| Entity Name: | ADRIENNE M. BURFORD-FOGGS, M.D., S.C. |
| Jurisdiction: | Illinois |
| Entity Type: | Corporation - Domestic BCA |
| Status: | Dissolved |
| Date Formed: | 10 Jun 1999 |
| Date of Dissolution: | 08 Nov 2024 |
| Company Number: | CORP_60535167 |
| File Number: | 60535167 |
| Type of Business: | Incorporated under the Medical Corporation Act |
| Date Status Change: | 08 Nov 2024 |
| Place of Formation: | ILLINOIS |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| KAZ CONSTRUCTION, INC. 401K PLAN | 2011 | 363967099 | 2013-02-18 | KAZ CONSTRUCTION, INC. | 2 | |||||||||||||||||||||||||||||||
|
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| Administrator’s EIN | 363967099 |
| Plan administrator’s name | KAZ CONSTRUCTION, INC. |
| Plan administrator’s address | PO BOX 1131, WOODSTOCK, IL, 60098 |
| Administrator’s telephone number | 8153377192 |
Signature of
| Role | Plan administrator |
| Date | 2013-02-18 |
| Name of individual signing | KEVIN J KASZYNSKI |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2007-10-01 |
| Business code | 236110 |
| Sponsor’s telephone number | 8153377192 |
| Plan sponsor’s address | PO BOX 1131, WOODSTOCK, IL, 60098 |
Plan administrator’s name and address
| Administrator’s EIN | 363967099 |
| Plan administrator’s name | KAZ CONSTRUCTION INC |
| Plan administrator’s address | PO BOX 1131, WOODSTOCK, IL, 60098 |
| Administrator’s telephone number | 8153377192 |
Signature of
| Role | Plan administrator |
| Date | 2012-01-06 |
| Name of individual signing | KEVIN J KASZYNSKI |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2007-10-01 |
| Business code | 236110 |
| Sponsor’s telephone number | 8153377192 |
| Plan sponsor’s address | PO BOX 1131, WOODSTOCK, IL, 60098 |
Plan administrator’s name and address
| Administrator’s EIN | 363967099 |
| Plan administrator’s name | KAZ CONSTRUCTION INC |
| Plan administrator’s address | PO BOX 1131, WOODSTOCK, IL, 60098 |
| Administrator’s telephone number | 8153377192 |
Signature of
| Role | Plan administrator |
| Date | 2012-01-06 |
| Name of individual signing | KEVIN J KASZYNSKI |
| Valid signature | Filed with authorized/valid electronic signature |
| Name and Address | Role | Appointment Date |
|---|---|---|
| ADRIENNE M BURFORD-FOGGS, 207 EAST OHIO ST UNIT #172, CHICAGO, 60611, COOK-NOT IN CITY OF CHICAGO | Agent | 2020-05-01 |
| Name and Address | Role |
|---|---|
| ADRIENNE M BURFORD-FOGGS 207 EOHIO #172 CHICAGO 606113238 | President |
| Class | Series | Voting Rights | Authorized Shares | Issued Shares | Par Value |
|---|---|---|---|---|---|
| COMM0N | No data | Voting Rights | 10000 | 1000000 | No data |
Date of last update: 20 Jan 2025
