| Entity Name: | SHIVAM HOTEL LLC |
| Jurisdiction: | Illinois |
| Entity Type: | Limited Liability Company |
| Status: | NGS |
| Date Formed: | 22 Oct 2009 |
| Branch of: | SHIVAM HOTEL LLC, NEW YORK (Company Number 3341365) |
| Company Number: | LLC_02884771 |
| File Number: | 02884771 |
| Type of Management: | Member Managed |
| Date Status Change: | 01 Oct 2024 |
| Expiration Date: | 31 Dec 2105 |
| Address | 37 ZINNIA DR, BELLEVILLE, 62221, IL |
| Place of Formation: | NEW YORK |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| SHIVAM HOTEL LLC 401(K) RETIREMENT PLAN | 2022 | 204871571 | 2023-05-16 | SHIVAM HOTEL LLC | 76 | |||||||||||||||||||||||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2023-05-16 |
| Name of individual signing | KEVIN WIGGS |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 1993-01-01 |
| Business code | 812990 |
| Sponsor’s telephone number | 6185480888 |
| Plan sponsor’s address | 126 N HOTZE RD, SALEM, IL, 628815237 |
Plan administrator’s name and address
| Administrator’s EIN | 204871571 |
| Plan administrator’s name | SHIVAM HOTEL LLC |
| Plan administrator’s address | 126 N HOTZE RD, SALEM, IL, 628815237 |
| Administrator’s telephone number | 6185480888 |
Signature of
| Role | Plan administrator |
| Date | 2010-04-22 |
| Name of individual signing | KEVIN WIGGS |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2010-04-22 |
| Name of individual signing | KEVIN WIGGS |
| Valid signature | Filed with authorized/valid electronic signature |
| Name and Address | Role | Appointment Date |
|---|---|---|
| KEVIN WIGGS, 37 ZINNIA DR, BELLEVILLE, 62221 | Agent | 2023-09-19 |
| Name and Address | Role | Appointment Date |
|---|---|---|
| PATEL, CHAMPAK B, 1008 MANOR HILL DR, NORMAN, OK, 73072 | Manager | 2023-12-21 |
| Inspection Nr | Report ID | Date Opened | Site Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 314851189 | 0524500 | 2011-05-12 | 725 TAYLOR STREET, EAST PEORIA, IL, 61611 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Citation ID | 01001 |
| Citaton Type | Serious |
| Standard Cited | 19260020 B02 |
| Issuance Date | 2011-05-20 |
| Abatement Due Date | 2011-06-01 |
| Current Penalty | 6300.0 |
| Initial Penalty | 6300.0 |
| Nr Instances | 1 |
| Nr Exposed | 1 |
| Gravity | 10 |
| Citation ID | 01002A |
| Citaton Type | Serious |
| Standard Cited | 19260451 G01 |
| Issuance Date | 2011-05-20 |
| Abatement Due Date | 2011-06-01 |
| Current Penalty | 6300.0 |
| Initial Penalty | 6300.0 |
| Nr Instances | 1 |
| Nr Exposed | 1 |
| Gravity | 10 |
| Citation ID | 01002B |
| Citaton Type | Serious |
| Standard Cited | 19260454 A |
| Issuance Date | 2011-05-20 |
| Abatement Due Date | 2011-06-01 |
| Nr Instances | 1 |
| Nr Exposed | 1 |
| Gravity | 10 |
| Citation ID | 01003A |
| Citaton Type | Serious |
| Standard Cited | 19260451 G01 |
| Issuance Date | 2011-05-20 |
| Abatement Due Date | 2011-06-01 |
| Current Penalty | 4410.0 |
| Nr Instances | 1 |
| Nr Exposed | 1 |
| Gravity | 10 |
| Citation ID | 01003B |
| Citaton Type | Serious |
| Standard Cited | 19260454 A |
| Issuance Date | 2011-05-20 |
| Abatement Due Date | 2011-06-01 |
| Nr Instances | 1 |
| Nr Exposed | 1 |
| Gravity | 10 |
| Citation ID | 01003C |
| Citaton Type | Serious |
| Standard Cited | 19260020 B02 |
| Issuance Date | 2011-05-20 |
| Abatement Due Date | 2011-06-01 |
| Nr Instances | 1 |
| Nr Exposed | 1 |
| Gravity | 10 |
| Inspection Type | Complaint |
| Scope | Partial |
| Safety/Health | Safety |
| Close Conference | 2011-05-10 |
| Emphasis | S: COMMERCIAL CONSTR, L: FALL, S: FALL FROM HEIGHT |
| Case Closed | 2011-05-20 |
Related Activity
| Type | Complaint |
| Activity Nr | 208046136 |
| Safety | Yes |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 2628908310 | 2021-01-21 | 0507 | PPS | 126 N Hotze Rd, Salem, IL, 62881-5237 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 17 Apr 2025
