SUBLETTE MECHANICAL, INC. EMPLOYEE GROUP HEALTH PLAN
|
2023
|
202783868
|
2024-06-18
|
SUBLETTE MECHANICAL, INC.
|
6
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2023-01-01
|
Business code |
811310
|
Sponsor’s telephone number |
8158495223
|
Plan sponsor’s
address |
PO BOX 246, SUBLETTE, IL, 613670246
|
Signature of
Role |
Plan administrator |
Date |
2024-06-18 |
Name of individual signing |
BRENDA VAESSEN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SUBLETTE MECHANICAL INC EMPLOYEE GROUP HEALTH PLAN
|
2022
|
202783868
|
2023-06-14
|
SUBLETTE MECHANICAL, INC.
|
6
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2022-01-01
|
Business code |
811310
|
Sponsor’s telephone number |
8158495223
|
Plan sponsor’s
address |
PO BOX 246, SUBLETTE, IL, 613670246
|
Signature of
Role |
Plan administrator |
Date |
2023-06-14 |
Name of individual signing |
BRENDA VAESSEN |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2023-06-14 |
Name of individual signing |
BRENDA VAESSEN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SUBLETTE MECHANICAL INC EMPLOYEE GROUP HEALTH PLAN
|
2020
|
202783868
|
2021-07-15
|
SUBLETTE MECHANICAL, INC.
|
5
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2020-01-01
|
Business code |
811310
|
Sponsor’s telephone number |
8158495223
|
Plan sponsor’s
address |
PO BOX 246, SUBLETTE, IL, 613670246
|
Signature of
Role |
Plan administrator |
Date |
2021-07-15 |
Name of individual signing |
BRENDA VAESSEN |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2021-07-15 |
Name of individual signing |
BRENDA VAESSEN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SUBLETTE MECHANICAL INC EMPLOYEE GROUP HEALTH PLAN
|
2019
|
202783868
|
2020-07-29
|
SUBLETTE MECHANICAL INC.
|
5
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2019-01-01
|
Business code |
811310
|
Sponsor’s telephone number |
8158495223
|
Plan sponsor’s
address |
PO BOX 246, SUBLETTE, IL, 61367
|
Signature of
Role |
Plan administrator |
Date |
2020-07-29 |
Name of individual signing |
BRENDA VAESSEN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SUBLETTE MECHANICAL INC EMPLOYEE GROUP HEALTH PLAN
|
2018
|
202783868
|
2019-07-24
|
SUBLETTE MECHANICAL INC
|
6
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2018-01-01
|
Business code |
811310
|
Sponsor’s telephone number |
8158495223
|
Plan sponsor’s
address |
PO BOX 246, SUBLETTE, IL, 613670246
|
Signature of
Role |
Plan administrator |
Date |
2019-07-24 |
Name of individual signing |
BRENDA VAESSEN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SUBLETTE MECHANICAL INC EMPLOYEE GROUP HEALTH PLAN
|
2017
|
202783868
|
2018-07-26
|
SUBLETTE MECHANICAL, INC.
|
6
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2017-01-01
|
Business code |
811310
|
Sponsor’s telephone number |
8158495223
|
Plan sponsor’s
address |
PO BOX 246, SUBLETTE, IL, 613670246
|
Signature of
Role |
Plan administrator |
Date |
2018-07-26 |
Name of individual signing |
BRENDA VAESSEN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|