SE COMMUNITY WORK CENTER, INC. DENTAL INSURANCE PLAN
|
2014
|
161074815
|
2015-07-30
|
S.E. COMMUNITY WORK CENTER, INC.
|
63
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
2006-11-01
|
Business code |
624310
|
Sponsor’s telephone number |
7166837100
|
Plan
sponsor’s DBA name |
SOUTHEAST WORKS
|
Plan sponsor’s mailing address |
181 LINCOLN ST., DEPEW, NY, 14043
|
Plan sponsor’s
address |
181 LINCOLN ST., DEPEW, NY, 14043
|
Number of participants as of the end of the plan year
Active participants |
60 |
Retired or separated participants receiving
benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2015-07-30 |
Name of individual signing |
MARY ELLEN LAWRIE |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SE COMMUNITY WORK CENTER, INC. DENTAL INSURANCE PLAN
|
2014
|
161074815
|
2015-07-30
|
S.E. COMMUNITY WORK CENTER, INC.
|
111
|
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
2006-11-01
|
Business code |
624310
|
Sponsor’s telephone number |
7166837100
|
Plan
sponsor’s DBA name |
SOUTHEAST WORKS
|
Plan sponsor’s mailing address |
181 LINCOLN ST., DEPEW, NY, 14043
|
Plan sponsor’s
address |
181 LINCOLN ST., DEPEW, NY, 14043
|
Plan administrator’s name and address
Administrator’s EIN |
161074815 |
Plan administrator’s name |
S.E. COMMUNITY WORK CENTER, INC. |
Plan administrator’s
address |
181 LINCOLN ST., DEPEW, NY, 14043 |
Administrator’s telephone number |
7166837100 |
Number of participants as of the end of the plan year
Active participants |
116 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
0 |
Number of
participants
with
account balances as of the end of the plan year |
0 |
Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
0 |
Signature of
Role |
Plan administrator |
Date |
2015-07-30 |
Name of individual signing |
MARY ELLEN LAWRIE |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
S.E. COMMUNITY WORK CENTER, INC. DENTAL INSURANCE PLAN
|
2013
|
161074815
|
2014-07-11
|
S.E. COMMUNITY WORK CENTER, INC.
|
124
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
2006-11-01
|
Business code |
624310
|
Sponsor’s telephone number |
7166837100
|
Plan
sponsor’s DBA name |
SOUTHEAST WORKS
|
Plan sponsor’s mailing address |
181 LINCOLN STREET, DEPEW, NY, 14043
|
Plan sponsor’s
address |
181 LINCOLN STREET, DEPEW, NY, 14043
|
Number of participants as of the end of the plan year
Active participants |
108 |
Retired or separated participants receiving
benefits |
2 |
Other
retired or separated participants entitled to future benefits |
0 |
Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
0 |
Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
0 |
Signature of
Role |
Plan administrator |
Date |
2014-07-10 |
Name of individual signing |
TIMOTHY PFOHL |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2014-07-10 |
Name of individual signing |
TIMOTHY PFOHL |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
S.E. COMMUNITY WORK CENTER, INC. HEALTH INSURANCE PLAN
|
2012
|
161074815
|
2013-06-20
|
S.E. COMMUNITY WORK CENTER, INC.
|
126
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2007-11-01
|
Business code |
624310
|
Sponsor’s telephone number |
7166837100
|
Plan
sponsor’s DBA name |
SOUTHEAST WORKS
|
Plan sponsor’s mailing address |
181 LINCOLN STREET, DEPEW, NY, 14043
|
Plan sponsor’s
address |
181 LINCOLN STREET, DEPEW, NY, 14043
|
Number of participants as of the end of the plan year
Active participants |
122 |
Retired or separated participants receiving
benefits |
2 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2013-06-19 |
Name of individual signing |
KARA MURPHY |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2013-06-19 |
Name of individual signing |
TIMOTHY PFOHL |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
S.E. COMMUNITY WORK CENTER, INC. HEALTH INSURANCE PLAN
|
2012
|
161074815
|
2013-06-20
|
S.E. COMMUNITY WORK CENTER, INC.
|
124
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2007-11-01
|
Business code |
624310
|
Sponsor’s telephone number |
7166837100
|
Plan
sponsor’s DBA name |
SOUTHEAST WORKS
|
Plan sponsor’s mailing address |
181 LINCOLN STREET, DEPEW, NY, 14043
|
Plan sponsor’s
address |
181 LINCOLN STREET, DEPEW, NY, 14043
|
Number of participants as of the end of the plan year
Active participants |
133 |
Retired or separated participants receiving
benefits |
2 |
Signature of
Role |
Plan administrator |
Date |
2013-06-19 |
Name of individual signing |
KARA MURPHY |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2013-06-19 |
Name of individual signing |
TIMOTHY PFOHL |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
S.E. COMMUNITY WORK CENTER, INC. DENTAL INSURANCE PLAN
|
2012
|
161074815
|
2013-06-20
|
S.E. COMMUNITY WORK CENTER, INC.
