|
D & C SHEET METAL INC EMPLOYEE GROUP HEALTH PLAN
|
2018
|
371038451
|
2019-07-26
|
D & C SHEET METAL INC.
|
6
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
501
|
| Effective date of plan |
2015-01-01
|
| Business code |
238220
|
| Sponsor’s telephone number |
6189976577
|
| Plan sponsor’s
address |
C/O WILLIAM D DAVIS, ADMINISTRATOR, 603 N MARKET STREET, MARION, IL, 62959
|
Signature of
| Role |
Plan administrator |
| Date |
2019-07-26 |
| Name of individual signing |
WILLIAM DAVIS |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
D & C SHEET METAL INC EMPLOYEE GROUP HEALTH PLAN
|
2017
|
371038451
|
2018-07-30
|
D & C SHEET METAL INC.
|
7
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
501
|
| Effective date of plan |
2015-01-01
|
| Business code |
238220
|
| Sponsor’s telephone number |
6189976577
|
| Plan sponsor’s
address |
C/O WILLIAM D DAVIS, ADMINISTRATOR, 603 N MARKET STREET, MARION, IL, 62959
|
Signature of
| Role |
Plan administrator |
| Date |
2018-07-30 |
| Name of individual signing |
WILLIAM DAVIS |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
D & C SHEET METAL INC EMPLOYEE GROUP HEALTH PLAN
|
2016
|
371038451
|
2017-07-31
|
D & C SHEET METAL INC.
|
8
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
501
|
| Effective date of plan |
2015-01-01
|
| Business code |
238220
|
| Sponsor’s telephone number |
6189976577
|
| Plan sponsor’s
address |
C/O WILLIAM D DAVIS, ADMINISTRATOR, 603 N MARKET STREET, MARION, IL, 62959
|
Signature of
| Role |
Plan administrator |
| Date |
2017-07-31 |
| Name of individual signing |
WILLIAM DAVIS |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
D & C SHEET METAL INC EMPLOYEE GROUP HEALTH PLAN
|
2015
|
371038451
|
2016-09-13
|
D & C SHEET METAL INC.
|
7
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
501
|
| Effective date of plan |
2015-01-01
|
| Business code |
238220
|
| Sponsor’s telephone number |
6189976577
|
| Plan sponsor’s
address |
C/O WILLIAM D DAVIS, ADMINISTRATOR, 603 N MARKET STREET, MARION, IL, 62959
|
Signature of
| Role |
Plan administrator |
| Date |
2016-08-15 |
| Name of individual signing |
WILLIAM DAVIS |
| Valid signature |
Filed with authorized/valid electronic signature |
|
| Role |
Employer/plan sponsor |
| Date |
2016-08-15 |
| Name of individual signing |
WILLIAM DAVIS |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
