CAS GROUP DBA CULVERS IN LAKE ZURI MEDOVA LIFESTYLE HEALTH PLAN
|
2021
|
473122459
|
2024-07-12
|
CAS GROUP
|
0
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2020-07-01
|
Business code |
722511
|
Sponsor’s telephone number |
8472767717
|
Plan
sponsor’s DBA name |
CULVERS IN LAKE ZURI
|
Plan sponsor’s
address |
645 N RAND RD, LAKE ZURICH, IL, 600472486
|
Plan administrator’s name and address
Administrator’s EIN |
200200514 |
Plan administrator’s name |
RECEIVERSHIP MANAGEMENT INC |
Plan administrator’s
address |
510 HOSPITAL DR STE 490, MADISON, TN, 371155049 |
Administrator’s telephone number |
6153700051 |
Signature of
Role |
Plan administrator |
Date |
2024-07-12 |
Name of individual signing |
ROBERT MOORE |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
CAS GROUP DBA CULVERS IN LAKE ZURI MEDOVA LIFESTYLE HEALTH PLAN
|
2020
|
473122459
|
2022-05-10
|
CAS GROUP
|
7
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2020-08-01
|
Business code |
722511
|
Sponsor’s telephone number |
8472767717
|
Plan
sponsor’s DBA name |
CULVERS IN LAKE ZURICH
|
Plan sponsor’s
address |
645 N RAND RD, LAKE ZURICH, IL, 600472486
|
Plan administrator’s name and address
Administrator’s EIN |
200200514 |
Plan administrator’s name |
RECEIVERSHIP MANAGEMENT INC |
Plan administrator’s
address |
510 HOSPITAL DR STE 490, MADISON, TN, 371155049 |
Administrator’s telephone number |
6153700051 |
Signature of
Role |
Plan administrator |
Date |
2022-04-25 |
Name of individual signing |
ROBERT MOORE |
Valid signature |
Filed with authorized/valid electronic signature |
|
|