Qliance Bankruptcy 1ww4b

5/17/18 4:51PM

Fill in this information to identify your case: United States Bankruptcy Court for the: WESTERN DISTRICT OF WASHINGTON Case number (if known)

Chapter

7 Check if this an amended filing

Official Form 201

Voluntary Petition for Non-Individuals Filing for Bankruptcy

4/16

If more space is needed, attach a separate sheet to this form. On the top of any additional pages, write the debtor's name and case number (if known). For more information, a separate document, Instructions for Bankruptcy Forms for Non-Individuals, is available.

1.

Debtor's name

2.

All other names debtor used in the last 8 years Include any assumed names, trade names and doing business as names

Qliance Management Inc.

Qliance

3.

Debtor's federal Employer Identification Number (EIN)

81-1559010

4.

Debtor's address

Principal place of business

Mailing address, if different from principal place of business

1915 2nd Ave. #1002 Seattle, WA 98101 Number, Street, City, State & ZIP Code

P.O. Box, Number, Street, City, State & ZIP Code

King

Location of principal assets, if different from principal place of business

County

Number, Street, City, State & ZIP Code

5.

Debtor's website (URL)

6.

Type of debtor

Corporation (including Limited Liability Company (LLC) and Limited Liability Partnership (LLP)) Partnership (excluding LLP) Other. Specify:

Official Form 201

Voluntary Petition for Non-Individuals Filing for Bankruptcy

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Debtor

Case number (if known)

Qliance Management Inc. Name

7.

Describe debtor's business

A. Check one: Health Care Business (as defined in 11 U.S.C. § 101(27A)) Single Asset Real Estate (as defined in 11 U.S.C. § 101(51B)) Railroad (as defined in 11 U.S.C. § 101(44)) Stockbroker (as defined in 11 U.S.C. § 101(53A)) Commodity Broker (as defined in 11 U.S.C. § 101(6)) Clearing Bank (as defined in 11 U.S.C. § 781(3)) None of the above B. Check all that apply Tax-exempt entity (as described in 26 U.S.C. §501) Investment company, including hedge fund or pooled investment vehicle (as defined in 15 U.S.C. §80a-3) Investment advisor (as defined in 15 U.S.C. §80b-2(a)(11)) C. NAICS (North American Industry Classification System) 4-digit code that best describes debtor. See http://www.uscourts.gov/four-digit-national-association-naics-codes.

6211 8.

Under which chapter of the Bankruptcy Code is the debtor filing?

Check one: Chapter 7 Chapter 9 Chapter 11. Check all that apply: Debtor's aggregate noncontingent liquidated debts (excluding debts owed to insiders or s) are less than $2,566,050 (amount subject to adjustment on 4/01/19 and every 3 years after that). The debtor is a small business debtor as defined in 11 U.S.C. § 101(51D). If the debtor is a small business debtor, attach the most recent balance sheet, statement of operations, cash-flow statement, and federal income tax return or if all of these documents do not exist, follow the procedure in 11 U.S.C. § 1116(1)(B). A plan is being filed with this petition. Acceptances of the plan were solicited prepetition from one or more classes of creditors, in accordance with 11 U.S.C. § 1126(b). The debtor is required to file periodic reports (for example, 10K and 10Q) with the Securities and Exchange Commission according to § 13 or 15(d) of the Securities Exchange Act of 1934. File the attachment to Voluntary Petition for Non-Individuals Filing for Bankruptcy under Chapter 11 (Official Form 201A) with this form. The debtor is a shell company as defined in the Securities Exchange Act of 1934 Rule 12b-2. Chapter 12

9.

Were prior bankruptcy cases filed by or against the debtor within the last 8 years?

No. Yes.

If more than 2 cases, attach a separate list.

10. Are any bankruptcy cases pending or being filed by a business partner or an of the debtor? List all cases. If more than 1, attach a separate list

Official Form 201

District

When

Case number

District

When

Case number

No Yes.

Debtor

Qliance Medical Group of WA PC

Relationship

District

Western District WA Seattle

Case number, if known

When

5/17/18

Voluntary Petition for Non-Individuals Filing for Bankruptcy

Case 18-11999-CMA

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Debtor

Case number (if known)

Qliance Management Inc. Name

11. Why is the case filed in this district?

Check all that apply: Debtor has had its domicile, principal place of business, or principal assets in this district for 180 days immediately preceding the date of this petition or for a longer part of such 180 days than in any other district. A bankruptcy case concerning debtor's , general partner, or partnership is pending in this district.

12. Does the debtor own or have possession of any real property or personal property that needs immediate attention?

No Yes.

Answer below for each property that needs immediate attention. Attach additional sheets if needed. Why does the property need immediate attention? (Check all that apply.) It poses or is alleged to pose a threat of imminent and identifiable hazard to public health or safety. What is the hazard? It needs to be physically secured or protected from the weather. It includes perishable goods or assets that could quickly deteriorate or lose value without attention (for example, livestock, seasonal goods, meat, dairy, produce, or securities-related assets or other options). Other Where is the property? Number, Street, City, State & ZIP Code Is the property insured? No Insurance agency

Yes.

name Phone

Statistical and istrative information 13. Debtor's estimation of available funds

.

Check one: Funds will be available for distribution to unsecured creditors. After any istrative expenses are paid, no funds will be available to unsecured creditors.

14. Estimated number of creditors

1-49 50-99 100-199 200-999

1,000-5,000 5001-10,000 10,001-25,000

25,001-50,000 50,001-100,000 More than100,000

15. Estimated Assets

$0 - $50,000 $50,001 - $100,000 $100,001 - $500,000 $500,001 - $1 million

$1,000,001 - $10 million $10,000,001 - $50 million $50,000,001 - $100 million $100,000,001 - $500 million

$500,000,001 - $1 billion $1,000,000,001 - $10 billion $10,000,000,001 - $50 billion More than $50 billion

16. Estimated liabilities

$0 - $50,000 $50,001 - $100,000 $100,001 - $500,000 $500,001 - $1 million

$1,000,001 - $10 million $10,000,001 - $50 million $50,000,001 - $100 million $100,000,001 - $500 million

$500,000,001 - $1 billion $1,000,000,001 - $10 billion $10,000,000,001 - $50 billion More than $50 billion

Official Form 201

Voluntary Petition for Non-Individuals Filing for Bankruptcy

Case 18-11999-CMA

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Debtor

Case number (if known)

Qliance Management Inc. Name

Request for Relief, Declaration, and Signatures WARNING -- Bankruptcy fraud is a serious crime. Making a false statement in connection with a bankruptcy case can result in fines up to $500,000 or imprisonment for up to 20 years, or both. 18 U.S.C. §§ 152, 1341, 1519, and 3571. 17. Declaration and signature of authorized representative of debtor

The debtor requests relief in accordance with the chapter of title 11, United States Code, specified in this petition. I have been authorized to file this petition on behalf of the debtor. I have examined the information in this petition and have a reasonable belief that the information is trued and correct. I declare under penalty of perjury that the foregoing is true and correct. Executed on

May 17, 2018 MM / DD / YYYY

X

/s/ Erika Bliss

Erika Bliss

Signature of authorized representative of debtor

Printed name

Title

18. Signature of attorney

X

CEO

/s/ Catherine J. Reny

Date May 17, 2018 MM / DD / YYYY

Signature of attorney for debtor

Catherine J. Reny 43058 Printed name

Wenokur Riordan PLLC Firm name

600 Stewart St Suite 1300 Seattle, WA 98101 Number, Street, City, State & ZIP Code phone

206-492-7084

Email address

[email protected]

43058 WA Bar number and State

Official Form 201

Voluntary Petition for Non-Individuals Filing for Bankruptcy

Case 18-11999-CMA

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Fill in this information to identify the case: Debtor name

Qliance Management Inc.

United States Bankruptcy Court for the:

WESTERN DISTRICT OF WASHINGTON

Case number (if known) Check if this is an amended filing

Official Form 202

Declaration Under Penalty of Perjury for Non-Individual Debtors

12/15

An individual who is authorized to act on behalf of a non-individual debtor, such as a corporation or partnership, must sign and submit this form for the schedules of assets and liabilities, any other document that requires a declaration that is not included in the document, and any amendments of those documents. This form must state the individual’s position or relationship to the debtor, the identity of the document, and the date. Bankruptcy Rules 1008 and 9011. WARNING -- Bankruptcy fraud is a serious crime. Making a false statement, concealing property, or obtaining money or property by fraud in connection with a bankruptcy case can result in fines up to $500,000 or imprisonment for up to 20 years, or both. 18 U.S.C. §§ 152, 1341, 1519, and 3571.

Declaration and signature I am the president, another officer, or an authorized agent of the corporation; a member or an authorized agent of the partnership; or another individual serving as a representative of the debtor in this case. I have examined the information in the documents checked below and I have a reasonable belief that the information is true and correct: Schedule A/B: Assets–Real and Personal Property (Official Form 206A/B) Schedule D: Creditors Who Have Claims Secured by Property (Official Form 206D) Schedule E/F: Creditors Who Have Unsecured Claims (Official Form 206E/F) Schedule G: Executory Contracts and Unexpired Leases (Official Form 206G) Schedule H: Codebtors (Official Form 206H) Summary of Assets and Liabilities for Non-Individuals (Official Form 206Sum) Amended Schedule Chapter 11 or Chapter 9 Cases: List of Creditors Who Have the 20 Largest Unsecured Claims and Are Not Insiders (Official Form 204) Other document that requires a declaration I declare under penalty of perjury that the foregoing is true and correct. Executed on

X /s/ Erika Bliss Signature of individual g on behalf of debtor

May 17, 2018

Erika Bliss Printed name

CEO Position or relationship to debtor

Official Form 202

Declaration Under Penalty of Perjury for Non-Individual Debtors

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Case 18-11999-CMA

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Fill in this information to identify the case: Debtor name

Qliance Management Inc.

United States Bankruptcy Court for the:

WESTERN DISTRICT OF WASHINGTON

Case number (if known) Check if this is an amended filing

Official Form 206Sum Summary of Assets and Liabilities for Non-Individuals Part 1: 1.

Summary of Assets

Schedule A/B: Assets-Real and Personal Property (Official Form 206A/B) 1a. Real property: Copy line 88 from Schedule A/B.............................................................................................................................

$

0.00

1b. Total personal property: Copy line 91A from Schedule A/B.........................................................................................................................

$

8,100.00

1c. Total of all property: Copy line 92 from Schedule A/B...........................................................................................................................

$

8,100.00

$

113,586.00

3a. Total claim amounts of priority unsecured claims: Copy the total claims from Part 1 from line 5a of Schedule E/F..........................................................................

$

216,115.49

3b. Total amount of claims of nonpriority amount of unsecured claims: Copy the total of the amount of claims from Part 2 from line 5b of Schedule E/F................................................

+$

1,349,812.86

Part 2:

Summary of Liabilities

2.

Schedule D: Creditors Who Have Claims Secured by Property (Official Form 206D) Copy the total dollar amount listed in Column A, Amount of claim, from line 3 of Schedule D....................................

3.

Schedule E/F: Creditors Who Have Unsecured Claims (Official Form 206E/F)

4.

12/15

Total liabilities ....................................................................................................................................................... Lines 2 + 3a + 3b

Official Form 206Sum

1,679,514.35

Summary of Assets and Liabilities for Non-Individuals

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Case 18-11999-CMA

$

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Fill in this information to identify the case: Debtor name

Qliance Management Inc.

United States Bankruptcy Court for the:

WESTERN DISTRICT OF WASHINGTON

Case number (if known) Check if this is an amended filing

Official Form 206A/B Schedule A/B: Assets - Real and Personal Property

12/15

Disclose all property, real and personal, which the debtor owns or in which the debtor has any other legal, equitable, or future interest. Include all property in which the debtor holds rights and powers exercisable for the debtor's own benefit. Also include assets and properties which have no book value, such as fully depreciated assets or assets that were not capitalized. In Schedule A/B, list any executory contracts or unexpired leases. Also list them on Schedule G: Executory Contracts and Unexpired Leases (Official Form 206G). Be as complete and accurate as possible. If more space is needed, attach a separate sheet to this form. At the top of any pages added, write the debtor’s name and case number (if known). Also identify the form and line number to which the additional information applies. If an additional sheet is attached, include the amounts from the attachment in the total for the pertinent part. For Part 1 through Part 11, list each asset under the appropriate category or attach separate ing schedules, such as a fixed asset schedule or depreciation schedule, that gives the details for each asset in a particular category. List each asset only once. In valuing the debtor’s interest, do not deduct the value of secured claims. See the instructions to understand the used in this form. Part 1: Cash and cash equivalents 1. Does the debtor have any cash or cash equivalents? No. Go to Part 2. Yes Fill in the information below. All cash or cash equivalents owned or controlled by the debtor

Part 2:

Current value of debtor's interest

Deposits and Prepayments

6. Does the debtor have any deposits or prepayments? No. Go to Part 3. Yes Fill in the information below.

Part 3:

s receivable

10. Does the debtor have any s receivable? No. Go to Part 4. Yes Fill in the information below. 11.

s receivable

0.00

11b. Over 90 days old: face amount

12.

0.00 =....

-

Unknown

doubtful or uncollectible s

Total of Part 3.

$0.00

Current value on lines 11a + 11b = line 12. Copy the total to line 82. Part 4:

Investments

13. Does the debtor own any investments? No. Go to Part 5. Yes Fill in the information below.

Part 5:

Inventory, excluding agriculture assets

18. Does the debtor own any inventory (excluding agriculture assets)?

Official Form 206A/B

Schedule A/B Assets - Real and Personal Property

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Debtor

Qliance Management Inc.

Case number (If known)

Name

No. Go to Part 6. Yes Fill in the information below.

Part 6:

Farming and fishing-related assets (other than titled motor vehicles and land)

27. Does the debtor own or lease any farming and fishing-related assets (other than titled motor vehicles and land)? No. Go to Part 7. Yes Fill in the information below.

Part 7:

Office furniture, fixtures, and equipment; and collectibles

38. Does the debtor own or lease any office furniture, fixtures, equipment, or collectibles? No. Go to Part 8. Yes Fill in the information below. General description

Net book value of debtor's interest (Where available)

39.

Office furniture

40.

Office fixtures

41.

Office equipment, including all computer equipment and communication systems equipment and software

2 Monitors 2 Servers 15 Switches Back up server power vault Microsoft Windows Server 2012 Dell Server Cabinet

$21,337.66

42.

Collectibles Examples: Antiques and figurines; paintings, prints, or other artwork; books, pictures, or other art objects; china and crystal; stamp, coin, or baseball card collections; other collections, memorabilia, or collectibles

43.

Total of Part 7. Add lines 39 through 42. Copy the total to line 86.

44.

Is a depreciation schedule available for any of the property listed in Part 7?

Valuation method used for current value

Current value of debtor's interest

Liquidation

$8,100.00

$8,100.00

No Yes 45.

Has any of the property listed in Part 7 been appraised by a professional within the last year? No Yes

Part 8:

Machinery, equipment, and vehicles

46. Does the debtor own or lease any machinery, equipment, or vehicles? No. Go to Part 9. Yes Fill in the information below.

Part 9:

Real property

54. Does the debtor own or lease any real property? No. Go to Part 10. Yes Fill in the information below.

Official Form 206A/B

Schedule A/B Assets - Real and Personal Property

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Debtor

Qliance Management Inc.

Case number (If known)

Name

Part 10:

Intangibles and intellectual property

59. Does the debtor have any interests in intangibles or intellectual property? No. Go to Part 11. Yes Fill in the information below.

Part 11:

All other assets

70. Does the debtor own any other assets that have not yet been reported on this form? Include all interests in executory contracts and unexpired leases not previously reported on this form. No. Go to Part 12. Yes Fill in the information below. Current value of debtor's interest

71.

Notes receivable Description (include name of obligor)

72.

Tax refunds and unused net operating losses (NOLs) Description (for example, federal, state, local)

73.

Interests in insurance policies or annuities

74.

Causes of action against third parties (whether or not a lawsuit has been filed)

Gregory Stean, et al for 2017 New Horizon/NH Acquisition debt settlement scam, theft/embezzlement/fraud of Medicaid and other funds Nature of claim theft/embezzlement/fraud Amount requested $0.00

75.

Other contingent and unliquidated claims or causes of action of every nature, including counterclaims of the debtor and rights to set off claims

76.

Trusts, equitable or future interests in property

77.

Other property of any kind not already listed Examples: Season tickets, country club hip

78.

