GRAHAM CORPORATION MEDICAL/DENTAL PLAN
|
2012
|
161194720
|
2013-10-14
|
GRAHAM CORPORATION
|
220
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1987-11-01
|
Business code |
333310
|
Sponsor’s telephone number |
5853432216
|
Plan sponsor’s mailing address |
20 FLORENCE AVENUE, BATAVIA, NY, 14020
|
Plan sponsor’s
address |
20 FLORENCE AVENUE, BATAVIA, NY, 14020
|
Plan administrator’s name and address
Administrator’s EIN |
161194720 |
Plan administrator’s name |
GRAHAM CORPORATION |
Plan administrator’s
address |
20 FLORENCE AVENUE, BATAVIA, NY, 14020 |
Administrator’s telephone number |
5853432216 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2013-10-14 |
Name of individual signing |
JEFFREY GLAJCH |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2013-10-14 |
Name of individual signing |
JEFFREY GLAJCH |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GRAHAM CORPORATION LONG TERM DISABILITY PLAN
|
2012
|
161194720
|
2013-10-14
|
GRAHAM CORPORATION
|
266
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
1987-11-01
|
Business code |
333310
|
Sponsor’s telephone number |
5853432216
|
Plan sponsor’s mailing address |
20 FLORENCE AVENUE, BATAVIA, NY, 14020
|
Plan sponsor’s
address |
20 FLORENCE AVENUE, BATAVIA, NY, 14020
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2013-10-14 |
Name of individual signing |
JEFFREY GLAJCH |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2013-10-14 |
Name of individual signing |
JEFFREY GLAJCH |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GRAHAM CORPORATION TRAVEL INSURANCE PLAN
|
2012
|
161194720
|
2013-10-14
|
GRAHAM CORPORATION
|
267
|
|
File |
View Page
|
Three-digit plan number (PN) |
511
|
Effective date of plan |
2000-01-01
|
Business code |
332300
|
Sponsor’s telephone number |
5853432216
|
Plan sponsor’s mailing address |
20 FLORENCE AVENUE, BATAVIA, NY, 14020
|
Plan sponsor’s
address |
20 FLORENCE AVENUE, BATAVIA, NY, 14020
|
Plan administrator’s name and address
Administrator’s EIN |
161194720 |
Plan administrator’s name |
GRAHAM CORPORATION |
Plan administrator’s
address |
20 FLORENCE AVENUE, BATAVIA, NY, 14020 |
Administrator’s telephone number |
5853432216 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2013-10-14 |
Name of individual signing |
JEFFREY GLAJCH |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2013-10-14 |
Name of individual signing |
JEFFREY GLAJCH |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GRAHAM CORPORATION ACCIDENTAL DEATH & DISMEMBERMENT PLAN
|
2012
|
161194720
|
2013-10-14
|
GRAHAM CORPORATION
|
267
|
|
File |
View Page
|
Three-digit plan number (PN) |
503
|
Effective date of plan |
1987-11-01
|
Business code |
333310
|
Sponsor’s telephone number |
5853432216
|
Plan sponsor’s mailing address |
20 FLORENCE AVENUE, BATAVIA, NY, 14020
|
Plan sponsor’s
address |
20 FLORENCE AVENUE, BATAVIA, NY, 14020
|
Plan administrator’s name and address
Administrator’s EIN |
161194720 |
Plan administrator’s name |
GRAHAM CORPORATION |
Plan administrator’s
address |
20 FLORENCE AVENUE, BATAVIA, NY, 14020 |
Administrator’s telephone number |
5853432216 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2013-10-14 |
Name of individual signing |
JEFFREY GLAJCH |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2013-10-14 |
Name of individual signing |
JEFFREY GLAJCH |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GRAHAM CORPORATION, LIFE INSURANCE PLAN
|
2012
|
161194720
|
2013-10-14
|
GRAHAM CORPORATION
|
267
|
|
File |
View Page
|
Three-digit plan number (PN) |
504
|
Effective date of plan |
1999-01-01
|
Business code |
333310
|
Sponsor’s telephone number |
5853432216
|
Plan sponsor’s mailing address |
20 FLORENCE AVENUE, BATAVIA, NY, 14020
|
Plan sponsor’s
address |
20 FLORENCE AVE., BATAVIA, NY, 14020
|
Plan administrator’s name and address
Administrator’s EIN |
161194720 |
Plan administrator’s name |
GRAHAM CORPORATION |
Plan administrator’s
address |
GRAHAM CORPORATION, BATAVIA, NY, 14020 |
Administrator’s telephone number |
5853432216 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2013-10-14 |
Name of individual signing |
JEFFREY GLAJCH |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2013-10-14 |
Name of individual signing |
JEFFREY GLAJCH |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GRAHAM CORPORATION LONG TERM DISABILITY PLAN
