|
PRAIRIE WOODWORKS INC. EMPLOYEE GROUP HEALTH PLAN
|
2018
|
821239139
|
2019-07-25
|
PRAIRIE WOODWORKS INC.
|
4
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
501
|
| Effective date of plan |
2017-09-01
|
| Business code |
337000
|
| Sponsor’s telephone number |
3093782418
|
| Plan sponsor’s
address |
PO BOX 21, 322 S. LINCOLN ST., DOWNS, IL, 61736
|
Signature of
| Role |
Plan administrator |
| Date |
2019-07-25 |
| Name of individual signing |
ROSS AMBUEHL |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
PRAIRIE WOODWORKS INC. EMPLOYEE GROUP HEALTH PLAN
|
2017
|
821239139
|
2019-07-25
|
PRAIRIE WOODWORKS INC.
|
0
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
501
|
| Effective date of plan |
2017-09-01
|
| Business code |
337000
|
| Sponsor’s telephone number |
3093782418
|
| Plan sponsor’s
address |
PO BOX 21, 322 S. LINCOLN ST., DOWNS, IL, 61736
|
Signature of
| Role |
Plan administrator |
| Date |
2019-07-25 |
| Name of individual signing |
ROSS AMBUEHL |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
