CARROLL DISTRIBUTING COMPANY EMPLOYEES INSURANCE BENEFIT PLAN
|
2011
|
591026900
|
2013-01-02
|
CARROLL DISTRIBUTING COMPANY
|
-
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1984-06-01
|
Business code |
424800
|
Sponsor’s telephone number |
3214216283
|
Plan sponsor’s mailing address |
1553 SILICON AVENUE, MELBOURNE, FL, 32940
|
Plan sponsor’s
address |
1553 SILICON AVENUE, MELBOURNE, FL, 32940
|
Plan administrator’s name and address
Administrator’s EIN |
591026900 |
Plan administrator’s name |
CARROLL DISTRIBUTING COMPANY |
Plan administrator’s
address |
1553 SILICON AVENUE, MELBOURNE, FL, 32940 |
Administrator’s telephone number |
3214216283 |
Signature of
Role |
Plan administrator |
Date |
2013-01-02 |
Name of individual signing |
BEVERLY HICKS |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2013-01-02 |
Name of individual signing |
BEVERLY HICKS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
CARROLL DISTRIBUTING COMPANY EMPLOYEES INSURANCE BENEFIT PLAN
|
2011
|
591026900
|
2013-01-02
|
CARROLL DISTRIBUTING COMPANY
|
-
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1984-06-01
|
Business code |
424800
|
Sponsor’s telephone number |
3214216283
|
Plan sponsor’s mailing address |
1553 SILICON AVENUE, MELBOURNE, FL, 32940
|
Plan sponsor’s
address |
1553 SILICON AVENUE, MELBOURNE, FL, 32940
|
Plan administrator’s name and address
Administrator’s EIN |
591026900 |
Plan administrator’s name |
CARROLL DISTRIBUTING COMPANY |
Plan administrator’s
address |
1553 SILICON AVENUE, MELBOURNE, FL, 32940 |
Administrator’s telephone number |
3214216283 |
Signature of
Role |
Plan administrator |
Date |
2013-01-02 |
Name of individual signing |
BEVERLY HICKS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
CARROLL DISTRIBUTING COMPANY EMPLOYEES INSURANCE BENEFIT PLAN
|
2011
|
591026900
|
2013-01-02
|
CARROLL DISTRIBUTING COMPANY
|
-
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1984-06-01
|
Business code |
424800
|
Sponsor’s telephone number |
3214216283
|
Plan sponsor’s mailing address |
1553 SILICON AVENUE, MELBOURNE, FL, 32940
|
Plan sponsor’s
address |
1553 SILICON AVENUE, MELBOURNE, FL, 32940
|
Plan administrator’s name and address
Administrator’s EIN |
591026900 |
Plan administrator’s name |
CARROLL DISTRIBUTING COMPANY |
Plan administrator’s
address |
1553 SILICON AVENUE, MELBOURNE, FL, 32940 |
Administrator’s telephone number |
3214216283 |
Signature of
Role |
Plan administrator |
Date |
2013-01-02 |
Name of individual signing |
BEVERLY HICKS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
CARROLL DISTRIBUTING COMPANY EMPLOYEES INSURANCE BENEFIT PLAN
|
2011
|
591026900
|
2013-01-02
|
CARROLL DISTRIBUTING COMPANY
|
-
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1984-06-01
|
Business code |
424800
|
Sponsor’s telephone number |
3214216283
|
Plan sponsor’s mailing address |
1553 SILICON AVENUE, MELBOURNE, FL, 32940
|
Plan sponsor’s
address |
1553 SILICON AVENUE, MELBOURNE, FL, 32940
|
Plan administrator’s name and address
Administrator’s EIN |
591026900 |
Plan administrator’s name |
CARROLL DISTRIBUTING COMPANY |
Plan administrator’s
address |
1553 SILICON AVENUE, MELBOURNE, FL, 32940 |
Administrator’s telephone number |
3214216283 |
Signature of
Role |
Plan administrator |
Date |
2013-01-02 |
Name of individual signing |
BEVERLY HICKS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
CARROLL DISTRIBUTING COMPANY EMPLOYEES INSURANCE BENEFIT PLAN
|
2011
|
591026900
|
2013-01-02
|
CARROLL DISTRIBUTING COMPANY
|
-
|
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1984-06-01
|
Business code |
424800
|
Sponsor’s telephone number |
3214216283
|
Plan sponsor’s mailing address |
1553 SILICON AVENUE, MELBOURNE, FL, 32940
|
Plan sponsor’s
address |
1553 SILICON AVENUE, MELBOURNE, FL, 32940
|
Plan administrator’s name and address
Administrator’s EIN |
591026900 |
Plan administrator’s name |
CARROLL DISTRIBUTING COMPANY |
Plan administrator’s
address |
1553 SILICON AVENUE, MELBOURNE, FL, 32940 |
Administrator’s telephone number |
3214216283 |
Signature of
Role |
Plan administrator |
Date |
2013-01-02 |
Name of individual signing |
BEVERLY HICKS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
CARROLL DISTRIBUTING COMPANY EMPLOYEES INSURANCE BENEFIT PLAN
|
2011
|
591026900
|
2013-01-02
|
