| Entity Name: | LOYAL ORDER OF MOOSE BRIDGEVIEW LODGE NO. 1104 |
| Jurisdiction: | Illinois |
| Entity Type: | Corporation - Not-for-Profit |
| Status: | Merged/Consolidated |
| Date Formed: | 04 Feb 1957 |
| Company Number: | CORP_36714514 |
| File Number: | 36714514 |
| Date Status Change: | 24 Nov 1992 |
| Place of Formation: | ILLINOIS |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| GREAT WEST ELECTRICAL SUPPLY INC PROFIT SHARING PLAN | 2012 | 362434058 | 2013-09-19 | GREAT WEST ELECTRICAL SUPPLY INC | 4 | |||||||||||||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2013-09-19 |
| Name of individual signing | RACHEL BOSWORTH |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 1967-01-01 |
| Business code | 443112 |
| Sponsor’s telephone number | 7087491220 |
| Plan sponsor’s address | 6227 W 26TH STREET, BERWYN, IL, 60402 |
Plan administrator’s name and address
| Administrator’s EIN | 362434058 |
| Plan administrator’s name | GREAT WEST ELECTRICAL SUPPLY INC |
| Plan administrator’s address | 6227 W 26TH STREET, BERWYN, IL, 60402 |
| Administrator’s telephone number | 7087491220 |
Signature of
| Role | Plan administrator |
| Date | 2012-10-12 |
| Name of individual signing | NICK SUTHEIMER |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 1967-01-01 |
| Business code | 443112 |
| Sponsor’s telephone number | 7087491220 |
| Plan sponsor’s address | 6227 W 26TH STREET, BERWYN, IL, 60402 |
Plan administrator’s name and address
| Administrator’s EIN | 362434058 |
| Plan administrator’s name | GREAT WEST ELECTRICAL SUPPLY INC |
| Plan administrator’s address | 6227 W 26TH STREET, BERWYN, IL, 60402 |
| Administrator’s telephone number | 7087491220 |
Signature of
| Role | Plan administrator |
| Date | 2011-07-26 |
| Name of individual signing | TED OKRZESIK |
| Valid signature | Filed with authorized/valid electronic signature |
| Name and Address | Role | Appointment Date |
|---|---|---|
| C T CORPORATION SYSTEM, 208 SO LASALLE ST, SUITE 814, CHICAGO, 60604, COOK-NOT IN CITY OF CHICAGO | Agent | 1992-04-14 |
Date of last update: 16 Jan 2025
