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  5. PREMO BAR INC.

PREMO BAR INC.

Company Details

Entity Name: PREMO BAR INC.
Jurisdiction: Illinois
Entity Type: Corporation - Domestic BCA
Status: Dissolved
Date Formed: 14 Oct 1994
Date of Dissolution: 18 Apr 2001
Company Number: CORP_58024554
File Number: 58024554
Type of Business: Manufacturing and mercantile (only)
Date Status Change: 18 Apr 2001
Place of Formation: ILLINOIS

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
LAKE COOK SURGICAL ASSOCIATES, P.C. 401(K) PROFIT SHARING PLAN 2012 363734585 2013-09-30 LAKE COOK SURGICAL ASSOCIATES, P.C. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1990-01-01
Business code 621111
Sponsor’s telephone number 8476359006
Plan sponsor’s address 1600 W. DEMPSTER, SUITE 103, PARK RIDGE, IL, 600681130

Plan administrator’s name and address
Administrator’s EIN 363734585
Plan administrator’s name LAKE COOK SURGICAL ASSOCIATES, P.C.
Plan administrator’s address 1600 W. DEMPSTER, SUITE 103, PARK RIDGE, IL, 600681130
Administrator’s telephone number 8476359006

Signature of
Role Plan administrator
Date 2013-09-30
Name of individual signing JANICE R. KLICH
Valid signature Filed with authorized/valid electronic signature
LAKE COOK SURGICAL ASSOCIATES, P.C. 401(K) PROFIT SHARING PLAN 2011 363734585 2012-10-11 LAKE COOK SURGICAL ASSOCIATES, P.C. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1990-01-01
Business code 621111
Sponsor’s telephone number 8476359006
Plan sponsor’s address 1600 W. DEMPSTER, SUITE 103, PARK RIDGE, IL, 600681130

Plan administrator’s name and address
Administrator’s EIN 363734585
Plan administrator’s name LAKE COOK SURGICAL ASSOCIATES, P.C.
Plan administrator’s address 1600 W. DEMPSTER, SUITE 103, PARK RIDGE, IL, 600681130
Administrator’s telephone number 8476359006

Signature of
Role Plan administrator
Date 2012-10-11
Name of individual signing JANICE R. KLICH
Valid signature Filed with authorized/valid electronic signature
LAKE COOK SURGICAL ASSOCIATES, P.C. 401(K) PROFIT SHARING PLAN 2010 363734585 2011-03-29 LAKE COOK SURGICAL ASSOCIATES, P.C. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1990-01-01
Business code 621111
Sponsor’s telephone number 8476359006
Plan sponsor’s address 1600 W. DEMPSTER, SUITE 103, PARK RIDGE, IL, 600681130

Plan administrator’s name and address
Administrator’s EIN 363734585
Plan administrator’s name LAKE COOK SURGICAL ASSOCIATES, P.C.
Plan administrator’s address 1600 W. DEMPSTER, SUITE 103, PARK RIDGE, IL, 600681130
Administrator’s telephone number 8476359006

Signature of
Role Plan administrator
Date 2011-03-29
Name of individual signing CHARLIE CLARK
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-03-29
Name of individual signing CHARLIE CLARK
Valid signature Filed with authorized/valid electronic signature
LAKE COOK SURGICAL ASSOCIATES, P.C. 401(K) PROFIT SHARING PLAN 2009 363734585 2010-10-14 LAKE COOK SURGICAL ASSOCIATES, P.C. 3
Three-digit plan number (PN) 001
Effective date of plan 1990-01-01
Business code 621111
Sponsor’s telephone number 8476359006
Plan sponsor’s address 1600 W. DEMPSTER, SUITE 103, PARK RIDGE, IL, 600681130

Plan administrator’s name and address
Administrator’s EIN 363734585
Plan administrator’s name LAKE COOK SURGICAL ASSOCIATES, P.C.
Plan administrator’s address 1600 W. DEMPSTER, SUITE 103, PARK RIDGE, IL, 600681130
Administrator’s telephone number 8476359006

Signature of
Role Plan administrator
Date 2010-10-14
Name of individual signing JANICE KLICH
Valid signature Filed with incorrect/unrecognized electronic signature
Role Employer/plan sponsor
Date 2010-10-14
Name of individual signing JANICE KLICH
Valid signature Filed with incorrect/unrecognized electronic signature
LAKE COOK SURGICAL ASSOCIATES, P.C. 401(K) PROFIT SHARING PLAN 2009 363734585 2010-10-14 LAKE COOK SURGICAL ASSOCIATES, P.C. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1990-01-01
Business code 621111
Sponsor’s telephone number 8476359006
Plan sponsor’s address 1600 W. DEMPSTER, SUITE 103, PARK RIDGE, IL, 600681130

Plan administrator’s name and address
Administrator’s EIN 363734585
Plan administrator’s name LAKE COOK SURGICAL ASSOCIATES, P.C.
Plan administrator’s address 1600 W. DEMPSTER, SUITE 103, PARK RIDGE, IL, 600681130
Administrator’s telephone number 8476359006

Signature of
Role Plan administrator
Date 2010-10-14
Name of individual signing JANICE KLICH
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-10-14
Name of individual signing JANICE KLICH
Valid signature Filed with authorized/valid electronic signature

Agent

Name and Address Role Appointment Date
RONALD E CAMPBELL, 2940 W 95TH ST, EVERGREEN PARK, 60642, COOK-NOT IN CITY OF CHICAGO Agent 1994-10-14

Shares

Class Series Voting Rights Authorized Shares Issued Shares Par Value
COMMON No data Voting Rights 1000 100000 No data

Related by officers

RONALD E CAMPBELL, 2940 W 95TH ST, EVERGREEN PARK, 60642, COOK-NOT IN CITY OF CHICAGO

FURNITURE DELIVERY SPECIALISTS, INC. HOME DELIVERY SPECIALISTS, INC. LA CUCINA DI ANGELINA, INC. R. T. R. LABOR LEASING, INC. PREMIER FURNITURE SERVICE, INC. NEWLAND INSURANCE AGENCY, INC.

Related by address

No related companies by address

Date of last update: 13 Jan 2025

Sources: Illinois Office of the Secretary of State

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