MERVIS INDUSTRIES GROUP HEALTH PLAN
|
2021
|
370812150
|
2023-05-11
|
MERVIS INDUSTRIES, INC
|
196
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1993-03-01
|
Business code |
423930
|
Sponsor’s telephone number |
2174425300
|
Plan
sponsor’s DBA name |
MERVIS RECYCLING
|
Plan sponsor’s mailing address |
3295 EAST MAIN STREET, PO BOX 827, DANVILLE, IL, 618340827
|
Plan sponsor’s
address |
3295 EAST MAIN STREET, PO BOX 827, DANVILLE, IL, 618340827
|
Number of participants as of the end of the plan year
Active participants |
200 |
Retired or separated participants receiving
benefits |
1 |
Signature of
Role |
Plan administrator |
Date |
2023-05-11 |
Name of individual signing |
MATT GRANDONE |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MERVIS INDUSTRIES GROUP HEALTH PLAN
|
2020
|
370812150
|
2022-04-19
|
MERVIS INDUSTRIES, INC
|
211
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1993-03-01
|
Business code |
423930
|
Sponsor’s telephone number |
2174425300
|
Plan
sponsor’s DBA name |
MERVIS RECYCLING
|
Plan sponsor’s mailing address |
3295 EAST MAIN STREET, PO BOX 827, DANVILLE, IL, 618340827
|
Plan sponsor’s
address |
3295 EAST MAIN STREET, PO BOX 827, DANVILLE, IL, 618340827
|
Number of participants as of the end of the plan year
Active participants |
200 |
Retired or separated participants receiving
benefits |
2 |
Signature of
Role |
Plan administrator |
Date |
2022-04-19 |
Name of individual signing |
MATT GRANDONE |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MERVIS INDUSTRIES, INC GROUP HEALTH PLAN
|
2019
|
370812150
|
2021-04-26
|
MERVIS INDUSTRIES, INC
|
211
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1993-03-01
|
Business code |
423930
|
Sponsor’s telephone number |
2174425300
|
Plan
sponsor’s DBA name |
MERVIS RECYCLING
|
Plan sponsor’s mailing address |
3295 EAST MAIN STREET, PO BOX 827, DANVILLE, IL, 618340827
|
Plan sponsor’s
address |
3295 EAST MAIN STREET, PO BOX 827, DANVILLE, IL, 618340827
|
Number of participants as of the end of the plan year
Active participants |
209 |
Retired or separated participants receiving
benefits |
2 |
Signature of
Role |
Plan administrator |
Date |
2021-04-26 |
Name of individual signing |
MATT GRANDONE |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MERVIS INDUSTRIES, INC GROUP HEALTH PLAN
|
2018
|
370812150
|
2020-04-24
|
MERVIS INDUSTRIES, INC
|
193
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1993-03-01
|
Business code |
423930
|
Sponsor’s telephone number |
2174425300
|
Plan
sponsor’s DBA name |
MERVIS RECYCLING
|
Plan sponsor’s mailing address |
3295 EAST MAIN STREET, PO BOX 827, DANVILLE, IL, 618340827
|
Plan sponsor’s
address |
3295 EAST MAIN STREET, PO BOX 827, DANVILLE, IL, 618340827
|
Number of participants as of the end of the plan year
Active participants |
210 |
Retired or separated participants receiving
benefits |
1 |
Signature of
Role |
Plan administrator |
Date |
2020-04-24 |
Name of individual signing |
MATT GRANDONE |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MERVIS INDUSTRIES, INC GROUP HEALTH PLAN
|
2017
|
370812150
|
2019-04-22
|
MERVIS INDUSTRIES, INC.
