GROUP TERM LIFE ACCIDENTAL DEATH/DISMEMBERMENT INSURANCE
|
2016
|
133234441
|
2017-03-23
|
PROJECT HOSPITALITY
|
265
|
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1999-08-01
|
Business code |
624200
|
Sponsor’s telephone number |
7184481544
|
Plan sponsor’s mailing address |
100 PARK AVE, STATEN ISLAND, NY, 103021440
|
Plan sponsor’s
address |
100 PARK AVE, STATEN ISLAND, NY, 103021440
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2017-03-23 |
Name of individual signing |
PHYLLIS GALLUCCI |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
EMPIRE HEALTHCHOICE DENTAL PLAN
|
2015
|
133234441
|
2017-03-27
|
PROJECT HOSPITALITY
|
434
|
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
1999-08-01
|
Business code |
624200
|
Sponsor’s telephone number |
7184481544
|
Plan sponsor’s mailing address |
100 PARK AVE, STATEN ISLAND, NY, 103021440
|
Plan sponsor’s
address |
100 PARK AVE, STATEN ISLAND, NY, 103021440
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2017-03-27 |
Name of individual signing |
PHYLLIS GALLUCCI |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GROUP TERM LIFE ACCIDENTAL DEATH/DISMEMBERMENT INSURANCE
|
2015
|
133234441
|
2016-05-18
|
PROJECT HOSPITALITY
|
247
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1999-08-01
|
Business code |
624200
|
Sponsor’s telephone number |
7184481544
|
Plan sponsor’s mailing address |
100 PARK AVE, STATEN ISLAND, NY, 103021440
|
Plan sponsor’s
address |
100 PARK AVE, STATEN ISLAND, NY, 103021440
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2016-05-18 |
Name of individual signing |
PHYLLIS GALLUCCI |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
AETNA MEDICAL PLAN
|
2014
|
133234441
|
2016-05-18
|
PROJECT HOSPITALITY, INC
|
333
|
|
File |
View Page
|
Three-digit plan number (PN) |
503
|
Effective date of plan |
1999-09-01
|
Business code |
624200
|
Sponsor’s telephone number |
7184481544
|
Plan sponsor’s mailing address |
100 PARK AVE, STATEN ISLAND, NY, 10302
|
Plan sponsor’s
address |
100 PARK AVE, STATEN ISLAND, NY, 10302
|
Signature of
Role |
Plan administrator |
Date |
2016-05-18 |
Name of individual signing |
PHYLLIS GALLUCCI |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
EMPIRE HEALTHCHOICE DENTAL PLAN
|
2014
|
133234441
|
2016-05-18
|
PROJECT HOSPITALITY
|
390
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
1999-08-01
|
Business code |
624200
|
Sponsor’s telephone number |
7184481544
|
Plan sponsor’s mailing address |
100 PARK AVE, STATEN ISLAND, NY, 10302
|
Plan sponsor’s
address |
100 PARK AVE, STATEN ISLAND, NY, 10302
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2016-05-18 |
Name of individual signing |
PHYLLIS GALLUCCI |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GROUP TERM LIFE ACCIDENTAL DEATH/DISMEMBERMENT INSURANCE
|
2014
|
133234441
|
2015-03-10
|
PROJECT HOSPITALITY, INC
|
224
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1999-08-01
|
Business code |
624200
|
Sponsor’s telephone number |
7184481544
|
Plan sponsor’s mailing address |
100 PARK AVE, STATEN ISLAND, NY, 10302
|
Plan sponsor’s
address |
100 PARK AVE, STATEN ISLAND, NY, 10302
|
Signature of
Role |
Plan administrator |
Date |
2015-03-10 |
Name of individual signing |
PHYLLIS GALLUCCI |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
EMPIRE HEALTHCHOICE DENTAL PLAN
|
2013
|
133234441
|
2015-03-10
|
PROJECT HOSPITALITY
|
207
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
1999-08-01
|
Business code |
624200
|
Sponsor’s telephone number |
7184481544
|
Plan sponsor’s mailing address |
100 PARK AVE, STATEN ISLAND, NY, 10302
|
Plan sponsor’s
address |
100 PARK AVE, STATEN ISLAND, NY, 10302
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2015-03-10 |
Name of individual signing |
PHYLLIS GALLUCCI |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
AETNA MEDICAL PLAN
|
2013
|
133234441
|
2015-03-10
|
PROJECT HOSPITALITY, INC
|
352
|
|
File |
View Page
|
Three-digit plan number (PN) |
503
|
Effective date of plan |
1999-09-01
|
Business code |
624200
|
Sponsor’s telephone number |
7184481544
|
Plan sponsor’s mailing address |
100 PARK AVE, STATEN ISLAND, NY, 10302
|
Plan sponsor’s
address |
100 PARK AVE, STATEN ISLAND, NY, 10302
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2015-03-10 |
Name of individual signing |
PHYLLIS GALLUCCI |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GROUP TERM LIFE ACCIDENTAL DEATH/ DISMEMBERMENT INSURANCE
|
2013
|
133234441
|
2014-03-04
|
PROJECT HOSPITALITY, INC
|
249
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1999-08-01
|
Business code |
624200
|
Sponsor’s telephone number |
7184481544
|
Plan sponsor’s mailing address |
100 PARK AVE, STATEN ISLAND, NY, 10302
|
Plan sponsor’s
address |
100 PARK AVE, STATEN ISLAND, NY, 10302
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2014-03-04 |
Name of individual signing |
JUNE DEUTSCH |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
EMPIRE HEALTHCHOICE DENTAL PLAN
|
2012
|
133234441
|
2014-03-11
|
PROJECT HOSPITALITY
|
223
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
1999-08-01
|
Business code |
624200
|
Sponsor’s telephone number |
7184481544
|
Plan sponsor’s mailing address |
100 PARK AVE, STATEN ISLAND, NY, 10302
|
Plan sponsor’s
address |
100 PARK AVE, STATEN ISLAND, NY, 10302
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2014-03-11 |
Name of individual signing |
JUNE DEUTSCH |
Valid signature |
Filed with authorized/valid electronic signature |
|
|