Total of Part 11.

Unknown

$0.00

Add lines 71 through 77. Copy the total to line 90. 79.

Has any of the property listed in Part 11 been appraised by a professional within the last year? No Yes

Official Form 206A/B

Schedule A/B Assets - Real and Personal Property

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Debtor

Qliance Management Inc.

Case number (If known)

Name

Part 12:

Summary

In Part 12 copy all of the totals from the earlier parts of the form Type of property

Current value of personal property

80. Cash, cash equivalents, and financial assets. Copy line 5, Part 1

$0.00

81. Deposits and prepayments. Copy line 9, Part 2.

$0.00

82. s receivable. Copy line 12, Part 3.

$0.00

83. Investments. Copy line 17, Part 4.

$0.00

84. Inventory. Copy line 23, Part 5.

$0.00

85. Farming and fishing-related assets. Copy line 33, Part 6.

$0.00

86. Office furniture, fixtures, and equipment; and collectibles. Copy line 43, Part 7.

Current value of real property

$8,100.00

87. Machinery, equipment, and vehicles. Copy line 51, Part 8.

$0.00

88. Real property. Copy line 56, Part 9.........................................................................................> 89. Intangibles and intellectual property. Copy line 66, Part 10. 90. All other assets. Copy line 78, Part 11.

$0.00

$0.00 +

91. Total. Add lines 80 through 90 for each column

$0.00 $8,100.00

+ 91b.

92. Total of all property on Schedule A/B. Add lines 91a+91b=92

Official Form 206A/B

$8,100.00

Schedule A/B Assets - Real and Personal Property

Software Copyright (c) 1996-2018 Best Case, LLC - www.bestcase.com

Case 18-11999-CMA

$0.00

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Fill in this information to identify the case: Debtor name

Qliance Management Inc.

United States Bankruptcy Court for the:

WESTERN DISTRICT OF WASHINGTON

Case number (if known) Check if this is an amended filing

Official Form 206D Schedule D: Creditors Who Have Claims Secured by Property

12/15

Be as complete and accurate as possible. 1. Do any creditors have claims secured by debtor's property?

No. Check this box and submit page 1 of this form to the court with debtor's other schedules. Debtor has nothing else to report on this form. Yes. Fill in all of the information below. Part 1:

List Creditors Who Have Secured Claims

2. List in alphabetical order all creditors who have secured claims. If a creditor has more than one secured claim, list the creditor separately for each claim.

Column A

Column B

Amount of claim

Value of collateral that s this claim

Do not deduct the value of collateral.

2.1

Acme Company

Describe debtor's property that is subject to a lien

Creditor's Name

UCC #2017-070-2880-3: All s

$0.00

Unknown

Unknown

Unknown

64 Beaver St. Suite 344 New York, NY 10004 Describe the lien

Creditor's mailing address

UCC-1 Is the creditor an insider or related party? No Creditor's email address, if known

Yes Is anyone else liable on this claim?

Date debt was incurred

No Yes. Fill out Schedule H: Codebtors (Official Form 206H)

Last 4 digits of number As of the petition filing date, the claim is: Check all that apply

Do multiple creditors have an interest in the same property?

Contingent

No

Unliquidated

Yes. Specify each creditor, including this creditor and its relative priority.

2.2

Disputed

Corporation Service Company

Describe debtor's property that is subject to a lien

Creditor's Name

UCC #2017-068-2381-2: All assets

PO Box 2576 Springfield, IL 62708 Describe the lien

Creditor's mailing address

UCC-1 Is the creditor an insider or related party? No Creditor's email address, if known

Yes Is anyone else liable on this claim?

Date debt was incurred

No Yes. Fill out Schedule H: Codebtors (Official Form 206H)

Last 4 digits of number As of the petition filing date, the claim is: Check all that apply

Do multiple creditors have an interest in the same property?

Official Form 206D

Schedule D: Creditors Who Have Claims Secured by Property

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Debtor

Case number (if know)

Qliance Management Inc. Name

Contingent

No Yes. Specify each creditor, including this creditor and its relative priority.

2.3

Unliquidated Disputed

Crestmark Equipment Finance

Describe debtor's property that is subject to a lien

Creditor's Name

UCC-1 #2017-066-1631-5

$58,000.00

Unknown

$45,212.00

Unknown

$10,374.00

Unknown

40950 Woodward Ave. Suite 201 Bloomfield Hills, MI 48304-5127 Describe the lien

Creditor's mailing address

Is the creditor an insider or related party? No Creditor's email address, if known

Date debt was incurred

Yes Is anyone else liable on this claim? No Yes. Fill out Schedule H: Codebtors (Official Form 206H)

Last 4 digits of number Do multiple creditors have an interest in the same property?

Contingent

No Yes. Specify each creditor, including this creditor and its relative priority.

2.4

As of the petition filing date, the claim is: Check all that apply Unliquidated Disputed

New Era Lending, LLC

Describe debtor's property that is subject to a lien

Creditor's Name

UCC #2017-083-6501-3: future receivables; siezed $1795.00 personal acct ckd

1201 North Orange St. Suite 762 Wilmington, DE 19801

Describe the lien

Creditor's mailing address

UCC-1 Is the creditor an insider or related party? No Creditor's email address, if known

Date debt was incurred

Yes Is anyone else liable on this claim? No Yes. Fill out Schedule H: Codebtors (Official Form 206H)

Last 4 digits of number Do multiple creditors have an interest in the same property?

Contingent

No Yes. Specify each creditor, including this creditor and its relative priority.

2.5

As of the petition filing date, the claim is: Check all that apply Unliquidated Disputed

Saturn Funding LLC

Describe debtor's property that is subject to a lien

Creditor's Name

UCC #2017-069-2592-9: All assets

c/o MCA Servicing Attn: Steven Berkovitch 40 Exchange Pl. Ste 1306 New York, NY 10005 Describe the lien

Creditor's mailing address

UCC-1 Official Form 206D

page 2 of 3

Additional Page of Schedule D: Creditors Who Have Claims Secured by Property

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Debtor

Case number (if know)

Qliance Management Inc. Name

Is the creditor an insider or related party? No Creditor's email address, if known

Date debt was incurred

Yes Is anyone else liable on this claim? No Yes. Fill out Schedule H: Codebtors (Official Form 206H)

Last 4 digits of number Do multiple creditors have an interest in the same property?

Contingent

No Yes. Specify each creditor, including this creditor and its relative priority.

2.6

As of the petition filing date, the claim is: Check all that apply

Technology Finance Corporation Creditor's Name

7077 E. Marilyn Rd Bldg 3 Ste 125 Scottsdale, AZ 85254

Unliquidated Disputed

$0.00

Describe debtor's property that is subject to a lien

Unknown

UCC #2017-122-6370-1: All equipment and other personal property Describe the lien

Creditor's mailing address

UCC-1 Is the creditor an insider or related party? No Creditor's email address, if known

Date debt was incurred

Yes Is anyone else liable on this claim? No Yes. Fill out Schedule H: Codebtors (Official Form 206H)

Last 4 digits of number Do multiple creditors have an interest in the same property?

Contingent

No Yes. Specify each creditor, including this creditor and its relative priority.

3.

As of the petition filing date, the claim is: Check all that apply Unliquidated Disputed

Total of the dollar amounts from Part 1, Column A, including the amounts from the Additional Page, if any.

Part 2:

$113,586.00

List Others to Be Notified for a Debt Already Listed in Part 1

List in alphabetical order any others who must be notified for a debt already listed in Part 1. Examples of entities that may be listed are collection agencies, assignees of claims listed above, and attorneys for secured creditors. If no others need to notified for the debts listed in Part 1, do not fill out or submit this page. If additional pages are needed, copy this page. Name and address On which line in Part 1 did Last 4 digits of you enter the related creditor? number for this entity

ABF Servicing Attn: Steven Berkovitch 40 Exchange Place Suite 1306 New York, NY 10005 Saturn Funding, LLC 333 7th Avenue, Floor 3 New York, NY 10001

Official Form 206D

Line

2.4

Line

2.5

page 3 of 3

Additional Page of Schedule D: Creditors Who Have Claims Secured by Property

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Case 18-11999-CMA

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Fill in this information to identify the case: Debtor name

Qliance Management Inc.

United States Bankruptcy Court for the:

WESTERN DISTRICT OF WASHINGTON

Case number (if known) Check if this is an amended filing

Official Form 206E/F Schedule E/F: Creditors Who Have Unsecured Claims

12/15

Be as complete and accurate as possible. Use Part 1 for creditors with PRIORITY unsecured claims and Part 2 for creditors with NONPRIORITY unsecured claims. List the other party to any executory contracts or unexpired leases that could result in a claim. Also list executory contracts on Schedule A/B: Assets - Real and Personal Property (Official Form 206A/B) and on Schedule G: Executory Contracts and Unexpired Leases (Official Form 206G). Number the entries in Parts 1 and 2 in the boxes on the left. If more space is needed for Part 1 or Part 2, fill out and attach the Additional Page of that Part included in this form.

Part 1:

List All Creditors with PRIORITY Unsecured Claims

1. Do any creditors have priority unsecured claims? (See 11 U.S.C. § 507). No. Go to Part 2. Yes. Go to line 2. 2. List in alphabetical order all creditors who have unsecured claims that are entitled to priority in whole or in part. If the debtor has more than 3 creditors with priority unsecured claims, fill out and attach the Additional Page of Part 1. Total claim 2.1

Priority creditor's name and mailing address

As of the petition filing date, the claim is: Check all that apply.

Brenda Borja 4032 Evanston Avenue N Seattle, WA 98103

Priority amount

$2,484.69

$2,484.69

$29,218.36

$29,218.36

Contingent Unliquidated Disputed

Date or dates debt was incurred

Basis for the claim:

Last 4 digits of number

Is the claim subject to offset?

Specify Code subsection of PRIORITY unsecured claim: 11 U.S.C. § 507(a) (4)

No Yes

2.2

Priority creditor's name and mailing address

As of the petition filing date, the claim is: Check all that apply.

Cheryl Kilodavis 9512 4th Ave. NW Seattle, WA 98117

Contingent Unliquidated Disputed

Date or dates debt was incurred

Basis for the claim:

Last 4 digits of number

Is the claim subject to offset?

Specify Code subsection of PRIORITY unsecured claim: 11 U.S.C. § 507(a) (4)

No Yes

Official Form 206E/F

Schedule E/F: Creditors Who Have Unsecured Claims

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Debtor

Case number (if known)

Qliance Management Inc. Name

2.3

Priority creditor's name and mailing address

$1,347.61

As of the petition filing date, the claim is: Check all that apply.

Christopher Baumann 10130 Idaho Avenue Everett, WA 98204

$1,347.61

Contingent Unliquidated Disputed

Date or dates debt was incurred

Basis for the claim:

Last 4 digits of number

Is the claim subject to offset?

Specify Code subsection of PRIORITY unsecured claim: 11 U.S.C. § 507(a) (4)

No Yes

2.4

Priority creditor's name and mailing address

$982.94

$982.94

$483.87

Unknown

$171,590.38

Unknown

As of the petition filing date, the claim is: Check all that apply.

Dionee Hilaire 406 N. L Street Tacoma, WA 98403

Contingent Unliquidated Disputed

Date or dates debt was incurred

Basis for the claim:

Last 4 digits of number

Is the claim subject to offset?

Specify Code subsection of PRIORITY unsecured claim: 11 U.S.C. § 507(a) (4)

No Yes

2.5

Priority creditor's name and mailing address

As of the petition filing date, the claim is: Check all that apply.

Employment Security Department PO Box 34468 SEATTLE, WA 98124-1468

Contingent Unliquidated Disputed

Date or dates debt was incurred

Basis for the claim:

Last 4 digits of number

Is the claim subject to offset?

Specify Code subsection of PRIORITY unsecured claim: 11 U.S.C. § 507(a) (8)

No Yes

2.6

Priority creditor's name and mailing address

As of the petition filing date, the claim is: Check all that apply.

Internal Revenue Service PO Box 7346 Philadelphia, PA 19101-7346

Contingent Unliquidated Disputed

Date or dates debt was incurred

Basis for the claim:

Last 4 digits of number

Is the claim subject to offset?

Specify Code subsection of PRIORITY unsecured claim: 11 U.S.C. § 507(a) (8)

No Yes

Official Form 206 E/F

Schedule E/F: Creditors Who Have Unsecured Claims

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Debtor

Case number (if known)

Qliance Management Inc. Name

2.7

Priority creditor's name and mailing address

As of the petition filing date, the claim is: Check all that apply.

Kathryn DeHan 9212 227th Ave. East Buckley, WA 98321

$1,238.25

$1,238.25

Contingent Unliquidated Disputed

Date or dates debt was incurred

Basis for the claim:

Last 4 digits of number

Is the claim subject to offset?

Specify Code subsection of PRIORITY unsecured claim: 11 U.S.C. § 507(a) (4)

No Yes

2.8

Priority creditor's name and mailing address

As of the petition filing date, the claim is: Check all that apply.

LaFawn Smith 607 Williams Avenue South, #21 Renton, WA 98047

$859.00

$859.00

Contingent Unliquidated Disputed

Date or dates debt was incurred

Basis for the claim:

Last 4 digits of number

Is the claim subject to offset?

Specify Code subsection of PRIORITY unsecured claim: 11 U.S.C. § 507(a) (4)

No Yes

2.9

Priority creditor's name and mailing address

As of the petition filing date, the claim is: Check all that apply.

Meagan Batcheldor 18909 11 th Avenue Court E Spanaway, WA 98387

$1,514.01

$1,514.01

$3,382.22

Unknown

Contingent Unliquidated Disputed

Date or dates debt was incurred

Basis for the claim:

Last 4 digits of number

Is the claim subject to offset?

Specify Code subsection of PRIORITY unsecured claim: 11 U.S.C. § 507(a) (4)

No Yes

2.10

Priority creditor's name and mailing address

As of the petition filing date, the claim is: Check all that apply.

Pierce County Budget & Finance 950 Fawcett Ave, STE 100 Tacoma, WA 98402

Contingent Unliquidated Disputed

Date or dates debt was incurred

Basis for the claim:

Last 4 digits of number

Is the claim subject to offset?

Specify Code subsection of PRIORITY unsecured claim: 11 U.S.C. § 507(a) (8)

No Yes

Official Form 206 E/F

Schedule E/F: Creditors Who Have Unsecured Claims

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Debtor

Case number (if known)

Qliance Management Inc. Name

2.11

Priority creditor's name and mailing address

$2,133.66

As of the petition filing date, the claim is: Check all that apply.

Stephanie Bracamonte 4905 Narrow Way NE Saint Michael, MN 55376

$2,133.66

Contingent Unliquidated Disputed

Date or dates debt was incurred

Basis for the claim:

Last 4 digits of number

Is the claim subject to offset?

Specify Code subsection of PRIORITY unsecured claim: 11 U.S.C. § 507(a) (4)

No Yes

2.12

Priority creditor's name and mailing address

$880.50

As of the petition filing date, the claim is: Check all that apply.

Tanya Knight 27224 23rd Avenue S Federal Way, WA 98003

$880.50

Contingent Unliquidated Disputed

Date or dates debt was incurred

Basis for the claim:

Last 4 digits of number

Is the claim subject to offset?

Specify Code subsection of PRIORITY unsecured claim: 11 U.S.C. § 507(a) (4)

No Yes

2.13

Priority creditor's name and mailing address

Unknown

As of the petition filing date, the claim is: Check all that apply.

WA Dept of L&I PO Box 44171 Olympia, WA 98504-4171

Unknown

Contingent Unliquidated Disputed

Date or dates debt was incurred

Basis for the claim:

Last 4 digits of number 6949

Is the claim subject to offset? No

Specify Code subsection of PRIORITY unsecured claim: 11 U.S.C. § 507(a) (8)

Part 2:

Yes

List All Creditors with NONPRIORITY Unsecured Claims

3. List in alphabetical order all of the creditors with nonpriority unsecured claims. If the debtor has more than 6 creditors with nonpriority unsecured claims, fill out and attach the Additional Page of Part 2. Amount of claim 3.1

Nonpriority creditor's name and mailing address

2420 Union Avenue Co-Tenancy c/o Crawford & Katica 2915 North McCarver Tacoma, WA 98403

Contingent Unliquidated Disputed Basis for the claim:

Date(s) debt was incurred

3.2

$0.00

As of the petition filing date, the claim is: Check all that apply.

lease: 2420 South Union Ave., Suite 100, Tacoma

Last 4 digits of number

Is the claim subject to offset?