|
2011
|
161194720
|
2012-10-02
|
GRAHAM CORPORATION
|
251
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
1987-11-01
|
Business code |
333310
|
Sponsor’s telephone number |
5853432216
|
Plan sponsor’s mailing address |
20 FLORENCE AVENUE, BATAVIA, NY, 14020
|
Plan sponsor’s
address |
20 FLORENCE AVENUE, BATAVIA, NY, 14020
|
Plan administrator’s name and address
Administrator’s EIN |
161194720 |
Plan administrator’s name |
GRAHAM CORPORATION |
Plan administrator’s
address |
20 FLORENCE AVENUE, BATAVIA, NY, 14020 |
Administrator’s telephone number |
5853432216 |
Number of participants as of the end of the plan year
Retired or separated participants receiving
benefits |
266 |
Signature of
Role |
Plan administrator |
Date |
2012-10-02 |
Name of individual signing |
JEFFREY GLAJCH |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GRAHAM CORPORATION ACCIDENTAL DEATH & DISMEMBERMENT PLAN
|
2011
|
161194720
|
2012-10-02
|
GRAHAM CORPORATION
|
251
|
|
File |
View Page
|
Three-digit plan number (PN) |
503
|
Effective date of plan |
1987-11-01
|
Business code |
333310
|
Sponsor’s telephone number |
5853432216
|
Plan sponsor’s mailing address |
20 FLORENCE AVENUE, BATAVIA, NY, 14020
|
Plan sponsor’s
address |
20 FLORENCE AVENUE, BATAVIA, NY, 14020
|
Plan administrator’s name and address
Administrator’s EIN |
161194720 |
Plan administrator’s name |
GRAHAM CORPORATION |
Plan administrator’s
address |
20 FLORENCE AVENUE, BATAVIA, NY, 14020 |
Administrator’s telephone number |
5853432216 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2012-10-02 |
Name of individual signing |
JEFFREY GLAJCH |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GRAHAM CORPORATION, LIFE INSURANCE PLAN
|
2011
|
161194720
|
2012-10-02
|
GRAHAM CORPORATION
|
256
|
|
File |
View Page
|
Three-digit plan number (PN) |
504
|
Effective date of plan |
1999-01-01
|
Business code |
333310
|
Sponsor’s telephone number |
5853432216
|
Plan sponsor’s mailing address |
20 FLORENCE AVENUE, BATAVIA, NY, 14020
|
Plan sponsor’s
address |
20 FLORENCE AVE., BATAVIA, NY, 14020
|
Plan administrator’s name and address
Administrator’s EIN |
161194720 |
Plan administrator’s name |
GRAHAM CORPORATION |
Plan administrator’s
address |
GRAHAM CORPORATION, BATAVIA, NY, 14020 |
Administrator’s telephone number |
5853432216 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2012-10-02 |
Name of individual signing |
JEFFREY GLAJCH |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2012-10-02 |
Name of individual signing |
JEFFREY GLAJCH |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GRAHAM CORPORATION TRAVEL INSURANCE PLAN
|
2011
|
161194720
|
2012-10-02
|
GRAHAM CORPORATION
|
256
|
|
File |
View Page
|
Three-digit plan number (PN) |
511
|
Effective date of plan |
2000-01-01
|
Business code |
332300
|
Sponsor’s telephone number |
5853432216
|
Plan sponsor’s mailing address |
20 FLORENCE AVENUE, BATAVIA, NY, 14020
|
Plan sponsor’s
address |
20 FLORENCE AVENUE, BATAVIA, NY, 14020
|
Plan administrator’s name and address
Administrator’s EIN |
161194720 |
Plan administrator’s name |
GRAHAM CORPORATION |
Plan administrator’s
address |
20 FLORENCE AVENUE, BATAVIA, NY, 14020 |
Administrator’s telephone number |
5853432216 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2012-10-02 |
Name of individual signing |
JEFFREY GLAJCH |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2012-10-02 |
Name of individual signing |
JEFFREY GLAJCH |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GRAHAM CORPORATION MEDICAL/DENTAL PLAN
|
2011
|
161194720
|
2012-10-02
|
GRAHAM CORPORATION
|
446
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1987-11-01
|
Business code |
333310
|
Sponsor’s telephone number |
5853432216
|
Plan sponsor’s mailing address |
20 FLORENCE AVENUE, BATAVIA, NY, 14020
|
Plan sponsor’s
address |
20 FLORENCE AVENUE, BATAVIA, NY, 14020
|
Plan administrator’s name and address
Administrator’s EIN |
161194720 |
Plan administrator’s name |
GRAHAM CORPORATION |
Plan administrator’s
address |
20 FLORENCE AVENUE, BATAVIA, NY, 14020 |
Administrator’s telephone number |
5853432216 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2012-10-02 |
Name of individual signing |
JEFFREY GLAJCH |
Valid signature |
Filed with authorized/valid electronic signature |
|
|