BLACKHAWK RESTAURANT GROUP, LLC EMPLOYEE BENEFIT PLAN
|
2023
|
454510375
|
2024-06-19
|
BLACKHAWK RESTAURANT GROUP, LLC
|
330
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2016-01-01
|
Business code |
722511
|
Sponsor’s telephone number |
6306565753
|
Plan sponsor’s mailing address |
17W635 BUTTERFIELD ROAD, STE 120, OAKBROOK TERRACE, IL, 60181
|
Plan sponsor’s
address |
17W635 BUTTERFIELD ROAD, STE 120, OAKBROOK TERRACE, IL, 60181
|
Plan administrator’s name and address
Administrator’s EIN |
454510375 |
Plan administrator’s name |
BLACKHAWK RESTAURANT GROUP, LLC |
Plan administrator’s
address |
17W635 BUTTERFIELD ROAD, STE 120, OAKBROOK TERRACE, IL, 60181 |
Administrator’s telephone number |
6306565753 |
Number of participants as of the end of the plan year
Active participants |
330 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2024-06-19 |
Name of individual signing |
MISTY CHURCHWARD |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BLACKHAWK RESTAURANT GROUP, LLC EMPLOYEE BENEFIT PLAN
|
2022
|
454510375
|
2023-06-16
|
BLACKHAWK RESTAURANT GROUP, LLC
|
316
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2016-01-01
|
Business code |
722511
|
Sponsor’s telephone number |
6306565753
|
Plan sponsor’s mailing address |
17W635 BUTTERFIELD ROAD, STE 120, OAKBROOK TERRACE, IL, 60181
|
Plan sponsor’s
address |
17W635 BUTTERFIELD ROAD, STE 120, OAKBROOK TERRACE, IL, 60181
|
Plan administrator’s name and address
Administrator’s EIN |
454510375 |
Plan administrator’s name |
BLACKHAWK RESTAURANT GROUP, LLC |
Plan administrator’s
address |
17W635 BUTTERFIELD ROAD, STE 120, OAKBROOK TERRACE, IL, 60181 |
Administrator’s telephone number |
6306565753 |
Number of participants as of the end of the plan year
Active participants |
329 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
1 |
Signature of
Role |
Plan administrator |
Date |
2023-06-16 |
Name of individual signing |
MISTY BENDER |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BLACKHAWK RESTAURANT GROUP, LLC EMPLOYEE BENEFIT PLAN
|
2021
|
454510375
|
2022-06-14
|
BLACKHAWK RESTAURANT GROUP, LLC
|
296
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2016-01-01
|
Business code |
722511
|
Sponsor’s telephone number |
6306565753
|
Plan sponsor’s mailing address |
17W635 BUTTERFIELD ROAD, STE 120, OAKBROOK TERRACE, IL, 60181
|
Plan sponsor’s
address |
17W635 BUTTERFIELD ROAD, STE 120, OAKBROOK TERRACE, IL, 60181
|
Plan administrator’s name and address
Administrator’s EIN |
454510375 |
Plan administrator’s name |
BLACKHAWK RESTAURANT GROUP, LLC |
Plan administrator’s
address |
17W635 BUTTERFIELD ROAD, STE 120, OAKBROOK TERRACE, IL, 60181 |
Administrator’s telephone number |
6306565753 |
Number of participants as of the end of the plan year
Active participants |
321 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2022-06-14 |
Name of individual signing |
MISTY BENDER |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BLACKHAWK RESTAURANT GROUP, LLC EMPLOYEE BENEFIT PLAN
|
2020
|
454510375
|
2021-06-15
|
BLACKHAWK RESTAURANT GROUP, LLC
|
336
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2016-01-01
|
Business code |
722511
|
Sponsor’s telephone number |
6306565753
|
Plan sponsor’s mailing address |
17W635 BUTTERFIELD ROAD, STE 120, OAKBROOK TERRACE, IL, 60181
|
Plan sponsor’s
address |
17W635 BUTTERFIELD ROAD, STE 120, OAKBROOK TERRACE, IL, 60181
|
Plan administrator’s name and address
Administrator’s EIN |
454510375 |
Plan administrator’s name |
BLACKHAWK RESTAURANT GROUP, LLC |
Plan administrator’s
address |
17W635 BUTTERFIELD ROAD, STE 120, OAKBROOK TERRACE, IL, 60181 |
Administrator’s telephone number |
6306565753 |
Number of participants as of the end of the plan year
Active participants |
336 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2021-06-15 |
Name of individual signing |
MISTY BENDER |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BLACKHAWK RESTAURANT GROUP, LLC EMPLOYEE BENEFIT PLAN
|
2019
|
454510375
|
2020-05-31
|
