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[X]
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ANNUAL REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
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For the fiscal year ended
December 31, 2014
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[ ]
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TRANSITION REPORT UNDER SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
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Colorado
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34-1720075
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(State or other jurisdiction of incorporation or organization)
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(I.R.S. Employer Identification No.)
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4120 Boardman-Canfield Road, Canfield, Ohio
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44406
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(Address of principal executive offices)
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(Zip Code)
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Large accelerated filer
☐
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Accelerated filer
☐
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Non-accelerated filer
☐
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Smaller reporting company
☑
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PART I
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Page
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Item 1.
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Business
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2
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Item 1A.
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Risk Factors
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13
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Item 1B.
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Unresolved Staff Comments
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14
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Item 2.
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Properties
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14
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Item 3.
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Legal Proceedings
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14
|
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Item 4.
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Mine Safety Disclosures
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14
|
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PART II
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||
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Item 5.
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Market for Registrant's Common Equity, Related Stockholder Matters and Issuer Purchases of Equity Securities
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15
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Item 6.
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Selected Financial Data
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15
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Item 7.
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Management's Discussion and Analysis of Financial Condition and Results of Operations
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16
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Item 7A.
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Quantitative and Qualitative Disclosures about Market Risk
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17
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Item 8.
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Financial Statements and Supplementary Data
|
17
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Item 9.
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Changes in and Disagreements With Accountants on Accounting and Financial Disclosure
|
19
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Item 9A.
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Controls and Procedures
|
19
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Item 9B.
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Other Information
|
19
|
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PART III
|
||
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Item 10.
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Directors, Executive Officers and Corporate Governance
|
20
|
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Item 11.
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Executive Compensation
|
21
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Item 12.
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Security Ownership of Certain Beneficial Owners and Management and Related Stockholder Matters
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22
|
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Item 13.
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Certain Relationships and Related Transactions and Director Independence
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22
|
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Item 14.
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Principal Accounting Fees and Services
|
23
|
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PART IV
|
||
|
Item 15.
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Exhibits, Financial Statement Schedules
|
24
|
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Signatures
|
25
|
|
| 1. | Providing in-home delivery, set-up, and maintenance of equipment; |
| 2. | Providing patients and caregivers with written instructions about home safety, self-care, and the proper use of equipment; |
| 3. | Processing claims to third-party payors and billing/collecting patient co-pays and deductibles. |
| 1. | Electric wheelchairs, scooters, and lift chairs |
| 2. | Manual wheelchairs and ambulatory equipment, such as wheeled walkers, canes, and crutches; |
| 3. | Hospital beds; |
| 4. | Bathroom equipment, such as bedside commodes, shower chairs, grab bars, and toilet risers; |
| 5. | Support surfaces, such as pressure pads and mattresses, for patients at risk for developing pressure sores or decubitus ulcers; |
| 6. | Threshold ramps, folding ramps, and lift systems for cars or vans that make it easy to exit the home or transport electric wheelchairs or scooters. |
| December 31, | ||||||||
| 2014 | 2013 | |||||||
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Medicare
|
22
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%
|
39
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%
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||||
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Medicaid
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20
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%
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23
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%
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Private pay/private insurance
|
41 | % |
33
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%
|
||||
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Other
|
17 | % |
5
|
%
|
||||
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Total
|
100 | % |
100
|
%
|
||||
| 1. | Reputation with referral sources, including local physicians and hospital-based professionals; |
| 2. | Price of products and services; |
| 3. | Accessibility and overall ease of doing business; |
| 4. | Quality of patient care and associated services; |
| 5. | Range of home healthcare products and services; |
| 6. | Ability to provide local maintenance service on products sold. |