|
189
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1993-03-01
|
Business code |
423930
|
Sponsor’s telephone number |
2174425300
|
Plan
sponsor’s DBA name |
MERVIS RECYCLING
|
Plan sponsor’s mailing address |
3295 EAST MAIN STREET, PO BOX 827, DANVILLE, IL, 618340827
|
Plan sponsor’s
address |
3295 EAST MAIN STREET, PO BOX 827, DANVILLE, IL, 618340827
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2019-04-22 |
Name of individual signing |
AMY HOOSE |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MERVIS INDUSTRIES, INC GROUP HEALTH PLAN
|
2016
|
370812150
|
2018-04-30
|
MERVIS INDUSTRIES, INC
|
208
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1993-03-01
|
Business code |
423930
|
Sponsor’s telephone number |
2174425300
|
Plan
sponsor’s DBA name |
MERVIS RECYCLING
|
Plan sponsor’s mailing address |
3295 EAST MAIN STREET, PO BOX 827, DANVILLE, IL, 618340827
|
Plan sponsor’s
address |
3295 EAST MAIN STREET, PO BOX 827, DANVILLE, IL, 618340827
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2018-04-30 |
Name of individual signing |
AMY HOOSE |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MERVIS INDUSTRIES, INC GROUP HEALTH PLAN
|
2015
|
370812150
|
2017-04-21
|
MERVIS INDUSTRIES, INC.
|
225
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1993-03-01
|
Business code |
423930
|
Sponsor’s telephone number |
2174425300
|
Plan
sponsor’s DBA name |
MERVIS RECYCLING
|
Plan sponsor’s mailing address |
3295 EAST MAIN STREET, PO BOX 827, DANVILLE, IL, 618340827
|
Plan sponsor’s
address |
3295 EAST MAIN STREET, PO BOX 827, DANVILLE, IL, 618340827
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2017-04-21 |
Name of individual signing |
AMY HOOSE |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MERVIS INDUSTRIES, INC GROUP HEALTH PLAN
|
2014
|
370812150
|
2016-05-19
|
MERVIS INDUSTRIES, INC.
|
232
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1993-03-01
|
Business code |
423930
|
Sponsor’s telephone number |
2174425300
|
Plan
sponsor’s DBA name |
MERVIS RECYCLING
|
Plan sponsor’s mailing address |
3295 E MAIN STREET, PO BOX 827, DANVILLE, IL, 618340827
|
Plan sponsor’s
address |
3295 E MAIN STREET, PO BOX 827, DANVILLE, IL, 618340827
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2016-05-19 |
Name of individual signing |
CANDICE UNDERHILL |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2016-05-19 |
Name of individual signing |
CANDICE UNDERHILL |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MERVIS INDUSTRIES, INC GROUP HEALTH PLAN
|
2013
|
370812150
|
2015-04-24
|
MERVIS INDUSTRIES, INC.
|
245
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1993-03-01
|
Business code |
423930
|
Sponsor’s telephone number |
2174425300
|
Plan sponsor’s mailing address |
3295 EAST MAIN STREET, P.O. BOX 827, DANVILLE, IL, 61834
|
Plan sponsor’s
address |
3295 EAST MAIN STREET, P.O. BOX 827, DANVILLE, IL, 61834
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2015-04-24 |
Name of individual signing |
CANDICE UNDERHILL |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MERVIS INDUSTRIES, INC GROUP HEALTH PLAN
|
2012
|
370812150
|
2014-04-30
|
MERVIS INDUSTRIES, INC
|
237
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1993-03-01
|
Business code |
423930
|
Sponsor’s telephone number |
2174425300
|
Plan sponsor’s mailing address |
3295 EAST MAIN STREET, PO BOX 827, DANVILLE, IL, 61834
|
Plan sponsor’s
address |
3295 EAST MAIN STREET, PO BOX 827, DANVILLE, IL, 61834
|
Plan administrator’s name and address
Administrator’s EIN |
370812150 |
Plan administrator’s name |
MERVIS INDUSTRIES, INC |
Plan administrator’s
address |
3295 EAST MAIN STREET, PO BOX 827, DANVILLE, IL, 61834 |
Administrator’s telephone number |
2174425300 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2014-04-30 |
Name of individual signing |
CANDICE UNDERHILL |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2014-04-30 |
Name of individual signing |
CANDICE UNDERHILL |
Valid signature |
Filed with authorized/valid electronic signature |
|
|