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  5. CLEAVELAND INSURANCE GROUP, INC.

CLEAVELAND INSURANCE GROUP, INC.

Company Details

Entity Name: CLEAVELAND INSURANCE GROUP, INC.
Jurisdiction: Illinois
Entity Type: Corporation - Foreign BCA
Status: Withdrawn
Date Formed: 28 May 2003
Company Number: CORP_62917407
File Number: 62917407
Type of Business: Insurance and/or real estate agencies and brokers
Date Status Change: 16 Jul 2014
Place of Formation: IOWA

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
CLEAVELAND INSURANCE GROUP 401(K) PLAN 2013 421432204 2014-07-14 CLEAVELAND INSURANCE GROUP 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-01-01
Business code 524210
Sponsor’s telephone number 3097949700
Plan sponsor’s address 1617 2ND AVE, ROCK ISLAND, IL, 612018625

Signature of
Role Plan administrator
Date 2014-07-14
Name of individual signing DEBORAH TAYLOR
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-07-14
Name of individual signing DEBORAH TAYLOR
Valid signature Filed with authorized/valid electronic signature
CLEAVELAND INSURANCE GROUP 401(K) PLAN 2013 421432204 2014-03-05 CLEAVELAND INSURANCE GROUP 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-01-01
Business code 524210
Sponsor’s telephone number 3097949700
Plan sponsor’s address 1617 2ND AVE, ROCK ISLAND, IL, 612018625

Signature of
Role Plan administrator
Date 2014-03-05
Name of individual signing THOMAS MCGOVERN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-03-05
Name of individual signing THOMAS MCGOVERN
Valid signature Filed with authorized/valid electronic signature
CLEAVELAND INSURANCE GROUP 401(K) PLAN 2012 421432204 2013-07-08 CLEAVELAND INSURANCE GROUP 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-01-01
Business code 524210
Sponsor’s telephone number 3097949700
Plan sponsor’s address 1617 2ND AVE, ROCK ISLAND, IL, 612018625

Signature of
Role Plan administrator
Date 2013-07-08
Name of individual signing DEBORAH TAYLOR
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-07-08
Name of individual signing DEBORAH TAYLOR
Valid signature Filed with authorized/valid electronic signature
CLEAVELAND INSURANCE GROUP 401(K) PLAN 2011 421432204 2012-05-16 CLEAVELAND INSURANCE GROUP 18
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-01-01
Business code 524210
Sponsor’s telephone number 3097949700
Plan sponsor’s address 1617 2ND AVE, ROCK ISLAND, IL, 612018625

Plan administrator’s name and address
Administrator’s EIN 421432204
Plan administrator’s name CLEAVELAND INSURANCE GROUP
Plan administrator’s address 1617 2ND AVE, ROCK ISLAND, IL, 612018625
Administrator’s telephone number 3097949700

Signature of
Role Plan administrator
Date 2012-05-16
Name of individual signing THOMAS MCGOVERN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-05-16
Name of individual signing THOMAS MCGOVERN
Valid signature Filed with authorized/valid electronic signature
CLEAVELAND INSURANCE GROUP 401(K) PLAN 2010 421432204 2011-07-18 CLEAVELAND INSURANCE GROUP 17
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-01-01
Business code 524210
Sponsor’s telephone number 3097949700
Plan sponsor’s address 1617 2ND AVE, ROCK ISLAND, IL, 612018625

Plan administrator’s name and address
Administrator’s EIN 421432204
Plan administrator’s name CLEAVELAND INSURANCE GROUP
Plan administrator’s address 1617 2ND AVE, ROCK ISLAND, IL, 612018625
Administrator’s telephone number 3097949700

Signature of
Role Plan administrator
Date 2011-07-18
Name of individual signing THOMAS MCGOVERN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-07-18
Name of individual signing THOMAS MCGOVERN
Valid signature Filed with authorized/valid electronic signature
CLEAVELAND INSURANCE GROUP 401(K) PLAN 2009 421432204 2010-07-23 CLEAVELAND INSURANCE GROUP 18
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-01-01
Business code 524210
Sponsor’s telephone number 3097949700
Plan sponsor’s address 1617 2ND AVE, ROCK ISLAND, IL, 612018625

Plan administrator’s name and address
Administrator’s EIN 421432204
Plan administrator’s name CLEAVELAND INSURANCE GROUP
Plan administrator’s address 1617 2ND AVE, ROCK ISLAND, IL, 612018625
Administrator’s telephone number 3097949700

Signature of
Role Plan administrator
Date 2010-07-23
Name of individual signing DEBORAH M TAYLOR
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-07-23
Name of individual signing DEBORAH M TAYLOR
Valid signature Filed with authorized/valid electronic signature

Agent

Name and Address Role Appointment Date
PHYLLIS K SCHWINDT, 1510 35TH AVE, ROCK ISLAND, 61201, ROCK ISLAND Agent 2003-05-28

President

Name and Address Role
THOMAS W MCGOVERN, 4408 LORTON AVENUE, DAVENPORT IA 52803 President

Shares

Class Series Voting Rights Authorized Shares Issued Shares Par Value
A COMMON No data Voting Rights 1000000 2048000 No data

Related by officers

No related officers

Related by address

No related companies by address

Date of last update: 16 Jan 2025

Sources: Illinois Office of the Secretary of State

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