| ● | Medical Necessity & Other Documentation Requirements . In order to ensure that Medicare beneficiaries only receive medically necessary and appropriate items and services, the Medicare program has adopted a number of documentation requirements. For example, the DME MAC Supplier Manuals provide that clinical information from the "patient's medical record" is required to justify the initial and ongoing medical necessity for the provision of DME. Some DME MACs, CMS staff and government subcontractors have taken the position, among other things, that the "patient's medical record" refers not to documentation maintained by the DME supplier but instead to documentation maintained by the patient's physician, healthcare facility or other clinician, and that clinical information created by the DME supplier's personnel and confirmed by the patient's physician is not sufficient to establish medical necessity. It may be difficult, and sometimes impossible, for us to obtain documentation from other healthcare providers. Moreover, auditors' interpretations of these policies are inconsistent and subject to individual interpretation. This is then translated to individual supplier significant error rates and aggregated into a DMEPOS industry error rate, which is significantly higher than other Medicare provider/supplier types. High error rates lead to further audit activity and regulatory burdens. In fact, DME MACs have continued to conduct extensive pre-payment reviews across the DME industry and have determined a wide range of error rates. For example, error rates for CPAP claims have ranged from 50% to 80%. DME MACs have repeatedly cited medical necessity documentation insufficiencies as the primary reason for claim denials. If these or other burdensome positions are generally adopted by auditors, DME MACs, other contractors or CMS in administering the Medicare program, we would have the right to challenge these positions as being contrary to law. If these interpretations of the documentation requirements are ultimately upheld, however, it could result in our making significant refunds and other payments to Medicare and our future revenues from Medicare may be significantly reduced. We have adjusted certain operational policies to address the current expectations of Medicare and its contractors. We cannot predict the adverse impact, if any, these interpretations of the Medicare documentation requirements or our revised policies might have on our operations, cash flow, and capital resources, but such impact could be material. |
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Page
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REPORT OF INDEPENDENT REGISTERED PUBLIC ACCOUNTING FIRM
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F-1
|
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REPORT OF INDEPENDENT REGISTERED PUBLIC ACCOUNTING FIRM
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F-2
|
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FINANCIAL STATEMENTS
|
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Balance Sheets
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F-3
|
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Statements of Operations
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F-4
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Statements of Changes in Stockholders' Deficit
|
F-5
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Statements of Cash Flows
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F-6
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Notes to Financial Statements
|
F-7 - F-15
|
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CANFIELD MEDICAL SUPPLY, INC.
|
||||||||
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BALANCE SHEETS
|
||||||||
|
December 31,
|
December 31,
|
|||||||
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ASSETS
|
2014
|
2013
|
||||||
|
(Restated)
|
||||||||
|
Current Assets
|
||||||||
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Cash
|
$
|
24,908
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$
|
669
|
||||
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Accounts receivable
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80,183
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58,647
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||||||
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Inventory
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14,314
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12,542
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||||||
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Total Current Assets
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119,405
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71,858
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||||||
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Equipment, net of accumulated depreciation of $24,465 and $1,912
|
47,309
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23,857
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||||||
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Total Assets
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$
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166,714
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$
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95,715
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||||
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LIABILITIES AND STOCKHOLDERS' EQUITY (DEFICIT)
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||||||||
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Current Liabilities
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||||||||
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Accounts payable and accrued liabilities
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$
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71,275
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$
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43,043
|
||||
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Related party notes payable
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-
|
8,500
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||||||
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Line of credit
|
80,252
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82,500
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||||||
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Current portion of long-term debt
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7,053
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3,537
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||||||
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Total Current Liabilities
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158,580
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137,580
|
||||||
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Long-term debt
|
28,772
|
17,784
|
||||||
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Total Liabilities
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187,352
|
155,364
|
||||||
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Stockholders' Equity (Deficit)
|
||||||||
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Preferred stock, no par value; 5,000,000 shares authorized;
|
||||||||
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no shared issued and outstanding
|
-
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-
|
||||||
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Common stock, no par value; 100,000,000 shares
|
||||||||
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authorized; 10,027,200 (2014) and 9,750,800 (2013) shares issued and outstanding
|
118,515
|
49,415
|
||||||
|
Accumulated deficit
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(139,153
|
)
|
(109,064
|
)
|
||||
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Total Stockholders' Equity (Deficit)
|
(20,638
|
)
|
(59,649
|
)
|
||||
|
Total Liabilities and Stockholders' Equity (Deficit)
|
$
|
166,714
|
$
|
95,715
|
||||
|
CANFIELD MEDICAL SUPPLY, INC.