Nonpriority creditor's name and mailing address

As of the petition filing date, the claim is: Check all that apply.

Adam's Interpreting Services PO Box 6122 Bellevue, WA 98008

No

Yes

$0.00

Contingent Unliquidated Disputed

Date(s) debt was incurred

Basis for the claim:

Notice Only

Last 4 digits of number Is the claim subject to offset?

Official Form 206 E/F

No

Yes

Schedule E/F: Creditors Who Have Unsecured Claims

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Debtor

Case number (if known)

Qliance Management Inc. Name

3.3

Nonpriority creditor's name and mailing address

Aidarex Pharmaceuticals LLC 595 North Smith Street Corona, CA 92880

$0.00

As of the petition filing date, the claim is: Check all that apply. Contingent Unliquidated Disputed

Date(s) debt was incurred

Basis for the claim:

Notice Only

Last 4 digits of number Is the claim subject to offset? 3.4

Nonpriority creditor's name and mailing address

Airgas Inc. West Division 2349495 4401 Airport Way S Seattle, WA 98108

Yes

$0.00

As of the petition filing date, the claim is: Check all that apply. Contingent Unliquidated Disputed Basis for the claim:

Date(s) debt was incurred

3.5

No

Notice Only

Last 4 digits of number

Is the claim subject to offset?

Nonpriority creditor's name and mailing address

As of the petition filing date, the claim is: Check all that apply.

Alice Franck 6335 Wilson Avenue S Seattle, WA 98118

No

Yes

$0.00

Contingent Unliquidated Disputed

Date(s) debt was incurred

Basis for the claim:

Notice Only

Last 4 digits of number Is the claim subject to offset? 3.6

Nonpriority creditor's name and mailing address

All Phase Comm LLC 4209 21st Ave W #200 Seattle, WA 98199

No

Yes

$17,256.84

As of the petition filing date, the claim is: Check all that apply. Contingent Unliquidated Disputed

Date(s) debt was incurred

Basis for the claim:

Last 4 digits of number Is the claim subject to offset? 3.7

Nonpriority creditor's name and mailing address

Alston & Bird LLP 1201 West Peachtree St Suite 4900 Atlanta, GA 30309

$949.00

As of the petition filing date, the claim is: Check all that apply.

Unliquidated Disputed Basis for the claim:

Legal services

Last 4 digits of number

Is the claim subject to offset?

Nonpriority creditor's name and mailing address

As of the petition filing date, the claim is: Check all that apply.

Ann Thurley 1915 2nd Ave. #1002 Seattle, WA 98101

No

Yes

$10,585.00

Contingent Unliquidated Disputed

Date(s) debt was incurred

garnished bank SS funds ($5250); atty fees + filing fee Basis for the claim:

Last 4 digits of number

Is the claim subject to offset? 3.9

Yes

Contingent

Date(s) debt was incurred

3.8

No

Nonpriority creditor's name and mailing address

Bankers Healthcare Group, LLC 201 Solar Street Syracuse, NY 13204

No

Yes

$0.00

As of the petition filing date, the claim is: Check all that apply. Contingent Unliquidated Disputed

Date(s) debt was incurred

Basis for the claim:

Notice Only

Last 4 digits of number Is the claim subject to offset?

Official Form 206 E/F

No

Yes

Schedule E/F: Creditors Who Have Unsecured Claims

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Debtor

Case number (if known)

Qliance Management Inc. Name

3.10

Nonpriority creditor's name and mailing address

BeavEx, Inc. 6901 S 194th St Kent, WA 98032

$6,269.18

As of the petition filing date, the claim is: Check all that apply. Contingent Unliquidated Disputed

Date(s) debt was incurred

Basis for the claim:

Last 4 digits of number Is the claim subject to offset? 3.11

Nonpriority creditor's name and mailing address

Benjamin McLaughlin 7501 Greenwood Avenue N #306 Seattle, WA 98103

No

Yes

$0.00

As of the petition filing date, the claim is: Check all that apply. Contingent Unliquidated Disputed

Date(s) debt was incurred

Basis for the claim:

Notice Only

Last 4 digits of number Is the claim subject to offset? 3.12

Nonpriority creditor's name and mailing address

Carena, Inc PO Box 673 Seattle, WA 98111

No

Yes

$0.00

As of the petition filing date, the claim is: Check all that apply. Contingent Unliquidated Disputed

Date(s) debt was incurred

Basis for the claim:

Notice Only

Last 4 digits of number Is the claim subject to offset? 3.13

Nonpriority creditor's name and mailing address

Carol Radio 3805 206th Place NE Sammamish, WA 98074

No

Yes

$0.00

As of the petition filing date, the claim is: Check all that apply. Contingent Unliquidated Disputed

Date(s) debt was incurred

Basis for the claim:

Notice Only

Last 4 digits of number Is the claim subject to offset? 3.14

Nonpriority creditor's name and mailing address

Center for Diagnostic Imaging PO Box 94624 Seattle, WA 98124-6924

No

Yes

$0.00

As of the petition filing date, the claim is: Check all that apply. Contingent Unliquidated Disputed

Date(s) debt was incurred

Basis for the claim:

Notice Only

Last 4 digits of number Is the claim subject to offset? 3.15

Nonpriority creditor's name and mailing address

Cheryl Kilodavis 9512 4th Ave. NW Seattle, WA 98117

No

Yes

$3,000.00

As of the petition filing date, the claim is: Check all that apply. Contingent Unliquidated Disputed

Date(s) debt was incurred

Basis for the claim:

Payments made to Kent Station

Last 4 digits of number Is the claim subject to offset? 3.16

Nonpriority creditor's name and mailing address

Christopher Gaynor 6250 1st Avenue S Seattle, WA 98118

No

Yes

$0.00

As of the petition filing date, the claim is: Check all that apply. Contingent Unliquidated Disputed

Date(s) debt was incurred

Basis for the claim:

Notice Only

Last 4 digits of number Is the claim subject to offset?

Official Form 206 E/F

No

Yes

Schedule E/F: Creditors Who Have Unsecured Claims

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Debtor

Case number (if known)

Qliance Management Inc. Name

3.17

Nonpriority creditor's name and mailing address

CICS Employment Services, Inc. 1220 SW Morrision St. #505 Portland, OR 97205

As of the petition filing date, the claim is: Check all that apply.

$1,938.00

Contingent Unliquidated Disputed

Date(s) debt was incurred

Basis for the claim:

Last 4 digits of number Is the claim subject to offset? 3.18

Nonpriority creditor's name and mailing address

CIGNA Life Insurance Co. of NA Two Liberty Place 1601 Chestnut Street Philadelphia, PA 19192

As of the petition filing date, the claim is: Check all that apply.

$2,359.91

Unliquidated Disputed Basis for the claim:

Last 4 digits of number

Is the claim subject to offset?

Nonpriority creditor's name and mailing address

As of the petition filing date, the claim is: Check all that apply.

CIGNA Medical Insurance Two Liberty Place 1601 Chestnut Street Philadelphia, PA 19192

No

Yes

$34,435.44

Contingent Unliquidated Disputed Basis for the claim:

Date(s) debt was incurred

3.20

Yes

Contingent

Date(s) debt was incurred

3.19

No

Last 4 digits of number

Is the claim subject to offset?

Nonpriority creditor's name and mailing address

As of the petition filing date, the claim is: Check all that apply.

City of Lynnwood PO Box 5008 Lynnwood, WA 98046-5008

No

Yes

$847.00

Contingent Unliquidated Disputed

Date(s) debt was incurred

Basis for the claim:

Last 4 digits of number Is the claim subject to offset? 3.21

Nonpriority creditor's name and mailing address

Colo (Zayo Group) 4772 Walnut St. Suite 100 Boulder, CO 80301

No

Yes

As of the petition filing date, the claim is: Check all that apply.

$15,754.35

Contingent Unliquidated Disputed

Date(s) debt was incurred

Basis for the claim:

Last 4 digits of number Is the claim subject to offset? 3.22

Nonpriority creditor's name and mailing address

Colonial Life 245 4th St #206 Bremerton, WA 98337

No

Yes

$973.60

As of the petition filing date, the claim is: Check all that apply. Contingent Unliquidated Disputed

Date(s) debt was incurred

Basis for the claim:

Last 4 digits of number Is the claim subject to offset? 3.23

Nonpriority creditor's name and mailing address

Comcast Business PO Box 34744 Seattle, WA 98124-1744

Yes

As of the petition filing date, the claim is: Check all that apply.

$40,037.87

Contingent Unliquidated Disputed

Date(s) debt was incurred Last 4 digits of number

No

Basis for the claim:

6663

Official Form 206 E/F

Is the claim subject to offset?

No

Yes

Schedule E/F: Creditors Who Have Unsecured Claims

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Debtor

Case number (if known)

Qliance Management Inc. Name

3.24

Nonpriority creditor's name and mailing address

Concur 62157 Collections Center Drive Chicago, Il 60693

As of the petition filing date, the claim is: Check all that apply.

$2,301.56

Contingent Unliquidated Disputed

Date(s) debt was incurred

Basis for the claim:

Last 4 digits of number Is the claim subject to offset? 3.25

Nonpriority creditor's name and mailing address

Davis Wright Tremaine LLP 1201 3rd Ave Seattle, WA 98101

No

Yes

$640.00

As of the petition filing date, the claim is: Check all that apply. Contingent Unliquidated Disputed

Date(s) debt was incurred

Basis for the claim:

Legal services

Last 4 digits of number Is the claim subject to offset? 3.26

Nonpriority creditor's name and mailing address

Duo TEC 2960 4th Ave S #112 Seattle, WA 98134

No

Yes

$394.56

As of the petition filing date, the claim is: Check all that apply. Contingent Unliquidated Disputed

Date(s) debt was incurred

Basis for the claim:

Last 4 digits of number Is the claim subject to offset? 3.27

Nonpriority creditor's name and mailing address

Edward Gregory Stean 9900 W. Sample Rd. Ste. 300 Pompano Beach, FL 33065

No

Yes

$0.00

As of the petition filing date, the claim is: Check all that apply. Contingent Unliquidated Disputed

Date(s) debt was incurred

Basis for the claim:

Notice Only

Last 4 digits of number Is the claim subject to offset? 3.28

Nonpriority creditor's name and mailing address

EIN Cap, Inc. 160 Pearl St. 5th Floor New York, NY 10005

No

Yes

As of the petition filing date, the claim is: Check all that apply.

$20,662.00

Contingent Unliquidated Disputed

Date(s) debt was incurred

Basis for the claim:

QMG

Last 4 digits of number Is the claim subject to offset? 3.29

Nonpriority creditor's name and mailing address

Electric Lightwave 300 Elliott Ave W STE 580 Seattle, WA 98119

No

Yes

As of the petition filing date, the claim is: Check all that apply.

$18,325.22

Contingent Unliquidated Disputed

Date(s) debt was incurred

Basis for the claim:

Last 4 digits of number Is the claim subject to offset? 3.30

Nonpriority creditor's name and mailing address

Emma Swingle 8212 Corliss Avenue N Seattle, WA 98103

No

Yes

$0.00

As of the petition filing date, the claim is: Check all that apply. Contingent Unliquidated Disputed

Date(s) debt was incurred

Basis for the claim:

Notice Only

Last 4 digits of number Is the claim subject to offset?

Official Form 206 E/F

No

Yes

Schedule E/F: Creditors Who Have Unsecured Claims

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Debtor

Case number (if known)

Qliance Management Inc. Name

3.31

Nonpriority creditor's name and mailing address

Epax Systems, Inc 7767 Lemona Ave Van Nuys,, CA 91402

$0.00

As of the petition filing date, the claim is: Check all that apply. Contingent Unliquidated Disputed

Date(s) debt was incurred

Basis for the claim:

Last 4 digits of number Is the claim subject to offset? 3.32

Nonpriority creditor's name and mailing address

Equinox Primary Care Attn: Erika Bliss 2200 6th Ave. #102 Seattle, WA 98121

No

Yes

$43,584.91

As of the petition filing date, the claim is: Check all that apply. Contingent Unliquidated Disputed Basis for the claim:

Date(s) debt was incurred

Monthly IT and medical recordkeeping expenses

(2017-ongoing)

Last 4 digits of number Is the claim subject to offset? 3.33

Nonpriority creditor's name and mailing address

Erika Bliss 1915 2nd Ave. #1002 Seattle, WA 98101

No

Yes

$4,500.00

As of the petition filing date, the claim is: Check all that apply. Contingent Unliquidated Disputed

Date(s) debt was incurred

Basis for the claim:

Payments made to Kent Station

Last 4 digits of number Is the claim subject to offset? 3.34

Nonpriority creditor's name and mailing address

Evergreen Radia LLC 1521 NE 128th St #200 Kirkland, WA 98034

No

Yes

$0.00

As of the petition filing date, the claim is: Check all that apply. Contingent Unliquidated Disputed

Date(s) debt was incurred

Basis for the claim:

Notice Only

Last 4 digits of number Is the claim subject to offset? 3.35

Nonpriority creditor's name and mailing address

Expedia/Tower 333 LLC? 333 108th Ave NE Bellevue, WA 98004

No

Yes

$0.00

As of the petition filing date, the claim is: Check all that apply. Contingent Unliquidated Disputed

Date(s) debt was incurred

Basis for the claim:

lease: 333 108th Ave. NE, Bellevue

Last 4 digits of number Is the claim subject to offset? 3.36

Nonpriority creditor's name and mailing address

First Choice Health Network 600 University St #1400 Seattle, WA 98101

No

Yes

$969.00

As of the petition filing date, the claim is: Check all that apply. Contingent Unliquidated Disputed

Date(s) debt was incurred

Basis for the claim:

Last 4 digits of number Is the claim subject to offset? 3.37

Nonpriority creditor's name and mailing address

First Premier Funding, LLC c/o Schweet Linde & Coulson Attn: Laurin S. Schweet 575 S. Michigan St. Seattle, WA 98108

Yes

Unliquidated Disputed Basis for the claim:

Notice Only

Is the claim subject to offset?

Last 4 digits of number

No

Yes

Schedule E/F: Creditors Who Have Unsecured Claims

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Case 18-11999-CMA

$0.00

As of the petition filing date, the claim is: Check all that apply.

Contingent

Date(s) debt was incurred

Official Form 206 E/F

No

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Debtor

Case number (if known)

Qliance Management Inc. Name

3.38

Nonpriority creditor's name and mailing address

Gemini Diversified Services 18350 Mt Langley St #101 Fountain Valley, CA 92708

$0.00

As of the petition filing date, the claim is: Check all that apply. Contingent Unliquidated Disputed

Date(s) debt was incurred

Basis for the claim:

Notice Only

Last 4 digits of number Is the claim subject to offset? 3.39

Nonpriority creditor's name and mailing address

GRE 509 Olive LLC 509 Olive Way, Suite 1019 Seattle, WA 98101

No

Yes

As of the petition filing date, the claim is: Check all that apply.

$133,081.74

Contingent Unliquidated Disputed

Date(s) debt was incurred

Basis for the claim:

commercial lease: 509 Olive Way, Suite 1607, Seattle

Last 4 digits of number Is the claim subject to offset? 3.40

Nonpriority creditor's name and mailing address

Guardian Security 1743 1st Ave S Seattle, WA 98134

No

Yes

$606.00

As of the petition filing date, the claim is: Check all that apply. Contingent Unliquidated Disputed

Date(s) debt was incurred

Basis for the claim:

Last 4 digits of number Is the claim subject to offset? 3.41

Nonpriority creditor's name and mailing address

Integra/Electric Lightwave 18110 SE 34th St Bldg One Ste 100 Vancouver, WA 98683-9497

Yes

As of the petition filing date, the claim is: Check all that apply.

$27,763.67

Contingent Unliquidated Disputed Basis for the claim:

Date(s) debt was incurred

3.42

No

Last 4 digits of number

Is the claim subject to offset?

Nonpriority creditor's name and mailing address

As of the petition filing date, the claim is: Check all that apply.

IT Source 1010 S 336th St, Suite 108 Federal Way, WA 98003

No

Yes

$72,245.27

Contingent Unliquidated Disputed

Date(s) debt was incurred

Basis for the claim:

Last 4 digits of number Is the claim subject to offset? 3.43

Nonpriority creditor's name and mailing address

Kabbage LOC 925B Peachtree St. NE #1688 Atlanta, GA 30309

No

Yes

As of the petition filing date, the claim is: Check all that apply.

