TBI AIRPORT MANAGEMENT, INC. RETIREE MEDICAL BENEFIT PLAN
|
2020
|
510398175
|
2021-07-19
|
TBI AIRPORT MANAGEMENT INC
|
1
|
|
File |
View Page
|
Three-digit plan number (PN) |
503
|
Effective date of plan |
2004-05-17
|
Business code |
488100
|
Sponsor’s telephone number |
4075854500
|
Plan sponsor’s
address |
2001 RED CLEVELAND BLVD, SANFORD, FL, 327734214
|
Signature of
Role |
Plan administrator |
Date |
2021-07-19 |
Name of individual signing |
R KEITH ROBINSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
TBI AIRPORT MANAGEMENT, INC. RETIREE MEDICAL BENEFIT PLAN
|
2020
|
510398175
|
2021-07-19
|
TBI AIRPORT MANAGEMENT INC
|
1
|
|
File |
View Page
|
Three-digit plan number (PN) |
503
|
Effective date of plan |
2004-05-17
|
Business code |
488100
|
Sponsor’s telephone number |
4075854500
|
Plan sponsor’s
address |
2001 RED CLEVELAND BLVD, SANFORD, FL, 327734214
|
Signature of
Role |
Plan administrator |
Date |
2021-07-19 |
Name of individual signing |
R KEITH ROBINSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
TBI AIRPORT MANAGEMENT, INC. RETIREE MEDICAL BENEFIT PLAN
|
2019
|
510398175
|
2021-07-19
|
TBI AIRPORT MANAGEMENT INC
|
1
|
|
File |
View Page
|
Three-digit plan number (PN) |
503
|
Effective date of plan |
2004-05-17
|
Business code |
488100
|
Plan sponsor’s
address |
2001 RED CLEVELAND BLVD, SANFORD, FL, 327734214
|
Signature of
Role |
Plan administrator |
Date |
2021-07-19 |
Name of individual signing |
R KEITH ROBINSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
TBI AIRPORT MANAGEMENT, INC. RETIREE MEDICAL BENEFIT PLAN
|
2017
|
510398175
|
2018-04-04
|
TBI AIRPORT MANAGEMENT, INC.
|
1
|
|
File |
View Page
|
Three-digit plan number (PN) |
503
|
Effective date of plan |
2004-05-17
|
Business code |
488100
|
Sponsor’s telephone number |
4075854500
|
Plan sponsor’s
address |
3212 RED CLEVELAND BLVD, SANFORD, FL, 327734207
|
Signature of
Role |
Plan administrator |
Date |
2018-04-04 |
Name of individual signing |
R KEITH ROBINSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2018-04-04 |
Name of individual signing |
R KEITH ROBINSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
TBI AIRPORT MANAGEMENT, INC. RETIREE MEDICAL BENEFIT PLAN
|
2016
|
510398175
|
2017-06-27
|
TBI AIRPORT MANAGEMENT, INC.
|
1
|
|
File |
View Page
|
Three-digit plan number (PN) |
503
|
Effective date of plan |
2004-05-17
|
Business code |
488100
|
Sponsor’s telephone number |
4075854500
|
Plan sponsor’s
address |
3212 RED CLEVELAND BLVD, SANFORD, FL, 327734207
|
Signature of
Role |
Plan administrator |
Date |
2017-06-27 |
Name of individual signing |
R KEITH ROBINSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
TBI AIRPORT MANAGEMENT, INC. RETIREE MEDICAL BENEFIT PLAN
|
2014
|
510398175
|
2015-10-09
|
TBI AIRPORT MANAGEMENT, INC.
|
1
|
|
File |
View Page
|
Three-digit plan number (PN) |
503
|
Effective date of plan |
2004-05-17
|
Business code |
488100
|
Sponsor’s telephone number |
4075854500
|
Plan sponsor’s
address |
3212 RED CLEVELAND BLVD., SANFORD, FL, 32773
|
Signature of
Role |
Plan administrator |
Date |
2015-10-09 |
Name of individual signing |
R KEITH ROBINSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
TBI AIRPORT MANAGEMETN, INC. RETIREE MEDICAL BENEFIT PLAN
|
2014
|
510398175
|
2015-10-08
|
TBI AIRPORT MANAGEMENT, INC.
|
1
|
|
File |
View Page
|
Three-digit plan number (PN) |
503
|
Effective date of plan |
2004-05-17
|
Business code |
488100
|
Sponsor’s telephone number |
4075854500
|
Plan sponsor’s
address |
3212 RED CLEVELAND BLVD., SANFORD, FL, 32773
|
Signature of
Role |
Plan administrator |
Date |
2015-10-08 |
Name of individual signing |
R KEITH ROBINSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
TBI AIRPORT MANAGEMENT, INC. RETIREE MEDICAL BENEFIT PLAN
|
2013
|
510398175
|
2014-10-15
|
TBI AIRPORT MANAGEMENT, INC.
|
1
|
|
File |
View Page
|
Three-digit plan number (PN) |
503
|
Effective date of plan |
2004-05-17
|
Business code |
488100
|
Sponsor’s telephone number |
4075854500
|
Plan sponsor’s
address |
3212 RED CLEVELAND BLVD., SANFORD, FL, 32773
|
Signature of
Role |
Plan administrator |
Date |
2014-10-14 |
Name of individual signing |
R KEITH ROBINSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
TBI AIRPORT MANAGEMENT, INC. RETIREE MEDICAL BENEFIT PLAN
|
2012
|
510398175
|
2013-09-05
|
TBI AIRPORT MANAGEMENT, INC.
|
1
|
|
File |
View Page
|
Three-digit plan number (PN) |
503
|
Effective date of plan |
2004-05-17
|
Business code |
488100
|
Sponsor’s telephone number |
4075854555
|
Plan sponsor’s
address |
3212 RED CLEVELAND BLVD., SANFORD, FL, 32773
|
Plan administrator’s name and address
Administrator’s EIN |
510398175 |
Plan administrator’s name |
TBI AIRPORT MANAGEMENT, INC. |
Plan administrator’s
address |
3212 RED CLEVELAND BLVD., SANFORD, FL, 32773 |
Administrator’s telephone number |
4075854555 |
Signature of
Role |
Plan administrator |
Date |
2013-09-05 |
Name of individual signing |
R KEITH ROBINSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
TBI AIRPORT MANAGEMENT, INC. RETIREE MEDICAL BENFIT PLAN
|
2010
|
510398175
|
2011-07-28
|
TBI AIRPORT MANAGEMENT, INC.
|
1
|
|
File |
View Page
|
Three-digit plan number (PN) |
503
|
Effective date of plan |
2004-05-17
|
Business code |
488100
|
Sponsor’s telephone number |
4075854555
|
Plan sponsor’s
address |
3212 RED CLEVELAND BLVD., SANFORD, FL, 32773
|
Plan administrator’s name and address
Administrator’s EIN |
510398175 |
Plan administrator’s name |
TBI AIRPORT MANAGEMENT, INC. |
Plan administrator’s
address |
3212 RED CLEVELAND BLVD., SANFORD, FL, 32773 |
Administrator’s telephone number |
4075854555 |
Signature of
Role |
Plan administrator |
Date |
2011-07-28 |
Name of individual signing |
R KEITH ROBINSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|