|
||||||||
|
STATEMENTS OF OPERATIONS
|
||||||||
|
Year Ended
|
Year Ended
|
|||||||
|
December 31, 2014
|
December 31, 2013
|
|||||||
|
(Restated)
|
||||||||
|
Sales (net of returns)
|
$
|
605,905
|
$
|
475,254
|
||||
|
Cost of goods sold
|
256,060
|
236,270
|
||||||
|
Gross profit
|
349,845
|
238,984
|
||||||
|
Operating expenses:
|
||||||||
|
Salaries and wages
|
179,235
|
97,299
|
||||||
|
Professional fees
|
33,757
|
42,145
|
||||||
|
Depreciation
|
28,093
|
1,912
|
||||||
|
Other selling, general and administrative
|
136,638
|
97,010
|
||||||
|
Total operating expenses
|
377,723
|
238,366
|
||||||
|
Income (loss) from operations
|
(27,878
|
)
|
618
|
|||||
|
Other income (expense):
|
||||||||
|
Interest expense
|
(3,923
|
)
|
(3,860
|
)
|
||||
|
Gain on disposal of fixed assets
|
1,712
|
-
|
||||||
|
(2,211
|
)
|
(3,860
|
)
|
|||||
|
Income (loss) before provision for income taxes
|
(30,089
|
)
|
(3,242
|
)
|
||||
|
Provision for income tax
|
-
|
-
|
||||||
|
Net income (loss)
|
$
|
(30,089
|
)
|
$
|
(3,242
|
)
|
||
|
Net income (loss) per share (basic and fully diluted)
|
$
|
(0.00
|
)
|
$
|
(0.00
|
)
|
||
|
Weighted average number of common shares outstanding
|
9,953,587
|
9,601,379
|
||||||
|
CANFIELD MEDICAL SUPPLY, INC.
|
||||||||||||||||
|
STATEMENTS OF STOCKHOLDERS' EQUITY (DEFICIT)
|
||||||||||||||||
|
Common Stock (No Par)
|
Accumulated
|
Stockholders'
|
||||||||||||||
|
Shares (1)
|
Amount
|
Deficit
|
Equity (Deficit)
|
|||||||||||||
|
Balances at December 31, 2012
|
9,500,000
|
$
|
15,500
|
$
|
(105,822
|
)
|
$
|
(90,322
|
)
|
|||||||
|
Sales of common stock
|
250,800
|
33,915
|
-
|
33,915
|
||||||||||||
|
Net income (loss) for the year (Restated)
|
-
|
-
|
(3,242
|
)
|
(3,242
|
)
|
||||||||||
|
Balances at December 31, 2013 (Restated)
|
9,750,800
|
$
|
49,415
|
$
|
(109,064
|
)
|
$
|
(59,649
|
)
|
|||||||
|
Sales of common stock
|
276,400
|
69,100
|
-
|
69,100
|
||||||||||||
|
Net income (loss) for the year
|
-
|
-
|
(30,089
|
)
|
(30,089
|
)
|
||||||||||
|
Balances at December 31, 2014
|
10,027,200
|
$
|
118,515
|
$
|
(139,153
|
)
|
$
|
(20,638
|
)
|
|||||||
|
CANFIELD MEDICAL SUPPLY, INC.
|
||||||||
|
STATEMENTS OF CASH FLOWS
|
||||||||
|
December 31,
|
December 31,
|
|||||||
|
2014
|
2013
|
|||||||
|
(Restated)
|
||||||||
|
Cash Flows From Operating Activities:
|
||||||||
|
Net income (loss)
|
$
|
(30,089
|
)
|
$
|
(3,242
|
)
|
||
|
Adjustments to reconcile net loss to net cash provided by
|
||||||||
|
(used for) operating activities:
|
||||||||
|
Gain on disposal of fixed assets
|
(1,712
|
)
|
-
|
|||||
|
Depreciation
|
28,093
|
1,912
|
||||||
|
Changes in current assets and liabilities:
|
||||||||
|
Increase in accounts receivable
|
(21,536
|
)
|
(44,188
|
)
|
||||
|
Increase in inventory
|
(1,772
|
)
|
(12,542
|
)
|
||||
|
Increase in accounts payable and accrued liabilities
|
28,232
|
22,410
|
||||||
|
Net cash provided by (used for) operating activities
|
1,216
|
(35,650
|
)
|
|||||
|
Cash Flows From Investing Activities:
|
||||||||
|
Purchase of property and equipment
|
(30,387
|
)
|
-
|
|||||
|
Net cash (used for) investing activities
|
(30,387
|
)
|
-
|
|||||
|
Cash Flows From Financing Activities:
|
||||||||
|
Net payments on line of credit
|
(2,248
|
)
|
(3,000
|
)
|
||||
|
Proceeds from notes payable, related parties
|
-
|
8,500
|
||||||
|
Payments on notes payable, related parties
|
(8,500
|
)
|
(6,000
|
)
|
||||
|
Payments on long-term debt
|
(4,942
|
)
|
(4,448
|
)
|
||||
|
Proceeds from sales of common stock.