$44,303.26

Contingent Unliquidated Disputed

Date(s) debt was incurred

Basis for the claim:

Last 4 digits of number Is the claim subject to offset? 3.44

Nonpriority creditor's name and mailing address

Kelsey Hobbs 521 Stadium Pl. S Seattle, WA 98104

No

Yes

$0.00

As of the petition filing date, the claim is: Check all that apply. Contingent Unliquidated Disputed

Date(s) debt was incurred

Basis for the claim:

Notice Only

Last 4 digits of number Is the claim subject to offset?

Official Form 206 E/F

No

Yes

Schedule E/F: Creditors Who Have Unsecured Claims

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Doc 1

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Filed 05/17/18

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Pg. 23 of 70

5/17/18 4:51PM

Debtor

Case number (if known)

Qliance Management Inc. Name

3.45

Nonpriority creditor's name and mailing address

Kent Station Retail, LLC c/o Green & Norwood PLLC 2722 Eastlake Avenue East Suite 350 Seattle, WA 98102

Unliquidated Disputed Basis for the claim:

judgment entered 5/11/2017 against QMI; stlmt agmt

11/2017

Last 4 digits of number

Is the claim subject to offset?

Nonpriority creditor's name and mailing address

As of the petition filing date, the claim is: Check all that apply.

Knight Capital, LLC 9 East Lockerman St. Suite 3A-543 Dover, DE 19901

No

Yes

$137,543.00

Contingent Unliquidated Disputed Basis for the claim:

Date(s) debt was incurred

3.47

$14,500.00

Contingent

Date(s) debt was incurred

3.46

As of the petition filing date, the claim is: Check all that apply.

Last 4 digits of number

Is the claim subject to offset?

Nonpriority creditor's name and mailing address

As of the petition filing date, the claim is: Check all that apply.

Kurt Velguth 5716 15th Avenue NE, Apt. B Seattle, WA 98105

No

Yes

$0.00

Contingent Unliquidated Disputed

Date(s) debt was incurred

Basis for the claim:

Notice Only

Last 4 digits of number Is the claim subject to offset? 3.48

Nonpriority creditor's name and mailing address

Lasher, Holzapfel, Sperry & Ebberson 601 Union St. Suite 2600 Seattle, WA 98101 Date(s) debt was incurred

No

Yes

As of the petition filing date, the claim is: Check all that apply.

$4,590.00

Contingent Unliquidated Disputed Basis for the claim:

Legal services

Last 4 digits of number Is the claim subject to offset? 3.49

Nonpriority creditor's name and mailing address

Laura Breyman 5122 162nd Place SE Bellevue, WA 98006

No

Yes

$0.00

As of the petition filing date, the claim is: Check all that apply. Contingent Unliquidated Disputed

Date(s) debt was incurred

Basis for the claim:

Notice Only

Last 4 digits of number Is the claim subject to offset? 3.50

Nonpriority creditor's name and mailing address

Lester Pitle 4825 45th Avenue S Seattle, WA 98118

No

Yes

$0.00

As of the petition filing date, the claim is: Check all that apply. Contingent Unliquidated Disputed

Date(s) debt was incurred

Basis for the claim:

Notice Only

Last 4 digits of number Is the claim subject to offset? 3.51

Nonpriority creditor's name and mailing address

Lumeon 10 Leake St Lambeth London SE1 7NN, UK

Yes

As of the petition filing date, the claim is: Check all that apply.

Unliquidated Disputed Basis for the claim:

Notice Only

Is the claim subject to offset?

Last 4 digits of number

No

Yes

Schedule E/F: Creditors Who Have Unsecured Claims

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Case 18-11999-CMA

Unknown

Contingent

Date(s) debt was incurred

Official Form 206 E/F

No

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Debtor

Case number (if known)

Qliance Management Inc. Name

3.52

Nonpriority creditor's name and mailing address

Mantis 187 Wolf Road Suite 101 Albany, NY 12205

$1,539.00

Contingent Unliquidated Disputed Basis for the claim:

Date(s) debt was incurred

3.53

As of the petition filing date, the claim is: Check all that apply.

judgment?

Last 4 digits of number

Is the claim subject to offset?

Nonpriority creditor's name and mailing address

As of the petition filing date, the claim is: Check all that apply.

Marcie Hamrick 1238 NW Blakely Court Seattle, WA 98177

No

Yes

$0.00

Contingent Unliquidated Disputed

Date(s) debt was incurred

Basis for the claim:

Notice Only

Last 4 digits of number Is the claim subject to offset? 3.54

Nonpriority creditor's name and mailing address

McKesson Medical Supplies 9954 Mayland Drive Richmond, VA 23233

No

Yes

$0.00

As of the petition filing date, the claim is: Check all that apply. Contingent Unliquidated Disputed

Date(s) debt was incurred

Basis for the claim:

Notice Only

Last 4 digits of number Is the claim subject to offset? 3.55

Nonpriority creditor's name and mailing address

Merchant Cash & Capital LLC dba BizFi Funding 460 Park Avenue South 10th Floor New York, NY 10016

Yes

$0.00

As of the petition filing date, the claim is: Check all that apply.

Contingent Unliquidated Disputed Basis for the claim:

Date(s) debt was incurred

3.56

No

Notice Only

Last 4 digits of number

Is the claim subject to offset?

Nonpriority creditor's name and mailing address

As of the petition filing date, the claim is: Check all that apply.

Merchant Funding Svcs 30 Broad St. 14th Fl. New York, NY 10004

No

Yes

$184,051.39

Contingent Unliquidated Disputed

Date(s) debt was incurred

Basis for the claim:

Notice Only

Last 4 digits of number Is the claim subject to offset? 3.57

Nonpriority creditor's name and mailing address

Merck Sharp & Dohme Corp 1 Merck Dr, Whitehouse Station Whitehouse Station, NJ 08889

No

Yes

$0.00

As of the petition filing date, the claim is: Check all that apply. Contingent Unliquidated Disputed

Date(s) debt was incurred

Basis for the claim:

Notice Only

Last 4 digits of number Is the claim subject to offset? 3.58

Nonpriority creditor's name and mailing address

Miss Sudsy 2310 Mildred St. SW Suite 126 University Place, WA 98466

No

Yes

As of the petition filing date, the claim is: Check all that apply.

$4,172.40

Contingent Unliquidated Disputed

Date(s) debt was incurred

Basis for the claim:

Last 4 digits of number Is the claim subject to offset?

Official Form 206 E/F

No

Yes

Schedule E/F: Creditors Who Have Unsecured Claims

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Case 18-11999-CMA

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Filed 05/17/18

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Debtor

Case number (if known)

Qliance Management Inc. Name

3.59

Nonpriority creditor's name and mailing address

Norima Consulting US 11590 W. Bernardo Court Suite 200 San Diego, CA 92127-1662

$54,936.00

Contingent Unliquidated Disputed Basis for the claim:

Date(s) debt was incurred

3.60

As of the petition filing date, the claim is: Check all that apply.

Last 4 digits of number

Is the claim subject to offset?

Nonpriority creditor's name and mailing address

As of the petition filing date, the claim is: Check all that apply.

Northup Place, LLC c/o Azose Commercial Prop 8451 SE 68th Street, Ste 200 Mercer Island, WA 98040

No

Yes

$60,497.86

Contingent Unliquidated Disputed Basis for the claim:

Date(s) debt was incurred

commercial lease: 15419 NE 2oth St. Suite 102 & 103,

Bellevue

Last 4 digits of number Is the claim subject to offset? 3.61

Nonpriority creditor's name and mailing address

Nu-Century Maintenance Systems 16541 Redmond Hwy, PMB#355-C Redmond, WA 98052

No

Yes

As of the petition filing date, the claim is: Check all that apply.

$3,226.56

Contingent Unliquidated Disputed

Date(s) debt was incurred

Basis for the claim:

Last 4 digits of number Is the claim subject to offset? 3.62

Nonpriority creditor's name and mailing address

Nuon Nop Cleaning 1112 S Dawson St Seattle, WA 98108

No

Yes

As of the petition filing date, the claim is: Check all that apply.

$5,600.00

Contingent Unliquidated Disputed

Date(s) debt was incurred

Basis for the claim:

Last 4 digits of number Is the claim subject to offset? 3.63

Nonpriority creditor's name and mailing address

Pacific Interpreters 707 SW Washington, Suite 200 Portland, OR 97205

No

Yes

$0.00

As of the petition filing date, the claim is: Check all that apply. Contingent Unliquidated Disputed

Date(s) debt was incurred

Basis for the claim:

Notice Only

Last 4 digits of number Is the claim subject to offset? 3.64

Nonpriority creditor's name and mailing address

Pacific Northwest Shredding 3215 Lafayette Ave S Seattle, WA 98144

No

Yes

As of the petition filing date, the claim is: Check all that apply.

$1,234.40

Contingent Unliquidated Disputed

Date(s) debt was incurred

Basis for the claim:

Last 4 digits of number Is the claim subject to offset? 3.65

Nonpriority creditor's name and mailing address

Pacific Office Automation Inc 14747 NW Greenbrier Parkway Beaverton, OR 97006

No

Yes

$152.34

As of the petition filing date, the claim is: Check all that apply. Contingent Unliquidated Disputed

Date(s) debt was incurred

Basis for the claim:

Last 4 digits of number Is the claim subject to offset?

Official Form 206 E/F

No

Yes

Schedule E/F: Creditors Who Have Unsecured Claims

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Case 18-11999-CMA

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Debtor

Case number (if known)

Qliance Management Inc. Name

3.66

Nonpriority creditor's name and mailing address

PerfectServe, Inc. 10024 Investment Drive Suite 200 Knoxville, TN 37932

Contingent Unliquidated Disputed Basis for the claim:

Date(s) debt was incurred

3.67

$0.00

As of the petition filing date, the claim is: Check all that apply.

Notice Only

Last 4 digits of number

Is the claim subject to offset?

Nonpriority creditor's name and mailing address

As of the petition filing date, the claim is: Check all that apply.

Physicians Insurance 43406 Busines Park Drive Temecula, CA 92590

No

Yes

$0.00

Contingent Unliquidated Disputed

Date(s) debt was incurred

Basis for the claim:

Notice Only

Last 4 digits of number Is the claim subject to offset? 3.68

Nonpriority creditor's name and mailing address

Pitney Bowes Inc 800 Vinial St # B201 Pittsburgh, PA 15212

No

Yes

As of the petition filing date, the claim is: Check all that apply.

$2,682.05

Contingent Unliquidated Disputed

Date(s) debt was incurred

Basis for the claim:

Last 4 digits of number Is the claim subject to offset? 3.69

Nonpriority creditor's name and mailing address

Power Up Lending Group, LTD 111 Grat Neck Roadd Suite 216 Great Neck, NY 11021

Yes

$0.00

As of the petition filing date, the claim is: Check all that apply. Contingent Unliquidated Disputed Basis for the claim:

Date(s) debt was incurred

3.70

No

Notice Only

Last 4 digits of number

Is the claim subject to offset?

Nonpriority creditor's name and mailing address

As of the petition filing date, the claim is: Check all that apply.

Propel Insurance 925 Fourth Avenue, Suite 3200 Seattle, WA 98104-1159

No

Yes

$278.61

Contingent Unliquidated Disputed

Date(s) debt was incurred

Basis for the claim:

Last 4 digits of number Is the claim subject to offset? 3.71

Nonpriority creditor's name and mailing address

Puget Sound Building Maintenance LLC

No

Yes

As of the petition filing date, the claim is: Check all that apply.

$3,194.18

Contingent Unliquidated

Mercer Island, WA 98040

Disputed

Date(s) debt was incurred

Basis for the claim:

Last 4 digits of number Is the claim subject to offset? 3.72

Nonpriority creditor's name and mailing address

Puget Sound Energy PO Box 91269 Bellevue, WA 98009

No

Yes

As of the petition filing date, the claim is: Check all that apply.

$2,645.59

Contingent Unliquidated Disputed

Date(s) debt was incurred

Basis for the claim:

Last 4 digits of number Is the claim subject to offset?

Official Form 206 E/F

No

Yes

Schedule E/F: Creditors Who Have Unsecured Claims

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Case 18-11999-CMA

Doc 1

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Debtor

Case number (if known)

Qliance Management Inc. Name

3.73

Nonpriority creditor's name and mailing address

Quest Diagnostics 8403 Fallbrook Avenue West Hills, CA 91304

$0.00

As of the petition filing date, the claim is: Check all that apply. Contingent Unliquidated Disputed

Date(s) debt was incurred

Basis for the claim:

Notice Only

Last 4 digits of number Is the claim subject to offset? 3.74

Nonpriority creditor's name and mailing address

Recology CleanScapes Inc. 7303 8th Ave S Seattle, WA 98108

No

Yes

$76.35

As of the petition filing date, the claim is: Check all that apply. Contingent Unliquidated Disputed

Date(s) debt was incurred

Basis for the claim:

Last 4 digits of number Is the claim subject to offset? 3.75

Nonpriority creditor's name and mailing address

RH Lynnwood Corp Center Assoc LLC PO Box 5003 Bellevue, WA 98009-5003 Date(s) debt was incurred

No

Yes

As of the petition filing date, the claim is: Check all that apply.

$19,590.00

Contingent Unliquidated Disputed Basis for the claim:

Last 4 digits of number Is the claim subject to offset? 3.76

Nonpriority creditor's name and mailing address

Roxanne Ho 6917 47th Street Court W University Place, WA 98466

No

Yes

$0.00

As of the petition filing date, the claim is: Check all that apply. Contingent Unliquidated Disputed

Date(s) debt was incurred

Basis for the claim:

Notice Only

Last 4 digits of number Is the claim subject to offset? 3.77

Nonpriority creditor's name and mailing address

Rubicon MD, Inc. 524 Broadway, 11th Floor New York, NY 10012

No

Yes

$0.00

As of the petition filing date, the claim is: Check all that apply. Contingent Unliquidated Disputed

Date(s) debt was incurred

Basis for the claim:

Notice Only

Last 4 digits of number Is the claim subject to offset? 3.78

Nonpriority creditor's name and mailing address

Sanofi Pasteur Inc 1 Discovery Dr Swiftwater, PA 18370

No

Yes

$0.00

As of the petition filing date, the claim is: Check all that apply. Contingent Unliquidated Disputed

Date(s) debt was incurred

Basis for the claim:

Notice Only

Last 4 digits of number Is the claim subject to offset? 3.79

Nonpriority creditor's name and mailing address

Smart Data Solutions, Inc. 960 Blue Gentian Road Eagan, MN 55121

No

Yes

As of the petition filing date, the claim is: Check all that apply.

$1,650.32

Contingent Unliquidated Disputed

Date(s) debt was incurred

Basis for the claim:

Last 4 digits of number Is the claim subject to offset?

Official Form 206 E/F

No

Yes

Schedule E/F: Creditors Who Have Unsecured Claims

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Case 18-11999-CMA

Doc 1

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Debtor

Case number (if known)

Qliance Management Inc. Name

3.80

Nonpriority creditor's name and mailing address

Spoken Communication 2101 Fourth Avenue, Suite 620 Seattle, WA 98121

As of the petition filing date, the claim is: Check all that apply.

$21,469.91

Contingent Unliquidated Disputed

Date(s) debt was incurred

Basis for the claim:

Last 4 digits of number Is the claim subject to offset? 3.81

Nonpriority creditor's name and mailing address

Stanford Dosimetry LLC 1204 Raymond St Bellingham, WA 98229-2416

No

Yes

$0.00

As of the petition filing date, the claim is: Check all that apply. Contingent Unliquidated Disputed

Date(s) debt was incurred

Basis for the claim:

Notice Only

Last 4 digits of number Is the claim subject to offset? 3.82

Nonpriority creditor's name and mailing address

Stericycle Inc. 28161 N. Keith Drive Lake Forest, IL 60045

No

Yes

$0.00

As of the petition filing date, the claim is: Check all that apply. Contingent Unliquidated Disputed

Date(s) debt was incurred

Basis for the claim:

Notice Only

Last 4 digits of number Is the claim subject to offset? 3.83

Nonpriority creditor's name and mailing address

Tacoma Public Utilities PO Box 11010 Tacoma, WA 98411-1010

No

Yes

$705.72

As of the petition filing date, the claim is: Check all that apply. Contingent Unliquidated Disputed

Date(s) debt was incurred

Basis for the claim:

Last 4 digits of number Is the claim subject to offset? 3.84

Nonpriority creditor's name and mailing address

TASC 2302 International Lane Madison, WI 53704

No

Yes

$316.25

As of the petition filing date, the claim is: Check all that apply. Contingent Unliquidated Disputed

Date(s) debt was incurred

Basis for the claim:

Last 4 digits of number Is the claim subject to offset? 3.85

Nonpriority creditor's name and mailing address

TheraCom LLC 150 N Field Dr. Two Conway Park Ste 200 Lake Forest, IL 60045

Yes

$0.00

As of the petition filing date, the claim is: Check all that apply. Contingent Unliquidated Disputed Basis for the claim:

Date(s) debt was incurred

3.86

No

Notice Only

Last 4 digits of number

Is the claim subject to offset?

