RENZI BROS., INC. GUARDIAN SUPPLEMENTAL PLANS
|
2022
|
161610963
|
2023-03-28
|
RENZI BROS., INC.
|
214
|
|
File |
View Page
|
Three-digit plan number (PN) |
505
|
Effective date of plan |
2021-01-01
|
Business code |
424400
|
Sponsor’s telephone number |
3157885610
|
Plan
sponsor’s DBA name |
RENZI FOODSERVICE
|
Plan sponsor’s mailing address |
901 RAIL DR, WATERTOWN, NY, 136012379
|
Plan sponsor’s
address |
901 RAIL DR, WATERTOWN, NY, 136012379
|
Plan administrator’s name and address
Administrator’s EIN |
161610963 |
Plan administrator’s name |
RENZI BROS., INC. |
Plan administrator’s
address |
901 RAIL DR, WATERTOWN, NY, 136012379 |
Administrator’s telephone number |
3157885610 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2023-03-28 |
Name of individual signing |
SHAUN PLESKACH |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
RENZI BROS., INC. HRA PLAN
|
2022
|
161610963
|
2023-03-28
|
RENZI BROS., INC.
|
126
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
2019-01-01
|
Business code |
424400
|
Sponsor’s telephone number |
3157885610
|
Plan
sponsor’s DBA name |
RENZI FOODSERVICE
|
Plan sponsor’s mailing address |
901 RAIL DR, WATERTOWN, NY, 136012379
|
Plan sponsor’s
address |
901 RAIL DR, WATERTOWN, NY, 136012379
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2023-03-28 |
Name of individual signing |
SHAUN PLESKACH |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
RENZI BROS., INC. HEALTH PLAN
|
2022
|
161610963
|
2023-03-28
|
RENZI BROS., INC.
|
146
|
|
File |
View Page
|
Three-digit plan number (PN) |
504
|
Effective date of plan |
2019-01-01
|
Business code |
424400
|
Sponsor’s telephone number |
3157885610
|
Plan
sponsor’s DBA name |
RENZI FOODSERVICE
|
Plan sponsor’s mailing address |
901 RAIL DR, WATERTOWN, NY, 136012379
|
Plan sponsor’s
address |
901 RAIL DR, WATERTOWN, NY, 136012379
|
Number of participants as of the end of the plan year
Active participants |
155 |
Retired or separated participants receiving
benefits |
1 |
Signature of
Role |
Plan administrator |
Date |
2023-03-28 |
Name of individual signing |
SHAUN PLESKACH |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
RENZI BROS., INC. HRA PLAN
|
2021
|
161610963
|
2023-03-24
|
RENZI BROS., INC.
|
133
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
2019-01-01
|
Business code |
424400
|
Sponsor’s telephone number |
3157885610
|
Plan
sponsor’s DBA name |
RENZI FOODSERVICE
|
Plan sponsor’s mailing address |
901 RAIL DR, WATERTOWN, NY, 136012379
|
Plan sponsor’s
address |
901 RAIL DR, WATERTOWN, NY, 136012379
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2023-03-24 |
Name of individual signing |
SHAUN PLESKACH |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
RENZI BROS., INC. GUARDIAN SUPPLEMENTAL PLANS
|
2021
|
161610963
|
2022-04-20
|
RENZI BROS., INC.
|
103
|
|
File |
View Page
|
Three-digit plan number (PN) |
505
|
Effective date of plan |
2021-01-01
|
Business code |
424400
|
Sponsor’s telephone number |
3157885610
|
Plan
sponsor’s DBA name |
RENZI FOODSERVICE
|
Plan sponsor’s mailing address |
901 RAIL DR, WATERTOWN, NY, 136012379
|
Plan sponsor’s
address |
901 RAIL DR, WATERTOWN, NY, 136012379
|
Plan administrator’s name and address
Administrator’s EIN |
161610963 |
Plan administrator’s name |
RENZI BROS., INC. |
Plan administrator’s
address |
901 RAIL DR, WATERTOWN, NY, 136012379 |
Administrator’s telephone number |
3157885610 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2022-04-20 |
Name of individual signing |
SHAUN PLESKACH |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2022-04-20 |
Name of individual signing |
SHAUN PLESKACH |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
RENZI BROS., INC. HEALTH PLAN
|
2021
|
161610963
|
2022-04-20
|
RENZI BROS., INC.
