LUNDSBERG CORPORATION

Company Details

Plan Name

Plan Year

EIN/PN

Received

Sponsor

Total number of participants

OTTAWA MEDICAL CENTER, P.C. 401(K) PROFIT SHARING

2010

362675518

2010-10-27

OTTAWA MEDICAL CENTER, P.C.

Plan administrator’s name and address

Administrator’s EIN	362675518
Plan administrator’s name	OTTAWA MEDICAL CENTER, P.C.
Plan administrator’s address	1614 E NORRIS DR, OTTAWA, IL, 61350
Administrator’s telephone number	8154313265

Signature of

Role	Plan administrator
Date	2010-10-27
Name of individual signing	JILL LOWE
Valid signature	Filed with authorized/valid electronic signature

Role	Employer/plan sponsor
Date	2010-10-27
Name of individual signing	BRIAN ROSBOROUGH
Valid signature	Filed with authorized/valid electronic signature

OTTAWA MEDICAL CENTER, P.C. 401(K) PROFIT SHARING AND SAVINGS PLAN

2009

362675518

2010-08-31

OTTAWA MEDICAL CENTER, P.C.

Plan administrator’s name and address

Administrator’s EIN	362675518
Plan administrator’s name	OTTAWA MEDICAL CENTER, P.C.
Plan administrator’s address	1614 E. NORRIS DRIVE, OTTAWA, IL, 61350
Administrator’s telephone number	8154313265

Signature of

Role	Plan administrator
Date	2010-08-31
Name of individual signing	BRIAN ROSBOROUGH
Valid signature	Filed with authorized/valid electronic signature

Role	Employer/plan sponsor
Date	2010-08-31
Name of individual signing	JILL LOWE
Valid signature	Filed with incorrect/unrecognized electronic signature

Name and Address	Role	Appointment Date
GENE A EICH, 6032 N LINCOLN AVE, MORTON GROVE, 60053, COOK-NOT IN CITY OF CHICAGO	Agent	1998-04-14

Name and Address	Role
GARY A LUNDSBERG, 135 BASSWOOD LAKE FOREST 60048	President

Class	Series	Voting Rights	Authorized Shares	Issued Shares	Par Value
COMM	No data	Voting Rights	1000	200000	No data

Date of last update: 27 Jan 2025