Nonpriority creditor's name and mailing address

As of the petition filing date, the claim is: Check all that apply.

TRA Medical Imaging 1304 Fawcett Ave., Suite 100 Tacoma, WA 98402

No

Yes

$0.00

Contingent Unliquidated Disputed

Date(s) debt was incurred

Basis for the claim:

Notice Only

Last 4 digits of number Is the claim subject to offset?

Official Form 206 E/F

No

Yes

Schedule E/F: Creditors Who Have Unsecured Claims

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Case 18-11999-CMA

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Debtor

Case number (if known)

Qliance Management Inc. Name

3.87

Nonpriority creditor's name and mailing address

Union Ave Investors LLC Attn: Dana Carlisle PO Box 394 Tacoma, WA 98401

As of the petition filing date, the claim is: Check all that apply.

Unliquidated Disputed

QMM Inc. lease: 2420 South Union Ave., Suite 100, Tacoma; judgment 7/13/2017 Pierce Cty #17-2-08490-1 Basis for the claim:

Date(s) debt was incurred Last 4 digits of number

Is the claim subject to offset? 3.88

$21,279.34

Contingent

Nonpriority creditor's name and mailing address

Universal Mechanical Service 8901 Willows Rd Redmond, WA 98052

No

Yes

$393.27

As of the petition filing date, the claim is: Check all that apply. Contingent Unliquidated Disputed

Date(s) debt was incurred

Basis for the claim:

Last 4 digits of number Is the claim subject to offset? 3.89

Nonpriority creditor's name and mailing address

US Bank Equipment Finance 13010 SW 68th Pkwy #100 Portland, OR 97223

Yes

As of the petition filing date, the claim is: Check all that apply.

$8,542.60

Contingent Unliquidated Disputed

Date(s) debt was incurred

Basis for the claim:

2 Koncia C654e

10 Canon IR500

Last 4 digits of number

Is the claim subject to offset? 3.90

No

Nonpriority creditor's name and mailing address

Vanguard Cleaning Systems of WA 6912 220th Street SW, Ste. 306 Mountlake Terrace, WA 98043

No

Yes

As of the petition filing date, the claim is: Check all that apply.

$2,235.00

Contingent Unliquidated Disputed

Date(s) debt was incurred

Basis for the claim:

Last 4 digits of number Is the claim subject to offset? 3.91

Nonpriority creditor's name and mailing address

Wave Business 401 Parkplace Center # 500 Kirkland, WA 98033

No

Yes

$245.11

As of the petition filing date, the claim is: Check all that apply. Contingent Unliquidated Disputed

Date(s) debt was incurred

Basis for the claim:

Last 4 digits of number Is the claim subject to offset? 3.92

Nonpriority creditor's name and mailing address

Wells Fargo Financial Leasing 800 Walnut Street MAC N0005-044 Des Moines, IA 50309

Yes

As of the petition filing date, the claim is: Check all that apply.

Unliquidated Disputed Basis for the claim:

Last 4 digits of number

Is the claim subject to offset?

Nonpriority creditor's name and mailing address

As of the petition filing date, the claim is: Check all that apply.

Yellowstone Capital LLC 30 Broad St. 14th Floor New York, NY 10004

No

Yes

Unliquidated Disputed Basis for the claim:

judgment in Erie County, NY #803808/2017 on

3/21/2017

Last 4 digits of number

Is the claim subject to offset?

No

Yes

Schedule E/F: Creditors Who Have Unsecured Claims

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Case 18-11999-CMA

$230,682.23

Contingent

Date(s) debt was incurred

Official Form 206 E/F

$58,000.00

Contingent

Date(s) debt was incurred

3.93

No

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Debtor

Case number (if known)

Qliance Management Inc. Name

Part 3:

List Others to Be Notified About Unsecured Claims

4. List in alphabetical order any others who must be notified for claims listed in Parts 1 and 2. Examples of entities that may be listed are collection agencies, assignees of claims listed above, and attorneys for unsecured creditors. If no others need to be notified for the debts listed in Parts 1 and 2, do not fill out or submit this page. If additional pages are needed, copy the next page. Name and mailing address

4.1

4.2

4.3

4.4

4.5

4.6

4.7

4.8

4.9

4.10

4.11

On which line in Part1 or Part 2 is the related creditor (if any) listed?

Barbara Roussin 9900 West Sample Road Coral Springs, FL 33065

Line

3.27 Not listed. Explain

CJC Law Office Attn: Christopher Cali 201 Solar St. Syracuse, NY 13204

Line

3.9 Not listed. Explain

EIN Cap, Inc. 2899 Ocean Ave. 2nd Fl. Brooklyn, NY 11235

Line

3.28 Not listed. Explain

Foster Pepper PLLC Attn: Miriam Chung 1111 Third Ave. Suite 3000 Seattle, WA 98101

Line

3.39 Not listed. Explain

Green & Norwood PLLC Attn: Matthew Green 2722 Eastlake Avenue East Suite 350 Seattle, WA 98102

Line

3.45 Not listed. Explain

Internal Revenue Service Special Procedures 915 2nd Ave., M/S W244 Seattle, WA 98174

Line

2.6 Not listed. Explain

Jameson Babbitt Stites Lombard Attn: Alan Bornstein 801 Second Ave. Suite 1000 Seattle, WA 98104

Line

3.60 Not listed. Explain

Johanna Rivadeneira 6530 Hayes Street Hollywood, FL 33024

Line

3.27 Not listed. Explain

Jude Overo 222 West 122nd Street Apt. 4-A New York, NY 10027

Line

3.27 Not listed. Explain

Livengood Alskog PLLC Attn: Rebecca Lauren Penn Attn: David Benjamin Johnston PO Box 908 Kirkland, WA 98083

Line

3.87 Not listed. Explain

Magnozzi & Kye, LLP Attn: Mark Magnozzi 23 Green St. STE 302 Huntington, NY 11743

Official Form 206 E/F

Line

3.55 Not listed. Explain

Schedule E/F: Creditors Who Have Unsecured Claims

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Case 18-11999-CMA

Last 4 digits of number, if any

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Debtor

Case number (if known)

Qliance Management Inc. Name

Name and mailing address

4.12

4.13

4.14

4.15

4.16

4.17

4.18

4.19

4.20

4.21

4.22

4.23

On which line in Part1 or Part 2 is the related creditor (if any) listed?

Naidich Wurman LLP 111 Great Neck Road Suite 214 Great Neck, NY 11021

Line

3.69 Not listed. Explain

Nura Adam 14205 SE 36th St. #100 Bellevue, WA 98006

Line

Patsy Britto 9900 West Sample Road Coral Springs, FL 33065

Line

Puget Sound Energy 355 110th Ave NE Bellevue, WA 98004

Line

Renata Bukhman, Esq. 17 State St. STE 4000 New York, NY 10004

Line

Renata Bukhman, Esq. 17 State St. STE 4000 New York, NY 10004

Line

3.2 Not listed. Explain

3.27 Not listed. Explain

3.72 Not listed. Explain

3.93 Not listed. Explain

3.56 Not listed. Explain

RTR Recovery Attn: Jacob Verstandig 122 East 42nd St. Suite 2112 New York, NY 10168

Line

3.37 Not listed. Explain

Sanjiv Matta 9900 West Sample Road Coral Springs, FL 33065

Line

Tacoma Public Utilities 3628 South 35th Street Tacoma, WA 98409

Line

3.27 Not listed. Explain

3.83 Not listed. Explain

Turnbull & Born PLLC Attn: Brian Born Commerce Building, Suite 1050 950 Pacific Ave. Tacoma, WA 98402

Line

3.89 Not listed. Explain

TVT Capital LLC 8 Hunters Lane Roslyn, NY 11576

Line

US Bank Equipment Finance 1310 Madrid Street Marshall, MN 56258

Line

Official Form 206 E/F

3.37 Not listed. Explain

3.89 Not listed. Explain

Schedule E/F: Creditors Who Have Unsecured Claims

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Case 18-11999-CMA

Last 4 digits of number, if any

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Debtor

Case number (if known)

Qliance Management Inc. Name

Name and mailing address

4.24

4.25

4.26

Part 4:

On which line in Part1 or Part 2 is the related creditor (if any) listed?

WA Attorney General's Office Labor & Industries Div. Attn: Diana Cartwright 800 Fifth Ave. Ste 2000 Seattle, WA 98104

Last 4 digits of number, if any

2.13

Line

Not listed. Explain

WA Dept of L&I Attn: David Johnson PO Box 44510 Olympia, WA 98504

2.13

Line

Not listed. Explain

WA Dept of L&I Attn: David Johnson 7273 Linderson Way SW Olympia, WA 98501

2.13

Line

Not listed. Explain

Total Amounts of the Priority and Nonpriority Unsecured Claims

5. Add the amounts of priority and nonpriority unsecured claims. Total of claim amounts 5a. Total claims from Part 1

5a.

5b. Total claims from Part 2

5b.

5c. Total of Parts 1 and 2 Lines 5a + 5b = 5c.

5c.

Official Form 206 E/F

$ +

$

$

216,115.49 1,349,812.86 1,565,928.35

Schedule E/F: Creditors Who Have Unsecured Claims

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Case 18-11999-CMA

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Fill in this information to identify the case: Debtor name

Qliance Management Inc. WESTERN DISTRICT OF WASHINGTON

United States Bankruptcy Court for the: Case number (if known)

Check if this is an amended filing

Official Form 206G Schedule G: Executory Contracts and Unexpired Leases

12/15

Be as complete and accurate as possible. If more space is needed, copy and attach the additional page, number the entries consecutively. 1.

Does the debtor have any executory contracts or unexpired leases? No. Check this box and file this form with the debtor's other schedules. There is nothing else to report on this form.

Yes. Fill in all of the information below even if the s of leases are listed on Schedule A/B: Assets - Real and Personal (Official Form 206A/B).

2. List all contracts and unexpired leases

2.1.

State what the contract or lease is for and the nature of the debtor's interest

List the contract number of any government contract

Official Form 206G

State the name and mailing address for all other parties with whom the debtor has an executory contract or unexpired lease

Settlement agreement re: judgment entered 5/11/2017 against QMI

State the term remaining

Kent Station Retail, LLC c/o Green & Norwood PLLC 2722 Eastlake Avenue East Suite 350 Seattle, WA 98102

Schedule G: Executory Contracts and Unexpired Leases

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Fill in this information to identify the case: Debtor name

Qliance Management Inc.

United States Bankruptcy Court for the:

WESTERN DISTRICT OF WASHINGTON

Case number (if known) Check if this is an amended filing

Official Form 206H Schedule H: Your Codebtors

12/15

Be as complete and accurate as possible. If more space is needed, copy the Additional Page, numbering the entries consecutively. Attach the Additional Page to this page. 1. Do you have any codebtors? No. Check this box and submit this form to the court with the debtor's other schedules. Nothing else needs to be reported on this form. Yes 2. In Column 1, list as codebtors all of the people or entities who are also liable for any debts listed by the debtor in the schedules of creditors, Schedules D-G. Include all guarantors and co-obligors. In Column 2, identify the creditor to whom the debt is owed and each schedule on which the creditor is listed. If the codebtor is liable on a debt to more than one creditor, list each creditor separately in Column 2. Column 1: Codebtor Column 2: Creditor

2.1

2.2

Name

Mailing Address

Name

Cheryl Kilodavis

9512 4th Ave. NW Seattle, WA 98117

Yellowstone Capital LLC

D E/F G

3.93

9512 4th Ave. NW Seattle, WA 98117

Kent Station Retail, LLC

D E/F G

3.45

Cheryl Kilodavis

Check all schedules that apply:

2.3

Cheryl Kilodavis

9512 4th Ave. NW Seattle, WA 98117

New Era Lending, LLC

2.4 D E/F G

2.4

Cheryl Kilodavis

9512 4th Ave. NW Seattle, WA 98117

WA Dept of L&I

D E/F G

2.13

9512 4th Ave. NW Seattle, WA 98117

Employment Security Department

D E/F G

2.5

2.5

Cheryl Kilodavis

Official Form 206H

Schedule H: Your Codebtors

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Debtor

Case number (if known)

Qliance Management Inc.

Additional Page to List More Codebtors Copy this page only if more space is needed. Continue numbering the lines sequentially from the previous page. Column 1: Codebtor Column 2: Creditor

2.6

2.7

2.8

2.9

Cheryl Kilodavis

Cheryl Kilodavis

Cheryl Kilodavis

Cheryl Kilodavis

9512 4th Ave. NW Seattle, WA 98117

Internal Revenue Service

D E/F G

2.6

9512 4th Ave. NW Seattle, WA 98117

EIN Cap, Inc.

D E/F G

3.28

9512 4th Ave. NW Seattle, WA 98117

Knight Capital, LLC

D E/F G

3.46

9512 4th Ave. NW Seattle, WA 98117

Mantis

D E/F G

3.52

2.10

Cheryl Kilodavis

9512 4th Ave. NW Seattle, WA 98117

Saturn Funding LLC

2.5 D E/F G

2.11

Cheryl Kilodavis

9512 4th Ave. NW Seattle, WA 98117

Brenda Borja

D E/F G

2.1

9512 4th Ave. NW Seattle, WA 98117

Cheryl Kilodavis

D E/F G

2.2

9512 4th Ave. NW Seattle, WA 98117

Christopher Baumann

D E/F G

2.3

2.12

2.13

Cheryl Kilodavis

Cheryl Kilodavis

Official Form 206H

Schedule H: Your Codebtors

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Debtor

Case number (if known)

Qliance Management Inc.

Additional Page to List More Codebtors Copy this page only if more space is needed. Continue numbering the lines sequentially from the previous page. Column 1: Codebtor Column 2: Creditor

2.14

2.15

2.16

2.17

Cheryl Kilodavis

Cheryl Kilodavis

Cheryl Kilodavis

Cheryl Kilodavis

9512 4th Ave. NW Seattle, WA 98117

Dionee Hilaire

9512 4th Ave. NW Seattle, WA 98117

LaFawn Smith

9512 4th Ave. NW Seattle, WA 98117

Meagan Batcheldor

9512 4th Ave. NW Seattle, WA 98117

Tanya Knight

D E/F G

2.4

D E/F G

2.8

D E/F G

2.9

D E/F G

2.12

2.18

Cheryl Kilodavis

9512 4th Ave. NW Seattle, WA 98117

Acme Company

2.1 D E/F G

2.19

Cheryl Kilodavis

9512 4th Ave. NW Seattle, WA 98117

Kathryn DeHan

D E/F G

2.7

9512 4th Ave. NW Seattle, WA 98117

Stephanie Bracamonte

D E/F G

2.11

1915 2nd Ave. #1002 Seattle, WA 98101

GRE 509 Olive LLC

D E/F G

3.39

2.20

2.21

Cheryl Kilodavis

Erika Bliss

Official Form 206H

Schedule H: Your Codebtors

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Debtor

Case number (if known)

Qliance Management Inc.

Additional Page to List More Codebtors Copy this page only if more space is needed. Continue numbering the lines sequentially from the previous page. Column 1: Codebtor Column 2: Creditor

2.22

2.23

2.24

Erika Bliss

Erika Bliss

Erika Bliss

1915 2nd Ave. #1002 Seattle, WA 98101

Northup Place, LLC

1915 2nd Ave. #1002 Seattle, WA 98101

D E/F G

3.60

Yellowstone Capital LLC

D E/F G

3.93

1915 2nd Ave. #1002 Seattle, WA 98101

Kent Station Retail, LLC

D E/F G

3.45

2.25

Erika Bliss

1915 2nd Ave. #1002 Seattle, WA 98101

Saturn Funding LLC

2.5 D E/F G

2.26

Erika Bliss

1915 2nd Ave. #1002 Seattle, WA 98101

New Era Lending, LLC

2.4 D E/F G

2.27

Erika Bliss

1915 2nd Ave. #1002 Seattle, WA 98101

WA Dept of L&I

D E/F G

2.13

1915 2nd Ave. #1002 Seattle, WA 98101

Employment Security Department

D E/F G

2.5

1915 2nd Ave. #1002 Seattle, WA 98101

Internal Revenue Service

D E/F G

2.6

2.28

2.29

Erika Bliss

Erika Bliss

Official Form 206H

Schedule H: Your Codebtors

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Debtor

Case number (if known)

Qliance Management Inc.

