| Entity Name: | HARRIS & KELLY OFFICE INTERIORS, LLC |
| Jurisdiction: | Illinois |
| Entity Type: | Limited Liability Company |
| Status: | Involuntary Dissolution |
| Date Formed: | 30 Jan 2008 |
| Company Number: | LLC_02450801 |
| File Number: | 02450801 |
| Type of Management: | Manager Managed |
| Date Status Change: | 13 Jul 2012 |
| Address | 4801 NORTH PROSPECT ROAD, PEORIA HEIGHTS, 61616, IL |
| Place of Formation: | ILLINOIS |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| BURGESS SQUARE HEALTHCARE CENTRE, INC. 401(K) PLAN AND TRUST | 2012 | 383855929 | 2013-05-31 | BURGESS SQUARE HEALTHCARE AND REHABILITATION CENTRE, LLC | 79 | |||||||||||||||||||||||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2013-05-29 |
| Name of individual signing | JOHN VRBA |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2013-05-29 |
| Name of individual signing | JOHN VRBA |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2000-07-01 |
| Business code | 623000 |
| Sponsor’s telephone number | 6309712645 |
| Plan sponsor’s address | 5801 SOUTH CASS AVENUE, WESTMONT, IL, 605592300 |
Plan administrator’s name and address
| Administrator’s EIN | 383855929 |
| Plan administrator’s name | BURGESS SQUARE HEALTHCARE AND REHABILITATION CENTRE, LLC |
| Plan administrator’s address | 5801 SOUTH CASS AVENUE, WESTMONT, IL, 605592300 |
| Administrator’s telephone number | 6309712645 |
Signature of
| Role | Plan administrator |
| Date | 2012-02-13 |
| Name of individual signing | JOHN F VRBA |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2012-02-13 |
| Name of individual signing | JOHN F VRBA |
| Valid signature | Filed with authorized/valid electronic signature |
| Name and Address | Role | Appointment Date |
|---|---|---|
| JAMES M. KELLY, 4801 NORTH PROSPECT ROAD, PEORIA HEIGHTS, 61616, PEORIA | Agent | 2008-01-30 |
| Name and Address | Role | Appointment Date |
|---|---|---|
| KELLY, JAMES, 4801 NORTH PROSPECT ROAD, PEORIA HEIGHTS, IL, 61616 | Manager | 2008-01-30 |
Date of last update: 13 Jan 2025