|
136
|
|
File |
View Page
|
Three-digit plan number (PN) |
504
|
Effective date of plan |
2019-01-01
|
Business code |
424400
|
Sponsor’s telephone number |
3157885610
|
Plan
sponsor’s DBA name |
RENZI FOODSERVICE
|
Plan sponsor’s mailing address |
901 RAIL DR, WATERTOWN, NY, 136012379
|
Plan sponsor’s
address |
901 RAIL DR, WATERTOWN, NY, 136012379
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2022-04-20 |
Name of individual signing |
SHAUN PLESKACH |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2022-04-20 |
Name of individual signing |
SHAUN PLESKACH |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
RENZI BROS., INC. HRA PLAN
|
2021
|
161610963
|
2022-04-20
|
RENZI BROS., INC.
|
133
|
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
2019-01-01
|
Business code |
424400
|
Sponsor’s telephone number |
3157885610
|
Plan
sponsor’s DBA name |
RENZI FOODSERVICE
|
Plan sponsor’s mailing address |
901 RAIL DR, WATERTOWN, NY, 136012379
|
Plan sponsor’s
address |
901 RAIL DR, WATERTOWN, NY, 136012379
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2022-04-20 |
Name of individual signing |
SHAUN PLESKACH |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2022-04-20 |
Name of individual signing |
SHAUN PLESKACH |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
RENZI BROS., INC. GUARDIAN VISION/SHORT TERM DISABILITY
|
2020
|
161610963
|
2021-03-08
|
RENZI BROS., INC.
|
118
|
|
File |
View Page
|
Three-digit plan number (PN) |
505
|
Effective date of plan |
2019-01-01
|
Business code |
424400
|
Sponsor’s telephone number |
3157885610
|
Plan
sponsor’s DBA name |
RENZI FOODSERVICE
|
Plan sponsor’s mailing address |
901 RAIL DR, WATERTOWN, NY, 136012379
|
Plan sponsor’s
address |
901 RAIL DRIVE, WATERTOWN, NY, 13601
|
Plan administrator’s name and address
Administrator’s EIN |
161610963 |
Plan administrator’s name |
RENZI BROS., INC. |
Plan administrator’s
address |
901 RAIL DR, WATERTOWN, NY, 136012379 |
Administrator’s telephone number |
3157885610 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2021-03-08 |
Name of individual signing |
SHAUN PLESKACH |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2021-03-08 |
Name of individual signing |
SHAUN PLESKACH |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
RENZI BROS., INC. DENTAL PLAN
|
2020
|
161610963
|
2021-03-08
|
RENZI BROS., INC.
|
131
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2019-01-01
|
Business code |
424400
|
Sponsor’s telephone number |
3157885610
|
Plan
sponsor’s DBA name |
RENZI FOODSERVICE
|
Plan sponsor’s mailing address |
901 RAIL DR, WATERTOWN, NY, 136012379
|
Plan sponsor’s
address |
901 RAIL DR, WATERTOWN, NY, 136012379
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2021-03-08 |
Name of individual signing |
SHAUN PLESKACH |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2021-03-08 |
Name of individual signing |
SHAUN PLESKACH |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
RENZI BROS., INC. HEALTH PLAN
|
2020
|
161610963
|
2021-03-08
|
RENZI BROS., INC.
|
134
|
|
File |
View Page
|
Three-digit plan number (PN) |
504
|
Effective date of plan |
2019-01-01
|
Business code |
424400
|
Sponsor’s telephone number |
3157885610
|
Plan
sponsor’s DBA name |
RENZI FOODSERVICE
|
Plan sponsor’s mailing address |
901 RAIL DR, WATERTOWN, NY, 136012379
|
Plan sponsor’s
address |
901 RAIL DR, WATERTOWN, NY, 136012379
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2021-03-08 |
Name of individual signing |
SHAUN PLESKACH |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2021-03-08 |
Name of individual signing |
SHAUN PLESKACH |
Valid signature |
Filed with authorized/valid electronic signature |
|
|