Additional Page to List More Codebtors Copy this page only if more space is needed. Continue numbering the lines sequentially from the previous page. Column 1: Codebtor Column 2: Creditor

2.30

2.31

2.32

2.33

2.34

2.35

2.36

2.37

Erika Bliss

Erika Bliss

Erika Bliss

Erika Bliss

Erika Bliss

Erika Bliss

Erika Bliss

Erika Bliss

1915 2nd Ave. #1002 Seattle, WA 98101

Kabbage LOC

1915 2nd Ave. #1002 Seattle, WA 98101

Knight Capital, LLC

1915 2nd Ave. #1002 Seattle, WA 98101

Mantis

1915 2nd Ave. #1002 Seattle, WA 98101

Brenda Borja

1915 2nd Ave. #1002 Seattle, WA 98101

Cheryl Kilodavis

1915 2nd Ave. #1002 Seattle, WA 98101

D E/F G

3.43

D E/F G

3.46

D E/F G

3.52

D E/F G

2.1

D E/F G

2.2

Christopher Baumann

D E/F G

2.3

1915 2nd Ave. #1002 Seattle, WA 98101

Dionee Hilaire

D E/F G

2.4

1915 2nd Ave. #1002 Seattle, WA 98101

LaFawn Smith

D E/F G

2.8

Official Form 206H

Schedule H: Your Codebtors

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Debtor

Case number (if known)

Qliance Management Inc.

Additional Page to List More Codebtors Copy this page only if more space is needed. Continue numbering the lines sequentially from the previous page. Column 1: Codebtor Column 2: Creditor

2.38

2.39

2.40

2.41

2.42

Erika Bliss

Erika Bliss

Erika Bliss

Erika Bliss

Qliance Medical Group of WA PC

1915 2nd Ave. #1002 Seattle, WA 98101

Meagan Batcheldor

1915 2nd Ave. #1002 Seattle, WA 98101

Tanya Knight

1915 2nd Ave. #1002 Seattle, WA 98101

Kathryn DeHan

1915 2nd Ave. #1002 Seattle, WA 98101

1915 2nd Ave. #1002 Seattle, WA 98101

Official Form 206H

D E/F G

2.9

D E/F G

2.12

D E/F G

2.7

Stephanie Bracamonte

D E/F G

2.11

EIN Cap, Inc.

D E/F G

3.28

Schedule H: Your Codebtors

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Fill in this information to identify the case: Debtor name

Qliance Management Inc.

United States Bankruptcy Court for the:

WESTERN DISTRICT OF WASHINGTON

Case number (if known) Check if this is an amended filing

Official Form 207 Statement of Financial Affairs for Non-Individuals Filing for Bankruptcy

04/16

The debtor must answer every question. If more space is needed, attach a separate sheet to this form. On the top of any additional pages, write the debtor’s name and case number (if known). Part 1:

Income

1. Gross revenue from business None. Identify the beginning and ending dates of the debtor’s fiscal year, which may be a calendar year

For prior year: From 1/01/2017 to 12/31/2017

Sources of revenue Check all that apply

Gross revenue (before deductions and exclusions)

$995,752.00

Operating a business Other

For year before that: From 1/01/2016 to 12/31/2016

$2,987,258.00

Operating a business Other

2. Non-business revenue Include revenue regardless of whether that revenue is taxable. Non-business income may include interest, dividends, money collected from lawsuits, and royalties. List each source and the gross revenue for each separately. Do not include revenue listed in line 1. None. Description of sources of revenue

Part 2:

Gross revenue from each source (before deductions and exclusions)

List Certain Transfers Made Before Filing for Bankruptcy

3. Certain payments or transfers to creditors within 90 days before filing this case List payments or transfers--including expense reimbursements--to any creditor, other than regular employee compensation, within 90 days before filing this case unless the aggregate value of all property transferred to that creditor is less than $6,425. (This amount may be adjusted on 4/01/19 and every 3 years after that with respect to cases filed on or after the date of adjustment.) None. Creditor's Name and Address

Official Form 207

Dates

Total amount of value

Reasons for payment or transfer Check all that apply

Statement of Financial Affairs for Non-Individuals Filing for Bankruptcy

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Debtor

Case number (if known)

Qliance Management Inc.

4. Payments or other transfers of property made within 1 year before filing this case that benefited any insider List payments or transfers, including expense reimbursements, made within 1 year before filing this case on debts owed to an insider or guaranteed or cosigned by an insider unless the aggregate value of all property transferred to or for the benefit of the insider is less than $6,425. (This amount may be adjusted on 4/01/19 and every 3 years after that with respect to cases filed on or after the date of adjustment.) Do not include any payments listed in line 3. Insiders include officers, directors, and anyone in control of a corporate debtor and their relatives; general partners of a partnership debtor and their relatives; s of the debtor and insiders of such s; and any managing agent of the debtor. 11 U.S.C. § 101(31). None. Insider's name and address Relationship to debtor

Dates

4.1.

June 2017

Erika Bliss 1915 2nd Ave. #1002 Seattle, WA 98101 member

Total amount of value

$1,775.00

Reasons for payment or transfer

Office quipment transferred as reimbursement for costs incurred to vacate/close down Qliance clinics.

5. Repossessions, foreclosures, and returns List all property of the debtor that was obtained by a creditor within 1 year before filing this case, including property repossessed by a creditor, sold at a foreclosure sale, transferred by a deed in lieu of foreclosure, or returned to the seller. Do not include property listed in line 6. None Creditor's name and address

Describe of the Property

Date

Value of property

6. Setoffs List any creditor, including a bank or financial institution, that within 90 days before filing this case set off or otherwise took anything from an of the debtor without permission or refused to make a payment at the debtor’s direction from an of the debtor because the debtor owed a debt. None Creditor's name and address

Description of the action creditor took

Date action was taken

Amount

EIN Cap, Inc. 160 Pearl St. 5th Floor New York, NY 10005

Set off from of Ann Thurley (principal Erika Bliss's mother) due to cosigner status on of Erika Bliss-QMG debt. All funds in the belonged to Ann Thurley and was Ms. Thurley's social security income. 6676 Last 4 digits of number:

2/15/2018 ($8000 siezed; $2250 returned to Ann Thurley on 4/17/18)

$5,750.00

Pacific Western Bank

$0.00 Last 4 digits of number:

Coordinated Care Corporation c/o Stoel Rives LLP Attn: Maren Norton 600 University St. Ste 3600 Seattle, WA 98101

Coordinated Care Corp. interpleader against Qliance re disbursement of funds owed to Qliance: judgment awarded $25,019.31 to Stoel Rives LLP (Coordinated Care's attorney); $46,584.52 to creditor First Premier Funding; balance (approx. $3396.17) to DOR.

3/23/2018

$75,000.00

Last 4 digits of number:

Part 3:

Legal Actions or Assignments

7. Legal actions, istrative proceedings, court actions, executions, attachments, or governmental audits List the legal actions, proceedings, investigations, arbitrations, mediations, and audits by federal or state agencies in which the debtor was involved in any capacity—within 1 year before filing this case. None. Case title Case number Official Form 207

Nature of case

Court or agency's name and address

Status of case

Statement of Financial Affairs for Non-Individuals Filing for Bankruptcy

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Debtor

Case number (if known)

Qliance Management Inc.

Case title Case number

Nature of case

Court or agency's name and address

Merchant Cash & Capital LLC v. Debtor, et al 604570/2017

Breach of Contract

Suffolk County, NY NY

Merchant Funding Svcs v. Debtor, et al 803812/2017

judgment entered 3/21/2017

Yellowstone Capital LLC v. Debtor, et al 803808/2017

judgment entered 3/21/2017

Northup Place, LLC v. Debtor, et al 17-2-30134-5 SEA

Commercial Lease; default judgment entered 1/30/2018: #18-9-02990-8

King County Superior

7.5.

GRE Medical Dental Building LLC v. Debtor, et al 18-2-05649-7 SEA

Commercial lease

King County Superior

Pending On appeal Concluded

7.6.

Kent Station Retail LLC v. Erika Bliss, et al 17-9-11120-7

Commercial lease; judgment entered 5/11/2017 against QMI

King County Superior

Pending On appeal

7.7.

US Bank Equipment Finance v. Debtor, et al 18-2-07259-0 SEA

replevin and monies owed

King County Superior

Pending On appeal Concluded

7.8.

Union Ave Investors v. Debtor et al 17-2-08490-1

judgment entered 7/13/2017

Pierce County Superior

Pending On appeal

Coordinated Care Corporation v. Debtor, et al 17-CV-01180

interpleader

US District, Western District of WA

Pending On appeal Concluded

Breach of Contract

Onondoga County, NY

Pending On appeal Concluded

Tax Warrant for overpaid benefits: #18-9-02305-5; dated 1/17/2018

King County Superior

Pending On appeal

Tax Warrant: #17-9-15723-1; dated 7/20/2017

King County Superior

7.1.

7.2.

7.3.

7.4.

7.9.

Status of case

Concluded

Erie County, NY

Pending On appeal Concluded

Erie County, NY

Pending On appeal Concluded Pending On appeal Concluded

Concluded

Concluded

7.10 Bankers Healthcare Group, . LLC

v. Erika Bliss, Cheryl Kilodavis 002720/2018 7.11 WA Employment Security . Department -

Tax Warrant for overpaid benefits 18-2-01404-2 7.12 WA State Dept. of Revenue . Tax Warrant

17-2-19326-7

Official Form 207

Pending On appeal

Concluded

Pending On appeal Concluded

Statement of Financial Affairs for Non-Individuals Filing for Bankruptcy

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Debtor

Case number (if known)

Qliance Management Inc.

Case title Case number 7.13 WA State Dept. of Revenue . Tax Warrant

17-2-19396-8

Nature of case

Court or agency's name and address

Tax Warrant: #17-9-15323-6; dated 7/20/2017

King County Superior

Status of case

Concluded

7.14 QMI and QMG appeal of WA . Dept of L&I Citation and

Pending On appeal Concluded

Assessment of wage payment violations #122862 and #123162 7.15 Power Up Lending Group, . LTD

v. Qliance et al 001569/17 7.16 Edward Stean v. Debtor . QMI and Dr. Erika Bliss

Pending On appeal

Judgment by Confession entered 3/20/17

Nassau County, NY

Dismissed on 9/6/2017

Palm Beach County, FL

Pending On appeal Concluded

50-2017-CA-005371

Pending On appeal Concluded

7.17 Debtor vs. Jude Overo et al . CACE-17-014898

Embezzlement/the ft/fraud re New Horizon Funding LLC debt settlement scam

7.18 U.S. Department of Justice . Federal Bureau of

Debtor notified by FBI on Feb. 4, 2018, of being possible victim of a crime re New Horizon Funding LLC debt settlement scam and theft of Medicare/Medicai d funds from Debtor's bank

Investigation FBI - Miami 318A-MM-2173571

7.19 Merchant Cash & Capital LLC . v. Qliance, et al

Broward County, Forida

Pending On appeal Concluded

breach of contract

Suffolk County, NY

Pending On appeal Concluded

small claims judgment entered 7/28/2017

KCDC- West Div. Seattle

Pending On appeal

604570/2017 7.20 Nura Adam, Adam's . Interpreting Services LLC

v. Qliance 175-02025

Pending On appeal Concluded

Concluded

7.21 .

Pending On appeal Concluded

8. Assignments and receivership List any property in the hands of an assignee for the benefit of creditors during the 120 days before filing this case and any property in the hands of a receiver, custodian, or other court-appointed officer within 1 year before filing this case.

Official Form 207

Statement of Financial Affairs for Non-Individuals Filing for Bankruptcy

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Debtor

Case number (if known)

Qliance Management Inc.

None

Part 4:

Certain Gifts and Charitable Contributions

9. List all gifts or charitable contributions the debtor gave to a recipient within 2 years before filing this case unless the aggregate value of the gifts to that recipient is less than $1,000 None

9.1.

Recipient's name and address

Description of the gifts or contributions

Goodwill

Office equipment and supplies

Dates given

Value

Oct. 2017

$5,000.00

Nov. 2017

$7,000.00

Nov. 2017

$5,500.00

Dec. 2017

$6,000.00

2/15/18

$9,700.00

Recipients relationship to debtor

none 9.2.

Rainier Valley Schools

Computer equipment and office supplies

Recipients relationship to debtor

none 9.3.

Vietnam Dental Outreach Program

Computers

Recipients relationship to debtor

none 9.4.

Ghanaian and Malian Schools

Computers

Recipients relationship to debtor

none 9.5.

DAWN (Domestic Abuse Women's Network

Computer equipment, furniture, office supplies, office equipment

Recipients relationship to debtor

Part 5:

Certain Losses

10. All losses from fire, theft, or other casualty within 1 year before filing this case. None Description of the property lost and how the loss occurred

Amount of payments received for the loss

Dates of loss

Value of property lost

If you have received payments to cover the loss, for example, from insurance, government compensation, or tort liability, list the total received. List unpaid claims on Official Form 106A/B (Schedule A/B: Assets – Real and Personal Property).

Part 6:

Certain Payments or Transfers

11. Payments related to bankruptcy

Official Form 207

Statement of Financial Affairs for Non-Individuals Filing for Bankruptcy

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Debtor

Case number (if known)

Qliance Management Inc.

List any payments of money or other transfers of property made by the debtor or person acting on behalf of the debtor within 1 year before the filing of this case to another person or entity, including attorneys, that the debtor consulted about debt consolidation or restructuring, seeking bankruptcy relief, or filing a bankruptcy case. None. Who was paid or who received the transfer? Address 11.1.

Wenokur Riordan PLLC 600 Stewart St Suite 1300 Seattle, WA 98101

If not money, describe any property transferred

Dates

Attorney Fees: $5000 Filing fee: $335

3/20/2018

Total amount or value

$5,335.00

Email or website address

[email protected] Who made the payment, if not debtor?

Ann Thurley

11.2.

August 12, 2017

Gloria Nagler

$300.00

Email or website address

Who made the payment, if not debtor?

12. Self-settled trusts of which the debtor is a beneficiary List any payments or transfers of property made by the debtor or a person acting on behalf of the debtor within 10 years before the filing of this case to a self-settled trust or similar device. Do not include transfers already listed on this statement. None. Name of trust or device

Describe any property transferred

Dates transfers were made

Total amount or value

13. Transfers not already listed on this statement List any transfers of money or other property by sale, trade, or any other means made by the debtor or a person acting on behalf of the debtor within 2 years before the filing of this case to another person, other than property transferred in the ordinary course of business or financial affairs. Include both outright transfers and transfers made as security. Do not include gifts or transfers previously listed on this statement. None. Who received transfer? Address

Description of property transferred or payments received or debts paid in exchange

Date transfer was made

Office equipment and supplies pursuant to Settlement Agreement/Bill of Sale dated Nov. 2017

Nov. 2017

Total amount or value

13.1 Kent Station Retail, LLC . c/o Green & Norwood PLLC

2722 Eastlake Avenue East Suite 350 Seattle, WA 98102

$12,600.00

Relationship to debtor

former lessor and judgment creditor

Part 7:

Previous Locations

14. Previous addresses Official Form 207

Statement of Financial Affairs for Non-Individuals Filing for Bankruptcy

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Debtor

Case number (if known)

Qliance Management Inc.

List all previous addresses used by the debtor within 3 years before filing this case and the dates the addresses were used.

Does not apply Address

Dates of occupancy From-To

14.1.

2101 4th Ave., Suite 600 Seattle, WA 98121

March 2016-May 2017 (. office)

14.2.

509 Olive Way, Suite 1607 Seattle, WA 98101

March 2016-June 2017 (clinic)

14.3.

521 2nd Place North, Suite 103 Kent, WA 98032

March 2016-May 2017 (clinic)

14.4.

2420 S. Union Ave., Suite 100 Tacoma, WA 98405

March 2016-June 2017 (clinic)

14.5.

15419 NE 20th Street Bellevue, WA 98007

March 2016-June 2017 (clinic)

14.6.

19401 40th Ave. West Lynnwood, WA 98036

March 2016-May 2017 (clinic)

14.7.