|
94
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
2006-11-01
|
Business code |
624310
|
Sponsor’s telephone number |
7166837100
|
Plan
sponsor’s DBA name |
SOUTHEAST WORKS
|
Plan sponsor’s mailing address |
181 LINCOLN STREET, DEPEW, NY, 14043
|
Plan sponsor’s
address |
181 LINCOLN STREET, DEPEW, NY, 14043
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2013-06-19 |
Name of individual signing |
KARA MURPHY |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2013-06-19 |
Name of individual signing |
TIMOTHY PFOHL |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
S.E. COMMUNITY WORK CENTER, INC. DENTAL INSURANCE PLAN
|
2012
|
161074815
|
2013-06-20
|
S.E. COMMUNITY WORK CENTER, INC.
|
94
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
2006-11-01
|
Business code |
624310
|
Sponsor’s telephone number |
7166837100
|
Plan
sponsor’s DBA name |
SOUTHEAST WORKS
|
Plan sponsor’s mailing address |
181 LINCOLN STREET, DEPEW, NY, 14043
|
Plan sponsor’s
address |
181 LINCOLN STREET, DEPEW, NY, 14043
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2013-06-19 |
Name of individual signing |
KARA MURPHY |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2013-06-19 |
Name of individual signing |
TIMOTHY PFOHL |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
S.E. COMMUNITY WORK CENTER, INC. DENTAL INSURANCE PLAN
|
2012
|
161074815
|
2013-06-20
|
S.E. COMMUNITY WORK CENTER, INC.
|
120
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
2006-11-01
|
Business code |
624310
|
Sponsor’s telephone number |
7166837100
|
Plan
sponsor’s DBA name |
SOUTHEAST WORKS
|
Plan sponsor’s mailing address |
181 LINCOLN STREET, DEPEW, NY, 14043
|
Plan sponsor’s
address |
181 LINCOLN STREET, DEPEW, NY, 14043
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2013-06-19 |
Name of individual signing |
KARA MURPHY |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2013-06-19 |
Name of individual signing |
TIMOTHY PFOHL |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
S.E. COMMUNITY WORK CENTER, INC. HEALTH INSURANCE PLAN
|
2011
|
161074815
|
2013-06-20
|
S.E. COMMUNITY WORK CENTER, INC.
|
134
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2007-11-01
|
Business code |
624310
|
Sponsor’s telephone number |
7166837100
|
Plan
sponsor’s DBA name |
SOUTHEAST WORKS
|
Plan sponsor’s mailing address |
181 LINCOLN STREET, DEPEW, NY, 14043
|
Plan sponsor’s
address |
181 LINCOLN STREET, DEPEW, NY, 14043
|
Plan administrator’s name and address
Administrator’s EIN |
161074815 |
Plan administrator’s name |
S.E. COMMUNITY WORK CENTER, INC. |
Plan administrator’s
address |
181 LINCOLN STREET, DEPEW, NY, 14043 |
Administrator’s telephone number |
7166837100 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2013-06-19 |
Name of individual signing |
KARA MURPHY |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2013-06-19 |
Name of individual signing |
TIMOTHY PFOHL |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
S.E. COMMUNITY WORK CENTER, INC. DENTAL INSURANCE PLAN
|
2011
|
161074815
|
2013-06-20
|
S.E. COMMUNITY WORK CENTER, INC.
|
119
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
2006-11-01
|
Business code |
624310
|
Sponsor’s telephone number |
7166837100
|
Plan
sponsor’s DBA name |
SOUTHEAST WORKS
|
Plan sponsor’s mailing address |
181 LINCOLN STREET, DEPEW, NY, 14043
|
Plan sponsor’s
address |
181 LINCOLN STREET, DEPEW, NY, 14043
|
Plan administrator’s name and address
Administrator’s EIN |
161074815 |
Plan administrator’s name |
S.E. COMMUNITY WORK CENTER, INC. |
Plan administrator’s
address |
181 LINCOLN STREET, DEPEW, NY, 14043 |
Administrator’s telephone number |
7166837100 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2013-06-19 |
Name of individual signing |
KARA MURPHY |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2013-06-19 |
Name of individual signing |
TIMOTHY PFOHL |
Valid signature |
Filed with authorized/valid electronic signature |
|
|