| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1998-06-01
|
| Business code |
238300
|
| Sponsor’s telephone number |
6303236768
|
| Plan sponsor’s
address |
16 E. BURLINGTON ROAD, RIVERSIDE, IL, 60546
|
Plan administrator’s name and address
| Administrator’s EIN |
362768901 |
| Plan administrator’s name |
PROVENCAL BUILDERS, INC. |
| Plan administrator’s
address |
16 E. BURLINGTON ROAD, RIVERSIDE, IL, 60546 |
| Administrator’s telephone number |
6303236768 |
Signature of
| Role |
Plan administrator |
| Date |
2010-10-14 |
| Name of individual signing |
HAROLD LIESENFELT |
| Valid signature |
Filed with authorized/valid electronic signature |
|
| Role |
Employer/plan sponsor |
| Date |
2010-10-14 |
| Name of individual signing |
HAROLD LIESENFELT |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
