COLLINS BROTHERS WORLDWIDE, LLC

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2005-01-01
Business code	493100
Sponsor’s telephone number	9148343030
Plan sponsor’s address	620 FIFTH AVENUE, LARCHMONT, NY, 105381995

Signature of

Role	Plan administrator
Date	2019-09-16
Name of individual signing	THERESE FERRETTI

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2005-01-01
Business code	493100
Sponsor’s telephone number	9148343030
Plan sponsor’s address	620 FIFTH AVENUE, LARCHMONT, NY, 105381995

Signature of

Role	Plan administrator
Date	2018-09-13
Name of individual signing	THERESE FERRETTI

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2005-01-01
Business code	493100
Sponsor’s telephone number	9148343030
Plan sponsor’s address	620 FIFTH AVENUE, LARCHMONT, NY, 105381995

Signature of

Role	Plan administrator
Date	2017-10-09
Name of individual signing	THERESE FERRETTI

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2005-01-01
Business code	493100
Sponsor’s telephone number	9148343030
Plan sponsor’s address	620 FIFTH AVENUE, LARCHMONT, NY, 105381995

Signature of

Role	Plan administrator
Date	2016-09-12
Name of individual signing	THERESE FERRETTI

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2005-01-01
Business code	493100
Sponsor’s telephone number	9148343030
Plan sponsor’s address	620 FIFTH AVENUE, LARCHMONT, NY, 105381995

Signature of

Role	Plan administrator
Date	2015-10-08
Name of individual signing	THERESE FERRETTI

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2005-01-01
Business code	493100
Sponsor’s telephone number	9148343030
Plan sponsor’s address	620 FIFTH AVENUE, LARCHMONT, NY, 105381995

Signature of

Role	Plan administrator
Date	2014-10-10
Name of individual signing	THERESE FERRETTI

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2005-01-01
Business code	493100
Sponsor’s telephone number	9148343030
Plan sponsor’s address	620 FIFTH AVENUE, LARCHMONT, NY, 105381995

Signature of

Role	Plan administrator
Date	2013-10-11
Name of individual signing	THERESE FERRETTI

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2005-01-01
Business code	493100
Sponsor’s telephone number	9148343030
Plan sponsor’s address	2 MADISON AVENUE SUITE 212, LARCHMONT, NY, 105381961

Plan administrator’s name and address

Administrator’s EIN	113734739
Plan administrator’s name	COLLINS BROTHERS WORLDWIDE, LLC
Plan administrator’s address	2 MADISON AVENUE SUITE 212, LARCHMONT, NY, 105381961
Administrator’s telephone number	9148343030

Signature of

Role	Plan administrator
Date	2012-10-10
Name of individual signing	GREGG PIERLEONI

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2005-01-01
Business code	493100
Sponsor’s telephone number	9148343030
Plan sponsor’s address	2 MADISON AVENUE SUITE 212, LARCHMONT, NY, 105381961

Plan administrator’s name and address

Administrator’s EIN	113734739
Plan administrator’s name	COLLINS BROTHERS WORLDWIDE, LLC
Plan administrator’s address	2 MADISON AVENUE SUITE 212, LARCHMONT, NY, 105381961
Administrator’s telephone number	9148343030

Signature of

Role	Plan administrator
Date	2011-09-30
Name of individual signing	GREGG PIERLEONI

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2005-01-01
Business code	493100
Sponsor’s telephone number	9148343030
Plan sponsor’s address	2 MADISON AVENUE SUITE 212, LARCHMONT, NY, 105381961

Plan administrator’s name and address

Administrator’s EIN	113734739
Plan administrator’s name	COLLINS BROTHERS WORLDWIDE, LLC
Plan administrator’s address	2 MADISON AVENUE SUITE 212, LARCHMONT, NY, 105381961
Administrator’s telephone number	9148343030

Signature of

Role	Plan administrator
Date	2010-10-08
Name of individual signing	GREGG PIERLEONI