CARROLL DISTRIBUTING COMPANY
|
-
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1984-06-01
|
Business code |
424800
|
Sponsor’s telephone number |
3214216283
|
Plan sponsor’s mailing address |
1553 SILICON AVENUE, MELBOURNE, FL, 32940
|
Plan sponsor’s
address |
1553 SILICON AVENUE, MELBOURNE, FL, 32940
|
Plan administrator’s name and address
Administrator’s EIN |
591026900 |
Plan administrator’s name |
CARROLL DISTRIBUTING COMPANY |
Plan administrator’s
address |
1553 SILICON AVENUE, MELBOURNE, FL, 32940 |
Administrator’s telephone number |
3214216283 |
Signature of
Role |
Plan administrator |
Date |
2013-01-02 |
Name of individual signing |
BEVERLY HICKS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
CARROLL DISTRIBUTING COMPANY EMPLOYEES INSURANCE BENEFIT PLAN
|
2011
|
591026900
|
2013-01-02
|
CARROLL DISTRIBUTING COMPANY
|
-
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1984-06-01
|
Business code |
424800
|
Sponsor’s telephone number |
3214216283
|
Plan sponsor’s mailing address |
1553 SILICON AVENUE, MELBOURNE, FL, 32940
|
Plan sponsor’s
address |
1553 SILICON AVENUE, MELBOURNE, FL, 32940
|
Plan administrator’s name and address
Administrator’s EIN |
591026900 |
Plan administrator’s name |
CARROLL DISTRIBUTING COMPANY |
Plan administrator’s
address |
1553 SILICON AVENUE, MELBOURNE, FL, 32940 |
Administrator’s telephone number |
3214216283 |
Signature of
Role |
Plan administrator |
Date |
2013-01-02 |
Name of individual signing |
BEVERLY HICKS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
CARROLL DISTRIBUTING COMPANY EMPLOYEES INSURANCE BENEFIT PLAN
|
2011
|
591026900
|
2013-01-02
|
CARROLL DISTRIBUTING COMPANY
|
-
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1984-06-01
|
Business code |
424800
|
Sponsor’s telephone number |
3214216283
|
Plan sponsor’s mailing address |
1553 SILICON AVENUE, MELBOURNE, FL, 32940
|
Plan sponsor’s
address |
1553 SILICON AVENUE, MELBOURNE, FL, 32940
|
Plan administrator’s name and address
Administrator’s EIN |
591026900 |
Plan administrator’s name |
CARROLL DISTRIBUTING COMPANY |
Plan administrator’s
address |
1553 SILICON AVENUE, MELBOURNE, FL, 32940 |
Administrator’s telephone number |
3214216283 |
Signature of
Role |
Plan administrator |
Date |
2013-01-02 |
Name of individual signing |
BEVERLY HICKS |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2013-01-02 |
Name of individual signing |
BEVERLY HICKS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
CARROLL DISTRIBUTING COMPANY EMPLOYEES INSURANCE BENEFIT PLAN
|
2011
|
591026900
|
2013-01-02
|
CARROLL DISTRIBUTING COMPANY
|
-
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1984-06-01
|
Business code |
424800
|
Sponsor’s telephone number |
3214216283
|
Plan sponsor’s mailing address |
1553 SILICON AVENUE, MELBOURNE, FL, 32940
|
Plan sponsor’s
address |
1553 SILICON AVENUE, MELBOURNE, FL, 32940
|
Plan administrator’s name and address
Administrator’s EIN |
591026900 |
Plan administrator’s name |
CARROLL DISTRIBUTING COMPANY |
Plan administrator’s
address |
1553 SILICON AVENUE, MELBOURNE, FL, 32940 |
Administrator’s telephone number |
3214216283 |
Signature of
Role |
Plan administrator |
Date |
2013-01-02 |
Name of individual signing |
BEVERLY HICKS |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2013-01-02 |
Name of individual signing |
BEVERLY HICKS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
CARROLL DISTRIBUTING COMPANY EMPLOYEES INSURANCE BENEFIT PLAN
|
2011
|
591026900
|
2013-01-02
|
CARROLL DISTRIBUTING COMPANY
|
-
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1984-06-01
|
Business code |
424800
|
Sponsor’s telephone number |
3214216283
|
Plan sponsor’s mailing address |
1553 SILICON AVENUE, MELBOURNE, FL, 32940
|
Plan sponsor’s
address |
1553 SILICON AVENUE, MELBOURNE, FL, 32940
|
Plan administrator’s name and address
Administrator’s EIN |
591026900 |
Plan administrator’s name |
CARROLL DISTRIBUTING COMPANY |
Plan administrator’s
address |
1553 SILICON AVENUE, MELBOURNE, FL, 32940 |
Administrator’s telephone number |
3214216283 |
Signature of
Role |
Plan administrator |
Date |
2013-01-02 |
Name of individual signing |
BEVERLY HICKS |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2013-01-02 |
Name of individual signing |
BEVERLY HICKS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|