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  5. COMPLETE SAFETY, INC.

COMPLETE SAFETY, INC.

Company Details

Entity Name: COMPLETE SAFETY, INC.
Jurisdiction: Illinois
Entity Type: Corporation - Domestic BCA
Status: Dissolved
Date Formed: 03 Jul 2003
Date of Dissolution: 14 Dec 2018
Company Number: CORP_62978139
File Number: 62978139
Type of Business: All Inclusive Purpose
Date Status Change: 14 Dec 2018
Place of Formation: ILLINOIS

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
COMPLETE SAFETY, INC., EMPLOYEE GROUP HEALTH PLAN 2016 200123126 2017-06-02 COMPLETE SAFETY, INC. 8
File View Page
Three-digit plan number (PN) 501
Effective date of plan 2016-01-01
Business code 541600
Sponsor’s telephone number 8154760172
Plan sponsor’s address 330 NORTH FIRST STREET, PO BOX 118, WILMINGTON, IL, 604810118

Signature of
Role Plan administrator
Date 2017-06-02
Name of individual signing JUDITH HUBRICH
Valid signature Filed with authorized/valid electronic signature
COMPLETE SAFETY, INC., EMPLOYEE GROUP HEALTH PLAN 2015 200123126 2016-07-27 COMPLETE SAFETY, INC. 8
File View Page
Three-digit plan number (PN) 501
Effective date of plan 2015-12-01
Business code 541600
Sponsor’s telephone number 8154760172
Plan sponsor’s address 330 NORTH FIRST STREET, PO BOX 118, WILMINGTON, IL, 604810118

Signature of
Role Plan administrator
Date 2016-07-27
Name of individual signing JUDITH HUBRICH
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-07-27
Name of individual signing JUDITH HUBRICH
Valid signature Filed with authorized/valid electronic signature
COMPLETE SAFETY, INC., EMPLOYEE GROUP HEALTH PLAN 2015 200123126 2016-07-07 COMPLETE SAFETY, INC. 0
Three-digit plan number (PN) 501
Effective date of plan 2015-12-01
Business code 541600
Sponsor’s telephone number 8154760172
Plan sponsor’s address 330 NORTH FIRST STREET, PO BOX 118, WILMINGTON, IL, 604810118

Signature of
Role Plan administrator
Date 2016-07-07
Name of individual signing JUDITH HUBRICH
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-07-07
Name of individual signing JUDITH HUBRICH
Valid signature Filed with authorized/valid electronic signature

Agent

Name and Address Role Appointment Date
JEFFREY A HUBRICH, 330 N 1ST STREET PO BOX 118, WILMINGTON, 60481, WILL Agent 2008-07-01

President

Name and Address Role
KEVIN L LAMB, 330 N FIRST ST WILMINGTON 60481 President

Shares

Class Series Voting Rights Authorized Shares Issued Shares Par Value
COMMON No data Voting Rights 10000 1000000 No data

Related by officers

No related officers

Related by address

No related companies by address

Date of last update: 23 Dec 2024

Sources: Illinois Office of the Secretary of State

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