PRO ACTION OF STEUBEN AND YATES, INC. HEALTH & WELFARE BENEFITS PLAN
|
2019
|
160914512
|
2020-07-06
|
PRO ACTION OF STEUBEN AND YATES, INC.
|
242
|
|
File |
View Page
|
Three-digit plan number (PN) |
520
|
Effective date of plan |
2005-01-01
|
Business code |
624100
|
Sponsor’s telephone number |
6077762125
|
Plan sponsor’s mailing address |
117 E. STEUBEN STREET, BATH, NY, 14810
|
Plan sponsor’s
address |
117 E. STEUBEN STREET, BATH, NY, 14810
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2020-07-06 |
Name of individual signing |
LOGAN CORNELL |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PRO ACTION OF STEUBEN AND YATES, INC. SECTION 105 HEALTH REIMBURSEMENT ARRANGEMENT
|
2019
|
160914512
|
2020-07-06
|
PRO ACTION OF STEUBEN AND YATES, INC.
|
104
|
|
File |
View Page
|
Three-digit plan number (PN) |
525
|
Effective date of plan |
2011-01-01
|
Business code |
624100
|
Sponsor’s telephone number |
6077762125
|
Plan sponsor’s mailing address |
117 E. STEUBEN STREET, BATH, NY, 14810
|
Plan sponsor’s
address |
117 E. STEUBEN STREET, BATH, NY, 14810
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2020-07-06 |
Name of individual signing |
LOGAN CORNELL |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PRO ACTION OF STEUBEN AND YATES, INC. SECTION 105 HEALTH REIMBURSEMENT ARRANGEMENT
|
2018
|
160914512
|
2019-07-24
|
PRO ACTION OF STEUBEN AND YATES, INC.
|
106
|
|
File |
View Page
|
Three-digit plan number (PN) |
525
|
Effective date of plan |
2011-01-01
|
Business code |
624100
|
Sponsor’s telephone number |
6077762125
|
Plan sponsor’s mailing address |
117 E. STEUBEN STREET, BATH, NY, 14810
|
Plan sponsor’s
address |
117 E. STEUBEN STREET, BATH, NY, 14810
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2019-07-24 |
Name of individual signing |
LOGAN CORNELL |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PRO ACTION OF STEUBEN AND YATES, INC. HEALTH & WELFARE BENEFITS PLAN
|
2018
|
160914512
|
2019-07-24
|
PRO ACTION OF STEUBEN AND YATES, INC.
|
234
|
|
File |
View Page
|
Three-digit plan number (PN) |
520
|
Effective date of plan |
2005-01-01
|
Business code |
624100
|
Sponsor’s telephone number |
6077762125
|
Plan sponsor’s mailing address |
117 E. STEUBEN STREET, BATH, NY, 14810
|
Plan sponsor’s
address |
117 E. STEUBEN STREET, BATH, NY, 14810
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2019-07-24 |
Name of individual signing |
LOGAN CORNELL |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PRO ACTION OF STEUBEN AND YATES, INC. HEALTH & WELFARE BENEFITS PLAN
|
2017
|
160914512
|
2018-07-09
|
PRO ACTION OF STEUBEN AND YATES, INC.
|
239
|
|
File |
View Page
|
Three-digit plan number (PN) |
520
|
Effective date of plan |
2005-01-01
|
Business code |
624100
|
Sponsor’s telephone number |
6077762125
|
Plan sponsor’s mailing address |
117 E. STEUBEN STREET, BATH, NY, 14810
|
Plan sponsor’s
address |
117 E. STEUBEN STREET, BATH, NY, 14810
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2018-07-09 |
Name of individual signing |
SAMANTHA TESTANI |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PRO ACTION OF STEUBEN AND YATES, INC. SECTION 105 HEALTH REIMBURSEMENT ARRANGEMENT
|
2017
|
160914512
|
2018-07-09
|
PRO ACTION OF STEUBEN AND YATES, INC.
|
114
|
|
File |
View Page
|
Three-digit plan number (PN) |
525
|
Effective date of plan |
2011-01-01
|
Business code |
624100
|
Sponsor’s telephone number |
6077762125
|
Plan sponsor’s mailing address |
117 E. STEUBEN STREET, BATH, NY, 14810
|
Plan sponsor’s
address |
117 E. STEUBEN STREET, BATH, NY, 14810
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2018-07-09 |
Name of individual signing |
SAMANTHA TESTANI |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PRO ACTION OF STEUBEN AND YATES, INC. HEALTH & WELFARE BENEFITS PLAN
|
2016
|
160914512
|
2017-05-16
|
PRO ACTION OF STEUBEN AND YATES, INC.
|
235
|
|
File |
View Page
|
Three-digit plan number (PN) |
520
|
Effective date of plan |
2005-01-01
|
Business code |
624100
|
Sponsor’s telephone number |
6077762125
|
Plan sponsor’s mailing address |
117 E. STEUBEN STREET, BATH, NY, 14810
|
Plan sponsor’s
address |
117 E. STEUBEN STREET, BATH, NY, 14810
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2017-05-16 |
Name of individual signing |
SAMANTHA TESTANI |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PRO ACTION OF STEUBEN AND YATES, INC. SECTION 105 HEALTH REIMBURSEMENT ARRANGEMENT
|
2016
|
160914512
|
2017-05-16
|
PRO ACTION OF STEUBEN AND YATES, INC.
|
114
|
|
File |
View Page
|
Three-digit plan number (PN) |
525
|
Effective date of plan |
2011-01-01
|
Business code |
624100
|
Sponsor’s telephone number |
6077762125
|
Plan sponsor’s mailing address |
117 E. STEUBEN STREET, BATH, NY, 14810
|
Plan sponsor’s
address |
117 E. STEUBEN STREET, BATH, NY, 14810
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2017-05-16 |
Name of individual signing |
SAMANTHA TESTANI |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PRO ACTION OF STEUBEN AND YATES, INC. SECTION 105 HEALTH REIMBURSEMENT ARRANGEMENT
|
2015
|
160914512
|
2016-07-01
|
PRO ACTION OF STEUBEN AND YATES, INC.
|
125
|
|
File |
View Page
|
Three-digit plan number (PN) |
525
|
Effective date of plan |
2011-01-01
|
Business code |
624100
|
Sponsor’s telephone number |
6077762125
|
Plan sponsor’s mailing address |
117 E. STEUBEN STREET, BATH, NY, 14810
|
Plan sponsor’s
address |
117 E. STEUBEN STREET, BATH, NY, 14810
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2016-07-01 |
Name of individual signing |
SAMANTHA TESTANI |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PRO ACTION OF STEUBEN AND YATES, INC. HEATLH & WELFARE BENEFITS PLAN
|
2015
|
160914512
|
2016-07-01
|
PRO ACTION OF STEUBEN AND YATES, INC.
|
240
|
|
File |
View Page
|
Three-digit plan number (PN) |
520
|
Effective date of plan |
2005-01-01
|
Business code |
624100
|
Sponsor’s telephone number |
6077762125
|
Plan sponsor’s mailing address |
117 E. STEUBEN STREET, BATH, NY, 14810
|
Plan sponsor’s
address |
117 E. STEUBEN STREET, BATH, NY, 14810
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2016-07-01 |
Name of individual signing |
SAMANTHA TESTANI |
Valid signature |
Filed with authorized/valid electronic signature |
|
|