BLACKHAWK RESTAURANT GROUP, LLC
|
339
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2016-01-01
|
Business code |
722511
|
Sponsor’s telephone number |
6306565753
|
Plan sponsor’s mailing address |
17W635 BUTTERFIELD ROAD, STE 120, OAKBROOK TERRACE, IL, 60181
|
Plan sponsor’s
address |
17W635 BUTTERFIELD ROAD, STE 120, OAKBROOK TERRACE, IL, 60181
|
Plan administrator’s name and address
Administrator’s EIN |
454510375 |
Plan administrator’s name |
BLACKHAWK RESTAURANT GROUP, LLC |
Plan administrator’s
address |
17W635 BUTTERFIELD ROAD, STE 120, OAKBROOK TERRACE, IL, 60181 |
Administrator’s telephone number |
6306565753 |
Number of participants as of the end of the plan year
Active participants |
340 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
15 |
Signature of
Role |
Plan administrator |
Date |
2020-05-31 |
Name of individual signing |
MISTY BENDER |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BLACKHAWK RESTAURANT GROUP, LLC EMPLOYEE BENEFIT PLAN
|
2018
|
454510375
|
2019-06-07
|
BLACKHAWK RESTAURANT GROUP, LLC
|
311
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2016-01-01
|
Business code |
722511
|
Sponsor’s telephone number |
6306565753
|
Plan sponsor’s mailing address |
17W635 BUTTERFIELD ROAD, STE 120, OAKBROOK TERRACE, IL, 60181
|
Plan sponsor’s
address |
17W635 BUTTERFIELD ROAD, STE 120, OAKBROOK TERRACE, IL, 60181
|
Plan administrator’s name and address
Administrator’s EIN |
454510375 |
Plan administrator’s name |
BLACKHAWK RESTAURANT GROUP, LLC |
Plan administrator’s
address |
17W635 BUTTERFIELD ROAD, STE 120, OAKBROOK TERRACE, IL, 60181 |
Administrator’s telephone number |
6306565753 |
Number of participants as of the end of the plan year
Active participants |
329 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
9 |
Signature of
Role |
Plan administrator |
Date |
2019-06-07 |
Name of individual signing |
MISTY BENDER |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BLACKHAWK RESTAURANT GROUP, LLC EMPLOYEE BENEFIT PLAN
|
2017
|
454510375
|
2018-06-14
|
BLACKHAWK RESTAURANT GROUP, LLC
|
280
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2016-01-01
|
Business code |
722511
|
Sponsor’s telephone number |
6306565753
|
Plan sponsor’s mailing address |
17W635 BUTTERFIELD ROAD, STE 120, OAKBROOK TERRACE, IL, 60181
|
Plan sponsor’s
address |
17W635 BUTTERFIELD ROAD, STE 120, OAKBROOK TERRACE, IL, 60181
|
Plan administrator’s name and address
Administrator’s EIN |
454510375 |
Plan administrator’s name |
BLACKHAWK RESTAURANT GROUP, LLC |
Plan administrator’s
address |
17W635 BUTTERFIELD ROAD, STE 120, OAKBROOK TERRACE, IL, 60181 |
Administrator’s telephone number |
6306565753 |
Number of participants as of the end of the plan year
Active participants |
256 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
1 |
Signature of
Role |
Plan administrator |
Date |
2018-06-14 |
Name of individual signing |
MISTY BENDER |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BLACKHAWK RESTAURANT GROUP, LLC EMPLOYEE BENEFIT PLAN
|
2016
|
454510375
|
2017-06-19
|
BLACKHAWK RESTAURANT GROUP, LLC
|
292
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2016-01-01
|
Business code |
722511
|
Sponsor’s telephone number |
6306565753
|
Plan sponsor’s mailing address |
17W635 BUTTERFIELD RD STE 120, OAKBROOK TERRACE, IL, 601814000
|
Plan sponsor’s
address |
17W635 BUTTERFIELD ROAD, STE 120, OAKBROOK TERRACE, IL, 60181
|
Plan administrator’s name and address
Administrator’s EIN |
454510375 |
Plan administrator’s name |
BLACKHAWK RESTAURANT GROUP, LLC |
Plan administrator’s
address |
17W635 BUTTERFIELD RD STE 120, OAKBROOK TERRACE, IL, 601814000 |
Administrator’s telephone number |
6306565753 |
Number of participants as of the end of the plan year
Active participants |
322 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
12 |
Signature of
Role |
Plan administrator |
Date |
2017-06-19 |
Name of individual signing |
MISTY BENDER |
Valid signature |
Filed with authorized/valid electronic signature |
|
|