|
69,100
|
33,915
|
||||||
|
Net cash provided by financing activities
|
53,410
|
28,967
|
||||||
|
Net Increase (Decrease) in Cash
|
24,239
|
(6,683
|
)
|
|||||
|
Cash At The Beginning Of The Period
|
669
|
7,352
|
||||||
|
Cash At The End Of The Period
|
$
|
24,908
|
$
|
669
|
||||
|
Schedule Of Non-Cash Investing And Financing Activities
|
||||||||
|
Purchase of equipment with long-term debt
|
$
|
19,446
|
$
|
25,769
|
||||
|
Supplemental Disclosure
|
||||||||
|
Cash paid for interest
|
$
|
5,460
|
$
|
3,860
|
||||
|
Cash paid for income taxes
|
$
|
-
|
$
|
-
|
||||
| December 31, | ||||||||
| 2014 | 2013 | |||||||
|
Medicare
|
22
|
%
|
39
|
%
|
||||
|
Medicaid
|
20
|
%
|
23
|
%
|
||||
|
Private pay/private insurance
|
41 | % |
33
|
%
|
||||
|
Other
|
17 | % |
5
|
%
|
||||
|
Total
|
100 | % |
100
|
%
|
||||
|
December 31,
|
||||||||
|
2014
|
2013
|
|||||||
|
Rent
|
$
|
27,492
|
$
|
27,492
|
||||
|
Office expenses
|
57,539 |
50,914
|
||||||
|
Other SG&A
|
51,607
|
18,604
|
||||||
|
Total
|
$
|
136,638
|
$
|
97,010
|
||||
|
December 31,
|
||||||||
| 2014 |
2013
|
|||||||
|
Office equipment
|
$
|
2,934
|
$
|
2,934
|
||||
|
Vehicles
|
42,282
|
22,835
|
||||||
|
Wheelchair rental pool
|
26,558
|
-
|
||||||
|
Total property and equipment
|
71,774
|
25,769
|
||||||
|
Accumulated depreciation
|
(24,465
|
)
|
(1,912
|
)
|
||||
|
Net property and equipment
|
$
|
47,309
|
$
|
23,857
|
||||
|
|
Office equipment
|
7 yeas
|
|
|
Vehicles
|
5 years
|
|
|
Wheelchair rental pool
|
13 months
|
|
December 31,
|
||||||||
|
2014
|
2013
|
|||||||
|
3.53% installment note payable $352 monthly, including interest, through July 2019, collateralized by vehicle
|
$
|
17,870
|
$
|
21,321
|
||||
|
2.99% installment note payable $350 monthly, including interest,through August 2019, collateralized by vehicle
|
17,955
|
-
|
||||||
|
35,825
|
21,321
|
|||||||
|
Less principal due within one year
|
(7,053
|
)
|
(3,537
|
)
|
||||
|
TOTAL LONG-TERM DEBT
|
$
|
28,772
|
$
|
17,784
|
||||
|
Principal payments due on long-term debt subsequent to December 31, 2014, are as follows:
|
||||
|
2015
|
$
|
7,053
|
||
|
2016
|
7,603
|
|||
|
2017
|
7,853
|
|||
|
2018
|
8,111
|
|||
|
2019
|
5,205
|
|||
|
TOTAL
|
$
|
35,825
|
||
|
Amount As Originally Filed
|
Restatement adjustment
|
Restated Amount
|
||||||||||
|
As of December 31, 2013
|
||||||||||||
|
Accounts receivable
|
$
|
30,921
|
$
|
27,726
|
$
|
58,647
|
||||||
|
Accumulated deficit
|
(136,790
|
)
|
27,726
|
(109,064
|
)
|
|||||||
|
Year ended December 31, 2013
|
||||||||||||
|
Revenue
|
447,528
|
27,726
|
475,254
|
|||||||||
|
Gross profit
|
211,258
|
27,726
|
238,984
|
|||||||||
|
Loss from operations
|
(27,108
|
)
|
27,726
|
618
|
||||||||
|
Net loss
|
(30,968
|
)
|
27,726
|
(3,242
|
)
|
|||||||
|
Net loss per share
|
$
|
0.00
|
$
|
0.00
|
$
|
0.00
|
||||||
|
Weighted Ave Shares
|
9,601,379
|
9,601,379
|
||||||||||
|
Name and Address
|
Age
|
Position(s)