333 108th Ave. NE, Suite M150 Bellevue, WA 98004

March 2016 – September 2016 (clinic)

14.8.

2318 4th Ave. Seattle, WA 98121

March 2016-June 2017 (clinic)

14.9.

1915 2nd Ave., #2405 Seattle, WA 98101

May 2017-Feb 2018 (mail,server,storage)

14.10 1915 2nd Ave., #1002 . Seattle, WA 98101

Feb 2018-present (mail,server,storage)

14.11 2200 6th Ave., Suite 520 . Seattle, WA 98121

Nov 2017-present (medical records mgmt)

Part 8:

Health Care Bankruptcies

15. Health Care bankruptcies Is the debtor primarily engaged in offering services and facilities for: - diagnosing or treating injury, deformity, or disease, or - providing any surgical, psychiatric, drug treatment, or obstetric care? No. Go to Part 9. Yes. Fill in the information below.

15.1.

Facility name and address

Nature of the business operation, including type of services the debtor provides

Qliance Primary Care 509 Olive Way, Suite 1607 Seattle, WA 98101

Primary care services by Qliance Medical Group of WA PC; March 2016-June 2017

Official Form 207

If debtor provides meals and housing, number of patients in debtor’s care

Location where patient records are maintained (if different from facility address). If electronic, identify any service provider.

How are records kept?

Equinox Primary Care 1915 2nd Ave., #1002 Seattle, WA 98101

Check all that apply:

Statement of Financial Affairs for Non-Individuals Filing for Bankruptcy

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Debtor

Case number (if known)

Qliance Management Inc.

Facility name and address

Nature of the business operation, including type of services the debtor provides

If debtor provides meals and housing, number of patients in debtor’s care Electronically Paper

15.2.

Qliance Primary Care 521 2nd Place North, Suite 103 Kent, WA 98032

Primary care services by Qliance Medical Group of WA PC; March 2016-May 2017 Location where patient records are maintained (if different from facility address). If electronic, identify any service provider.

How are records kept?

Equinox Primary Care 1915 2nd Ave., #1002 Seattle, WA 98101

Check all that apply:

Electronically Paper 15.3.

Qliance Primary Care 2420 S. Union Ave., Suite 100 Tacoma, WA 98405

Primary care services by Qliance Medical Group of WA PC; March 2016-June 2017 Location where patient records are maintained (if different from facility address). If electronic, identify any service provider.

How are records kept?

Equinox Primary Care 1915 2nd Ave., #1002 Seattle, WA 98101

Check all that apply:

Electronically Paper 15.4.

Primary care services by Qliance Medical Group of WA PC; March 2016-June 2017

Qliance Primary Care 15419 NE 20th Street Bellevue, WA 98007

Location where patient records are maintained (if different from facility address). If electronic, identify any service provider.

How are records kept?

Equinox Primary Care 1915 2nd Ave., #1002 Seattle, WA 98101

Check all that apply:

Electronically Paper 15.5.

Primary care services by Qliance Medical Group of WA PC; March 2016-May 2017

Qliance Primary Care 19401 40th Ave. West Lynnwood, WA 98036

Location where patient records are maintained (if different from facility address). If electronic, identify any service provider.

How are records kept?

Equinox Primary Care 1915 2nd Ave., #1002 Seattle, WA 98101

Check all that apply:

Electronically Paper 15.6.

Qliance Primary Care 333 108th Ave. NE, Suite M150 Bellevue, WA 98004

Official Form 207

Primary care services by Qliance Medical Group of WA PC; March 2016 - September 2016 Location where patient records are maintained (if different from facility address). If electronic, identify any service provider.

How are records kept?

Equinox Primary Care 1915 2nd Ave., #1002 Seattle, WA 98101

Check all that apply:

Statement of Financial Affairs for Non-Individuals Filing for Bankruptcy

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Debtor

Case number (if known)

Qliance Management Inc.

Facility name and address

Nature of the business operation, including type of services the debtor provides

If debtor provides meals and housing, number of patients in debtor’s care Electronically Paper

15.7.

Primary care services by Qliance Medical Group of WA PC; March 2016-June 2017

Qliance Primary Care 2318 4th Ave. Seattle, WA 98121

Location where patient records are maintained (if different from facility address). If electronic, identify any service provider.

How are records kept?

Equinox Primary Care 1915 2nd Ave., #1002 Seattle, WA 98101

Check all that apply:

Electronically Paper Part 9:

Personally Identifiable Information

16. Does the debtor collect and retain personally identifiable information of customers? No. Yes. State the nature of the information collected and retained.

Personal Identifiers and Personal Health Information Does the debtor have a about that information? No Yes 17. Within 6 years before filing this case, have any employees of the debtor been participants in any ERISA, 401(k), 403(b), or other pension or profit-sharing plan made available by the debtor as an employee benefit? No. Go to Part 10. Yes. Does the debtor serve as plan ? No Go to Part 10. Yes. Fill in below: Name of plan

Employer identification number of the plan EIN: 81-1559010

Charles Schwab 401(k) plan Has the plan been terminated? No Yes No Go to Part 10. Yes. Fill in below: Name of plan

Employer identification number of the plan EIN: 81-1559010

Transamerica Has the plan been terminated? No Yes

Part 10:

Certain Financial s, Safe Deposit Boxes, and Storage Units

Official Form 207

Statement of Financial Affairs for Non-Individuals Filing for Bankruptcy

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Debtor

Case number (if known)

Qliance Management Inc.

18. Closed financial s Within 1 year before filing this case, were any financial s or instruments held in the debtor’s name, or for the debtor’s benefit, closed, sold, moved, or transferred? Include checking, savings, money market, or other financial s; certificates of deposit; and shares in banks, credit unions, brokerage houses, cooperatives, associations, and other financial institutions. None Financial Institution name and Address

Last 4 digits of number

Type of or instrument

Date was closed, sold, moved, or transferred

Last balance before closing or transfer

18.1.

Wells Fargo Bank

XXXX-1914

Checking Savings Money Market Brokerage Other

January 2017

$0.00

18.2.

Bank of America

XXXX-1822

Checking Savings Money Market Brokerage Other

May 2017

$0.00

19. Safe deposit boxes List any safe deposit box or other depository for securities, cash, or other valuables the debtor now has or did have within 1 year before filing this case.

None Depository institution name and address

Names of anyone with access to it Address

Description of the contents

Do you still have it?

20. Off-premises storage List any property kept in storage units or warehouses within 1 year before filing this case. Do not include facilities that are in a part of a building in which the debtor does business.

None Facility name and address

Names of anyone with access to it

Description of the contents

Public Storage 10020 Martin Luther King Jr. Way Seattle, WA 98178

Erika Bliss 1915 2nd Ave., #1002 Seattle, WA 98101

Office and Medical equipment and supplies

No Yes

Kirkland Way Storage 11200 Kirkland Way Kirkland, WA 98033

Erika Bliss 1915 2nd Ave. #1002 Seattle, WA 98101

Office and Medical equipment and supplies

No Yes

Part 11:

Do you still have it?

Property the Debtor Holds or Controls That the Debtor Does Not Own

21. Property held for another List any property that the debtor holds or controls that another entity owns. Include any property borrowed from, being stored for, or held in trust. Do not list leased or rented property. None

Part 12:

Details About Environment Information

Official Form 207

Statement of Financial Affairs for Non-Individuals Filing for Bankruptcy

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Debtor

Case number (if known)

Qliance Management Inc.

For the purpose of Part 12, the following definitions apply: Environmental law means any statute or governmental regulation that concerns pollution, contamination, or hazardous material, regardless of the medium affected (air, land, water, or any other medium). Site means any location, facility, or property, including disposal sites, that the debtor now owns, operates, or utilizes or that the debtor formerly owned, operated, or utilized. Hazardous material means anything that an environmental law defines as hazardous or toxic, or describes as a pollutant, contaminant, or a similarly harmful substance. Report all notices, releases, and proceedings known, regardless of when they occurred. 22. Has the debtor been a party in any judicial or istrative proceeding under any environmental law? Include settlements and orders. No. Yes. Provide details below. Case title Case number

Court or agency name and address

Nature of the case

Status of case

23. Has any governmental unit otherwise notified the debtor that the debtor may be liable or potentially liable under or in violation of an environmental law? No. Yes. Provide details below. Site name and address

Governmental unit name and address

Environmental law, if known

Date of notice

Environmental law, if known

Date of notice

24. Has the debtor notified any governmental unit of any release of hazardous material? No. Yes. Provide details below. Site name and address

Part 13:

Governmental unit name and address

Details About the Debtor's Business or Connections to Any Business

25. Other businesses in which the debtor has or has had an interest List any business for which the debtor was an owner, partner, member, or otherwise a person in control within 6 years before filing this case. Include this information even if already listed in the Schedules. None Business name address

Describe the nature of the business

Employer Identification number Do not include Social Security number or ITIN.

Dates business existed 26. Books, records, and financial statements 26a. List all ants and bookkeepers who maintained the debtor’s books and records within 2 years before filing this case. None Name and address

Date of service From-To

26a.1.

Denise Williams (former employee)

March 2016-June 2016

26a.2.

Wesley Howe 7027 139th Place NE Redmond, WA 98052

July 2016-present

26b. List all firms or individuals who have audited, compiled, or reviewed debtor’s books of and records or prepared a financial statement within 2 years before filing this case. Official Form 207

Statement of Financial Affairs for Non-Individuals Filing for Bankruptcy

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Debtor

Case number (if known)

Qliance Management Inc.

None

26c. List all firms or individuals who were in possession of the debtor’s books of and records when this case is filed. None Name and address

If any books of and records are unavailable, explain why

26c.1.

Erika Bliss/Equinox Primary Care 1915 2nd Ave. #1002 Seattle, WA 98101

26c.2.

Cheryl Kilodavis 9512 4th Ave. NW Seattle, WA 98117

26d. List all financial institutions, creditors, and other parties, including mercantile and trade agencies, to whom the debtor issued a financial statement within 2 years before filing this case. None Name and address 26d.1.

ICG Enterprises

26d.2.

Paramount Lending

27. Inventories Have any inventories of the debtor’s property been taken within 2 years before filing this case? No Yes. Give the details about the two most recent inventories. Name of the person who supervised the taking of the inventory

Date of inventory

The dollar amount and basis (cost, market, or other basis) of each inventory

28. List the debtor’s officers, directors, managing , general partners, in control, controlling shareholders, or other people in control of the debtor at the time of the filing of this case. Name

Address

Position and nature of any interest

% of interest, if any

Erika Bliss

1915 2nd Ave. #1002 Seattle, WA 98101

member and CEO

51

Name

Address

Position and nature of any interest

% of interest, if any

Cheryl Kilodavis

9512 4th Ave. NW Seattle, WA 98117

member and President/Secretary

49

29. Within 1 year before the filing of this case, did the debtor have officers, directors, managing , general partners, in control of the debtor, or shareholders in control of the debtor who no longer hold these positions?

No Yes. Identify below.

30. Payments, distributions, or withdrawals credited or given to insiders Within 1 year before filing this case, did the debtor provide an insider with value in any form, including salary, other compensation, draws, bonuses, loans, credits on loans, stock redemptions, and options exercised? Official Form 207

Statement of Financial Affairs for Non-Individuals Filing for Bankruptcy

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Debtor

Case number (if known)

Qliance Management Inc.

No Yes. Identify below. Name and address of recipient

Amount of money or description and value of property

Dates

Reason for providing the value

$22,916

April 2017

salary

$14,583

April 2017

salary

30.1 Cheryl Kilodavis . 9512 4th Ave. NW

Seattle, WA 98117 Relationship to debtor

member and President 30.2 Erika Bliss . 1915 2nd Ave. #1002

Seattle, WA 98101 Relationship to debtor

member, CEO

31. Within 6 years before filing this case, has the debtor been a member of any consolidated group for tax purposes? No Yes. Identify below. Name of the parent corporation

Employer Identification number of the parent corporation

32. Within 6 years before filing this case, has the debtor as an employer been responsible for contributing to a pension fund? No Yes. Identify below. Name of the pension fund

Part 14:

Employer Identification number of the parent corporation

Signature and Declaration

WARNING -- Bankruptcy fraud is a serious crime. Making a false statement, concealing property, or obtaining money or property by fraud in connection with a bankruptcy case can result in fines up to $500,000 or imprisonment for up to 20 years, or both. 18 U.S.C. §§ 152, 1341, 1519, and 3571. I have examined the information in this Statement of Financial Affairs and any attachments and have a reasonable belief that the information is true and correct. I declare under penalty of perjury that the foregoing is true and correct. Executed on

May 17, 2018

/s/ Erika Bliss

Erika Bliss

Signature of individual g on behalf of the debtor

Printed name

Position or relationship to debtor

CEO

Are additional pages to Statement of Financial Affairs for Non-Individuals Filing for Bankruptcy (Official Form 207) attached? No Yes

Official Form 207

Statement of Financial Affairs for Non-Individuals Filing for Bankruptcy

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B2030 (Form 2030) (12/15)

United States Bankruptcy Court Western District of Washington Qliance Management Inc.

In re

Case No. Chapter

Debtor(s)

7

DISCLOSURE OF COMPENSATION OF ATTORNEY FOR DEBTOR(S) 1.

2.

Pursuant to 11 U .S.C. § 329(a) and Fed. Bankr. P. 2016(b), I certify that I am the attorney for the above named debtor(s) and that compensation paid to me within one year before the filing of the petition in bankruptcy, or agreed to be paid to me, for services rendered or to be rendered on behalf of the debtor(s) in contemplation of or in connection with the bankruptcy case is as follows: For legal services, I have agreed to accept

$

5,000.00

Prior to the filing of this statement I have received

$

5,000.00

Balance Due

$

0.00

The source of the compensation paid to me was: Debtor

3.

Other (specify):

Ann Thurley 1915 2nd Ave. #1002 Seattle, WA 98101

The source of compensation to be paid to me is: Debtor

4.

Other (specify):

I have not agreed to share the above-disclosed compensation with any other person unless they are and associates of my law firm. I have agreed to share the above-disclosed compensation with a person or persons who are not or associates of my law firm. A copy of the agreement, together with a list of the names of the people sharing in the compensation is attached.

5.

In return for the above-disclosed fee, I have agreed to render legal service for all aspects of the bankruptcy case, including: a. b. c. d.

6.

Analysis of the debtor's financial situation, and rendering advice to the debtor in determining whether to file a petition in bankruptcy; Preparation and filing of any petition, schedules, statement of affairs and plan which may be required; Representation of the debtor at the meeting of creditors and confirmation hearing, and any adjourned hearings thereof; [Other provisions as needed] Negotiations with secured creditors to reduce to market value; exemption planning; preparation and filing of reaffirmation agreements and applications as needed; preparation and filing of motions pursuant to 11 USC 522(f)(2)(A) for avoidance of liens on household goods.

By agreement with the debtor(s), the above-disclosed fee does not include the following service: Representation of the debtors in any dischargeability actions, judicial lien avoidances, relief from stay actions or any other adversary proceeding. CERTIFICATION

I certify that the foregoing is a complete statement of any agreement or arrangement for payment to me for representation of the debtor(s) in this bankruptcy proceeding. May 17, 2018 Date

/s/ Catherine J. Reny Catherine J. Reny 43058 Signature of Attorney Wenokur Riordan PLLC 600 Stewart St Suite 1300 Seattle, WA 98101 206-492-7084 Fax: 206-219-4141 [email protected] Name of law firm

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United States Bankruptcy Court Western District of Washington In re

Qliance Management Inc. Debtor(s)

Case No. Chapter

7

VERIFICATION OF CREDITOR MATRIX

I, the CEO of the corporation named as the debtor in this case, hereby that the attached list of creditors is true and correct to the best of my knowledge.

