Compliane Questions 4 CCTs and PSAs do not omplete Part IV. MTIAs, IEs, and GIAs do not omplete lines 4a, 4e, 4f, 4g, 4h, 4k, 4m, 4n, or IEs also do not omplete lines 4j and 4l. MTIAs also do not omplete line 4l. a b During the plan year: Yes No Amount Was there a failure to transmit to the plan any partiipant ontributions within the time period desribed in 29 CFR ? Continue to answer Yes for any prior year failures until fully orreted. (See instrutions and DOL s Voluntary Fiduiary Corretion Program.)... Were any loans by the plan or fixed inome obligations due the plan in default as of the lose of the plan year or lassified during the year as unolletible? Disregard partiipant loans seured by partiipant s aount balane. (Attah Shedule G (Form 5500) Part I if Yes is heked.)... 4a 4b X X

14 d Shedule H (Form 5500) 2016 Page 4-1 x Yes No Amount Were any leases to whih the plan was a party in default or lassified during the year as unolletible? (Attah Shedule G (Form 5500) Part II if Yes is heked.)... 4 X Were there any nonexempt transations with any party-in-interest? (Do not inlude transations reported on line 4a. Attah Shedule G (Form 5500) Part III if Yes is heked.)... 4d X e Was this plan overed by a fidelity bond?... 4e X f Did the plan have a loss, whether or not reimbursed by the plan s fidelity bond, that was aused by fraud or dishonesty?... 4f X g h Did the plan hold any assets whose urrent value was neither readily determinable on an established market nor set by an independent third party appraiser?... 4g X Did the plan reeive any nonash ontributions whose value was neither readily determinable on an established market nor set by an independent third party appraiser?... 4h X i Did the plan have assets held for investment? (Attah shedule(s) of assets if Yes is heked, and see instrutions for format requirements.)... 4i X j Were any plan transations or series of transations in exess of 5% of the urrent value of plan assets? (Attah shedule of transations if Yes is heked, and see instrutions for format requirements.)... 4j X k Were all the plan assets either distributed to partiipants or benefiiaries, transferred to another plan, or brought under the ontrol of the PBGC?... 4k X l Has the plan failed to provide any benefit when due under the plan?... 4l X m If this is an individual aount plan, was there a blakout period? (See instrutions and 29 CFR )... 4m n If 4m was answered Yes, hek the Yes box if you either provided the required notie or one of the exeptions to providing the notie applied under 29 CFR n o Defined Benefit Plan or Money Purhase Pension Plan Only: Were any distributions made during the plan year to an employee who attained age 62 and had not separated from servie?... 4o 5a Has a resolution to terminate the plan been adopted during the plan year or any prior plan year? If Yes, enter the amount of any plan assets that reverted to the employer this year... X Yes X No Amount:- 5b If, during this plan year, any assets or liabilities were transferred from this plan to another plan(s), identify the plan(s) to whih assets or liabilities were transferred. (See instrutions.) 5b(1) Name of plan(s) 5b(2) EIN(s) 5b(3) PN(s) If the plan is a defined benefit plan, is it overed under the PBGC insurane program (See ERISA setion 4021.)?... X Yes X No X Not determined If Yes is heked, enter the My PAA onfirmation number from the PBGC premium filing for this plan year (See instrutions.) Part V Trust Information 6a Name of trust 6b Trust s EIN 6 Name of trustee or ustodian 6d Trustee s or ustodian s telephone number

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