| Entity Name: | BLACK INDUSTRIAL & SAFETY SUPPLY, INC. |
| Jurisdiction: | Illinois |
| Entity Type: | Corporation - Domestic BCA |
| Status: | Goodstanding |
| Date Formed: | 31 Aug 2016 |
| Company Number: | CORP_70842815 |
| File Number: | 70842815 |
| Type of Business: | All Inclusive Purpose |
| Place of Formation: | ILLINOIS |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| BLACK INDUSTRIAL & SAFETY SUPPLY 401K PLAN | 2023 | 813828226 | 2024-09-20 | BLACK INDUSTRIAL & SAFETY SUPPLY, INC. | 17 | |||||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2024-09-20 |
| Name of individual signing | AMANDA ZENGER |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2017-01-01 |
| Business code | 332510 |
| Sponsor’s telephone number | 2195010510 |
| Plan sponsor’s address | 11136 WEST GRAND AVENUE, MELROSE PARK, IL, 60164 |
Signature of
| Role | Plan administrator |
| Date | 2023-09-28 |
| Name of individual signing | AMANDA ZENGER |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2017-01-01 |
| Business code | 332510 |
| Sponsor’s telephone number | 2195010510 |
| Plan sponsor’s address | 11136 WEST GRAND AVENUE, MELROSE PARK, IL, 60164 |
Signature of
| Role | Plan administrator |
| Date | 2022-05-01 |
| Name of individual signing | AMANDA ZENGER |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2017-01-01 |
| Business code | 332510 |
| Sponsor’s telephone number | 2195010510 |
| Plan sponsor’s address | 11136 WEST GRAND AVENUE, MELROSE PARK, IL, 60164 |
Signature of
| Role | Plan administrator |
| Date | 2021-05-18 |
| Name of individual signing | AMANDA ZENGER |
| Valid signature | Filed with authorized/valid electronic signature |
| Name and Address | Role | Appointment Date |
|---|---|---|
| RICHARD W KUHN, 552 S WASHINGTON ST STE 100, NAPERVILLE, 60540, DU PAGE | Agent | 2016-08-31 |
| Name and Address | Role |
|---|---|
| AMANDA ZENGER 775 KIMBERLY DR CAROL STREAM IL 60188 | President |
| Name | Change Date |
|---|---|
| ASURGEN, INC. | 2016-12-09 |
| Class | Series | Voting Rights | Authorized Shares | Issued Shares | Par Value |
|---|---|---|---|---|---|
| COMMON | No data | Voting Rights | 2000 | 1000000 | No data |
Date of last update: 20 Jan 2025