Date:

May 17, 2018

/s/ Erika Bliss Erika Bliss/CEO

Signer/Title

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} b k 1 { C r e d i t o A s M a x

2420 UNION AVENUE CO-TENANCY C/O CRAWFORD & KATICA 2915 NORTH MCCARVER TACOMA, WA 98403 ABF SERVICING ATTN: STEVEN BERKOVITCH 40 EXCHANGE PLACE SUITE 1306 NEW YORK, NY 10005 ACME COMPANY 64 BEAVER ST. SUITE 344 NEW YORK, NY 10004 ADAM'S INTERPRETING SERVICES PO BOX 6122 BELLEVUE, WA 98008 AIDAREX PHARMACEUTICALS LLC 595 NORTH SMITH STREET CORONA, CA 92880 AIRGAS INC. WEST DIVISION 2349495 4401 AIRPORT WAY S SEATTLE, WA 98108 ALICE FRANCK 6335 WILSON AVENUE S SEATTLE, WA 98118 ALL PHASE COMM LLC 4209 21ST AVE W #200 SEATTLE, WA 98199 ALSTON & BIRD LLP 1201 WEST PEACHTREE ST SUITE 4900 ATLANTA, GA 30309 ANN THURLEY 1915 2ND AVE. #1002 SEATTLE, WA 98101

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BANKERS HEALTHCARE GROUP, LLC 201 SOLAR STREET SYRACUSE, NY 13204 BARBARA ROUSSIN 9900 WEST SAMPLE ROAD CORAL SPRINGS, FL 33065 BEAVEX, INC. 6901 S 194TH ST KENT, WA 98032 BENJAMIN MCLAUGHLIN 7501 GREENWOOD AVENUE N #306 SEATTLE, WA 98103 BRENDA BORJA 4032 EVANSTON AVENUE N SEATTLE, WA 98103 CARENA, INC PO BOX 673 SEATTLE, WA 98111 CAROL RADIO 3805 206TH PLACE NE SAMMAMISH, WA 98074 CENTER FOR DIAGNOSTIC IMAGING PO BOX 94624 SEATTLE, WA 98124-6924 CHERYL KILODAVIS 9512 4TH AVE. NW SEATTLE, WA 98117 CHRISTOPHER BAUMANN 10130 IDAHO AVENUE EVERETT, WA 98204 CHRISTOPHER GAYNOR 6250 1ST AVENUE S SEATTLE, WA 98118

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CICS EMPLOYMENT SERVICES, INC. 1220 SW MORRISION ST. #505 PORTLAND, OR 97205 CIGNA LIFE INSURANCE CO. OF NA TWO LIBERTY PLACE 1601 CHESTNUT STREET PHILADELPHIA, PA 19192 CIGNA MEDICAL INSURANCE TWO LIBERTY PLACE 1601 CHESTNUT STREET PHILADELPHIA, PA 19192 CITY OF LYNNWOOD PO BOX 5008 LYNNWOOD, WA 98046-5008 CJC LAW OFFICE ATTN: CHRISTOPHER CALI 201 SOLAR ST. SYRACUSE, NY 13204 COLO (ZAYO GROUP) 4772 WALNUT ST. SUITE 100 BOULDER, CO 80301 COLONIAL LIFE 245 4TH ST #206 BREMERTON, WA 98337 COMCAST BUSINESS PO BOX 34744 SEATTLE, WA 98124-1744 CONCUR 62157 COLLECTIONS CENTER DRIVE CHICAGO, IL 60693 CORPORATION SERVICE COMPANY PO BOX 2576 SPRINGFIELD, IL 62708

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CRESTMARK EQUIPMENT FINANCE 40950 WOODWARD AVE. SUITE 201 BLOOMFIELD HILLS, MI 48304-5127 DAVIS WRIGHT TREMAINE LLP 1201 3RD AVE SEATTLE, WA 98101 DIONEE HILAIRE 406 N. L STREET TACOMA, WA 98403 DUO TEC 2960 4TH AVE S #112 SEATTLE, WA 98134 EDWARD GREGORY STEAN 9900 W. SAMPLE RD. STE. 300 POMPANO BEACH, FL 33065 EIN CAP, INC. 160 PEARL ST. 5TH FLOOR NEW YORK, NY 10005 EIN CAP, INC. 2899 OCEAN AVE. 2ND FL. BROOKLYN, NY 11235 ELECTRIC LIGHTWAVE 300 ELLIOTT AVE W STE 580 SEATTLE, WA 98119 EMMA SWINGLE 8212 CORLISS AVENUE N SEATTLE, WA 98103 EMPLOYMENT SECURITY DEPARTMENT PO BOX 34468 SEATTLE, WA 98124-1468 EPAX SYSTEMS, INC 7767 LEMONA AVE VAN NUYS,, CA 91402

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EQUINOX PRIMARY CARE ATTN: ERIKA BLISS 2200 6TH AVE. #102 SEATTLE, WA 98121 ERIKA BLISS 1915 2ND AVE. #1002 SEATTLE, WA 98101 EVERGREEN RADIA LLC 1521 NE 128TH ST #200 KIRKLAND, WA 98034 EXPEDIA/TOWER 333 LLC? 333 108TH AVE NE BELLEVUE, WA 98004 FIRST CHOICE HEALTH NETWORK 600 UNIVERSITY ST #1400 SEATTLE, WA 98101 FIRST PREMIER FUNDING, LLC C/O SCHWEET LINDE & COULSON ATTN: LAURIN S. SCHWEET 575 S. MICHIGAN ST. SEATTLE, WA 98108 FOSTER PEPPER PLLC ATTN: MIRIAM CHUNG 1111 THIRD AVE. SUITE 3000 SEATTLE, WA 98101 GEMINI DIVERSIFIED SERVICES 18350 MT LANGLEY ST #101 FOUNTAIN VALLEY, CA 92708 GRE 509 OLIVE LLC 509 OLIVE WAY, SUITE 1019 SEATTLE, WA 98101 GREEN & NORWOOD PLLC ATTN: MATTHEW GREEN 2722 EASTLAKE AVENUE EAST SUITE 350 SEATTLE, WA 98102

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GUARDIAN SECURITY 1743 1ST AVE S SEATTLE, WA 98134 INTEGRA/ELECTRIC LIGHTWAVE 18110 SE 34TH ST BLDG ONE STE 100 VANCOUVER, WA 98683-9497 INTERNAL REVENUE SERVICE PO BOX 7346 PHILADELPHIA, PA 19101-7346 INTERNAL REVENUE SERVICE SPECIAL PROCEDURES 915 2ND AVE., M/S W244 SEATTLE, WA 98174 IT SOURCE 1010 S 336TH ST, SUITE 108 FEDERAL WAY, WA 98003 JAMESON BABBITT STITES LOMBARD ATTN: ALAN BORNSTEIN 801 SECOND AVE. SUITE 1000 SEATTLE, WA 98104 JOHANNA RIVADENEIRA 6530 HAYES STREET HOLLYWOOD, FL 33024 JUDE OVERO 222 WEST 122ND STREET APT. 4-A NEW YORK, NY 10027 KABBAGE LOC 925B PEACHTREE ST. NE #1688 ATLANTA, GA 30309 KATHRYN DEHAN 9212 227TH AVE. EAST BUCKLEY, WA 98321

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KELSEY HOBBS 521 STADIUM PL. S SEATTLE, WA 98104 KENT STATION RETAIL, LLC C/O GREEN & NORWOOD PLLC 2722 EASTLAKE AVENUE EAST SUITE 350 SEATTLE, WA 98102 KNIGHT CAPITAL, LLC 9 EAST LOCKERMAN ST. SUITE 3A-543 DOVER, DE 19901 KURT VELGUTH 5716 15TH AVENUE NE, APT. B SEATTLE, WA 98105 LAFAWN SMITH 607 WILLIAMS AVENUE SOUTH, #21 RENTON, WA 98047 LASHER, HOLZAPFEL, SPERRY & EBBERSON 601 UNION ST. SUITE 2600 SEATTLE, WA 98101 LAURA BREYMAN 5122 162ND PLACE SE BELLEVUE, WA 98006 LESTER PITLE 4825 45TH AVENUE S SEATTLE, WA 98118 LIVENGOOD ALSKOG PLLC ATTN: REBECCA LAUREN PENN ATTN: DAVID BENJAMIN JOHNSTON PO BOX 908 KIRKLAND, WA 98083 LUMEON 10 LEAKE ST LAMBETH LONDON SE1 7NN, UK

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MAGNOZZI & KYE, LLP ATTN: MARK MAGNOZZI 23 GREEN ST. STE 302 HUNTINGTON, NY 11743 MANTIS 187 WOLF ROAD SUITE 101 ALBANY, NY 12205 MARCIE HAMRICK 1238 NW BLAKELY COURT SEATTLE, WA 98177 MCKESSON MEDICAL SUPPLIES 9954 MAYLAND DRIVE RICHMOND, VA 23233 MEAGAN BATCHELDOR 18909 11 TH AVENUE COURT E SPANAWAY, WA 98387 MERCHANT CASH & CAPITAL LLC DBA BIZFI FUNDING 460 PARK AVENUE SOUTH 10TH FLOOR NEW YORK, NY 10016 MERCHANT FUNDING SVCS 30 BROAD ST. 14TH FL. NEW YORK, NY 10004 MERCK SHARP & DOHME CORP 1 MERCK DR, WHITEHOUSE STATION WHITEHOUSE STATION, NJ 08889 MISS SUDSY 2310 MILDRED ST. SW SUITE 126 UNIVERSITY PLACE, WA 98466 NAIDICH WURMAN LLP 111 GREAT NECK ROAD SUITE 214 GREAT NECK, NY 11021

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NEW ERA LENDING, LLC 1201 NORTH ORANGE ST. SUITE 762 WILMINGTON, DE 19801 NORIMA CONSULTING US 11590 W. BERNARDO COURT SUITE 200 SAN DIEGO, CA 92127-1662 NORTHUP PLACE, LLC C/O AZOSE COMMERCIAL PROP 8451 SE 68TH STREET, STE 200 MERCER ISLAND, WA 98040 NU-CENTURY MAINTENANCE SYSTEMS 16541 REDMOND HWY, PMB#355-C REDMOND, WA 98052 NUON NOP CLEANING 1112 S DAWSON ST SEATTLE, WA 98108 NURA ADAM 14205 SE 36TH ST. #100 BELLEVUE, WA 98006 PACIFIC INTERPRETERS 707 SW WASHINGTON, SUITE 200 PORTLAND, OR 97205 PACIFIC NORTHWEST SHREDDING 3215 LAFAYETTE AVE S SEATTLE, WA 98144 PACIFIC OFFICE AUTOMATION INC 14747 NW GREENBRIER PARKWAY BEAVERTON, OR 97006 PATSY BRITTO 9900 WEST SAMPLE ROAD CORAL SPRINGS, FL 33065

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PERFECTSERVE, INC. 10024 INVESTMENT DRIVE SUITE 200 KNOXVILLE, TN 37932 PHYSICIANS INSURANCE 43406 BUSINES PARK DRIVE TEMECULA, CA 92590 PIERCE COUNTY BUDGET & FINANCE 950 FAWCETT AVE, STE 100 TACOMA, WA 98402 PITNEY BOWES INC 800 VINIAL ST # B201 PITTSBURGH, PA 15212 POWER UP LENDING GROUP, LTD 111 GRAT NECK ROADD SUITE 216 GREAT NECK, NY 11021 PROPEL INSURANCE 925 FOURTH AVENUE, SUITE 3200 SEATTLE, WA 98104-1159 PUGET SOUND BUILDING MAINTENANCE LLC MERCER ISLAND, WA 98040

PUGET SOUND ENERGY PO BOX 91269 BELLEVUE, WA 98009 PUGET SOUND ENERGY 355 110TH AVE NE BELLEVUE, WA 98004 QUEST DIAGNOSTICS 8403 FALLBROOK AVENUE WEST HILLS, CA 91304 RECOLOGY CLEANSCAPES INC. 7303 8TH AVE S SEATTLE, WA 98108

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RENATA BUKHMAN, ESQ. 17 STATE ST. STE 4000 NEW YORK, NY 10004 RH LYNNWOOD CORP CENTER ASSOC LLC PO BOX 5003 BELLEVUE, WA 98009-5003 ROXANNE HO 6917 47TH STREET COURT W UNIVERSITY PLACE, WA 98466 RTR RECOVERY ATTN: JACOB VERSTANDIG 122 EAST 42ND ST. SUITE 2112 NEW YORK, NY 10168 RUBICON MD, INC. 524 BROADWAY, 11TH FLOOR NEW YORK, NY 10012 SANJIV MATTA 9900 WEST SAMPLE ROAD CORAL SPRINGS, FL 33065 SANOFI PASTEUR INC 1 DISCOVERY DR SWIFTWATER, PA 18370 SATURN FUNDING LLC C/O MCA SERVICING ATTN: STEVEN BERKOVITCH 40 EXCHANGE PL. STE 1306 NEW YORK, NY 10005 SATURN FUNDING, LLC 333 7TH AVENUE, FLOOR 3 NEW YORK, NY 10001 SMART DATA SOLUTIONS, INC. 960 BLUE GENTIAN ROAD EAGAN, MN 55121

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SPOKEN COMMUNICATION 2101 FOURTH AVENUE, SUITE 620 SEATTLE, WA 98121 STANFORD DOSIMETRY LLC 1204 RAYMOND ST BELLINGHAM, WA 98229-2416 STEPHANIE BRACAMONTE 4905 NARROW WAY NE SAINT MICHAEL, MN 55376 STERICYCLE INC. 28161 N. KEITH DRIVE LAKE FOREST, IL 60045 TACOMA PUBLIC UTILITIES PO BOX 11010 TACOMA, WA 98411-1010 TACOMA PUBLIC UTILITIES 3628 SOUTH 35TH STREET TACOMA, WA 98409 TANYA KNIGHT 27224 23RD AVENUE S FEDERAL WAY, WA 98003 TASC 2302 INTERNATIONAL LANE MADISON, WI 53704 TECHNOLOGY FINANCE CORPORATION 7077 E. MARILYN RD BLDG 3 STE 125 SCOTTSDALE, AZ 85254 THERACOM LLC 150 N FIELD DR. TWO CONWAY PARK STE 200 LAKE FOREST, IL 60045 TRA MEDICAL IMAGING 1304 FAWCETT AVE., SUITE 100 TACOMA, WA 98402

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TURNBULL & BORN PLLC ATTN: BRIAN BORN COMMERCE BUILDING, SUITE 1050 950 PACIFIC AVE. TACOMA, WA 98402 TVT CAPITAL LLC 8 HUNTERS LANE ROSLYN, NY 11576 UNION AVE INVESTORS LLC ATTN: DANA CARLISLE PO BOX 394 TACOMA, WA 98401 UNIVERSAL MECHANICAL SERVICE 8901 WILLOWS RD REDMOND, WA 98052 US BANK EQUIPMENT FINANCE 13010 SW 68TH PKWY #100 PORTLAND, OR 97223 US BANK EQUIPMENT FINANCE 1310 MADRID STREET MARSHALL, MN 56258 VANGUARD CLEANING SYSTEMS OF WA 6912 220TH STREET SW, STE. 306 MOUNTLAKE TERRACE, WA 98043 WA ATTORNEY GENERAL'S OFFICE LABOR & INDUSTRIES DIV. ATTN: DIANA CARTWRIGHT 800 FIFTH AVE. STE 2000 SEATTLE, WA 98104 WA DEPT OF L&I PO BOX 44171 OLYMPIA, WA 98504-4171 WA DEPT OF L&I ATTN: DAVID JOHNSON PO BOX 44510 OLYMPIA, WA 98504

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WA DEPT OF L&I ATTN: DAVID JOHNSON 7273 LINDERSON WAY SW OLYMPIA, WA 98501 WAVE BUSINESS 401 PARKPLACE CENTER # 500 KIRKLAND, WA 98033 WELLS FARGO FINANCIAL LEASING 800 WALNUT STREET MAC N0005-044 DES MOINES, IA 50309 YELLOWSTONE CAPITAL LLC 30 BROAD ST. 14TH FLOOR NEW YORK, NY 10004

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United States Bankruptcy Court Western District of Washington In re

Qliance Management Inc.

Case No. Chapter

Debtor(s)

7

CORPORATE OWNERSHIP STATEMENT (RULE 7007.1) Pursuant to Federal Rule of Bankruptcy Procedure 7007.1 and to enable the Judges to evaluate possible disqualification or recusal, the undersigned counsel for Qliance Management Inc. in the above captioned action, certifies that the following is a (are) corporation(s), other than the debtor or a governmental unit, that directly or indirectly own(s) 10% or more of any class of the corporation's(s') equity interests, or states that there are no entities to report under FRBP 7007.1:

None [Check if applicable]

May 17, 2018

/s/ Catherine J. Reny Catherine J. Reny 43058

Date

Signature of Attorney or Litigant Counsel for Qliance Management Inc. Wenokur Riordan PLLC 600 Stewart St Suite 1300 Seattle, WA 98101 206-492-7084 Fax:206-219-4141 [email protected]

Software Copyright (c) 1996-2018 Best Case, LLC - www.bestcase.com

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