|
||
|
Michael J. West
4120 Boardman-Canfield Road
Canfield, OH 44406
|
61
|
President, Chief Executive Officer and Director
|
||
|
Stephen H. West
16325 E. Dorado Ave.
Centennial, CO 80045
|
59
|
Chief Financial Officer, Secretary and Director
|
|
Name and Principal Position
|
Year
|
Salary
($)
|
Bonus
($)
|
Stock
Awards($)
|
Option
Awards($)
|
Non-Equity
Incentive Plan
Compensation
($)
|
Nonqualified
Deferred
Compensation
Earnings($)
|
All Other
Compensation
($)
|
Total($)
|
|||||||||||||||||||||||||
|
Michael West
|
2014
|
$
|
67,750
|
-
|
-
|
-
|
-
|
-
|
-
|
$
|
67,500
|
|||||||||||||||||||||||
|
|
2013 |
$
|
45,000
|
-
|
-
|
-
|
-
|
-
|
-
|
$
|
45,000
|
|||||||||||||||||||||||
|
Steve West
|
2014
|
$ |
-
|
-
|
-
|
-
|
-
|
-
|
-
|
$
|
- | |||||||||||||||||||||||
|
|
2013 | $ |
-
|
-
|
-
|
-
|
-
|
-
|
-
|
$
|
-
|
|||||||||||||||||||||||
|
Name and Address of Beneficial Owner
|
Beneficial
Ownership
|
Approximate
Percent Owned
|
||
|
Michael J. West
4120 Boardman-Canfield Road
Canfield, OH 44406
|
8,344,000
|
79.3%
|
||
|
Stephen H. West
16325 East Dorado Avenue
Centennial, CO 80015
|
300,000
|
2.9%
|
||
|
All Officers and Directors as a group
(2 persons)
|
8,644,000
|
82.2%
|
|
Name
|
Amount
|
Security
|
Due Date
|
|||
|
Michael J. West
|
$1,000
|
125,000 shares
|
August 24, 2013
|
|||
|
Stephen H. West
|
$2,500
|
10,000 shares
|
September 11, 2014
|
|
|
|
CANFIELD MEDICAL SUPPLY, INC.
(Registrant)
|
|
|
|
|
|
|
|
|
|
Date: September 19, 2016
|
|
By:
/s/ Michael J. West
|
|
|
|
Name: Michael J. West
Title: President and CEO (Principal Executive Officer)
|
|
|
|
|
|
|
|
|
|
Date: September 19, 2016
|
|
By:
/s/ Stephen H. West
|
|
|
|
Name: Stephen H. West
Title: Chief Financial Officer,
(Principal Financial and Principal Accounting Officer)
|
|
Name
|
Title
|
Date
|
|
|
|
|
|
|
|
/s/ Michael J. West
|
President, CEO (Principal Executive
|
September 19, 2016
|
|
|
Michael J. West
|
Officer) and Director
|
|
|
|
|
|
|
|
|
|
|
|
|
|
/s/ Stephen H. West
|
Chief Financial Officer (Principal
|
September 19, 2016
|
|
|
Stephen H. West
|
Financial and Principal Accounting
|
|
|
|
|
Officer) and Director
|
|
|
Exhibit
Number
|
Description
|
|
Articles of Incorporation and Bylaws
|
|
|
3.1
|
Articles of Incorporation (incorporated herein by reference to Exhibit 3.1 filed with Form S-1 filed with the SEC on July 12, 2012)
|
|
3.2
|
Bylaws (incorporated by reference herein to Exhibit 3.2 filed with Form S-1 filed with the SEC on July 12, 2012)
|
|
31.1
|
Certification by CEO (filed herewith electronically)
|
|
31.2
|
Certification by CFO (filed herewith electronically)
|
|
32.1
|
Certification of CEO pursuant to 18. U.S.C. Section 1350 as adopted, pursuant to Section 906 of Sarbanes-Oxley Act of 2002 (filed herewith electronically)
|
|
32.2
|
Certification of CFO pursuant to 18. U.S.C. Section 1350 as adopted, pursuant to Section 906 of Sarbanes-Oxley Act of 2002 (filed herewith electronically)
|
|
101
|
XBRL
|
No information found
* THE VALUE IS THE MARKET VALUE AS OF THE LAST DAY OF THE QUARTER FOR WHICH THE 13F WAS FILED.
| FUND | NUMBER OF SHARES | VALUE ($) | PUT OR CALL |
|---|
| DIRECTORS | AGE | BIO | OTHER DIRECTOR MEMBERSHIPS |
|---|
No information found
No Customers Found
No Suppliers Found
Price
Yield
| Owner | Position | Direct Shares | Indirect Shares |
|---|