HEALTH AND WELFARE PLAN
|
2015
|
592365790
|
2016-10-25
|
DOUBLE EAGLE DISTRIBUTING, INC.
|
150
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
1984-04-02
|
Business code |
424800
|
Sponsor’s telephone number |
9544262970
|
Plan sponsor’s mailing address |
50 LOCK RD, DEERFIELD BEACH, FL, 334421513
|
Plan sponsor’s
address |
50 LOCK RD, DEERFIELD BEACH, FL, 334421513
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2016-10-25 |
Name of individual signing |
JOSEPH HORSFALL |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2016-10-25 |
Name of individual signing |
JOSEPH HORSFALL |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
HEALTH AND WELFARE PLAN
|
2014
|
592365790
|
2015-10-27
|
DOUBLE EAGLE DISTRIBUTING, INC.
|
145
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
1984-04-02
|
Business code |
424800
|
Sponsor’s telephone number |
9544262970
|
Plan sponsor’s mailing address |
50 LOCK ROAD, DEERFIELD BEACH, FL, 33442
|
Plan sponsor’s
address |
50 LOCK ROAD, DEERFIELD BEACH, FL, 33442
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2015-10-27 |
Name of individual signing |
JOSEPH HORSFALL |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2015-10-27 |
Name of individual signing |
JOSEPH HORSFALL |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
HEALTH AND WELFARE PLAN
|
2013
|
592365790
|
2014-10-31
|
DOUBLE EAGLE DISTRIBUTING, INC.
|
145
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
1984-04-02
|
Business code |
424800
|
Sponsor’s telephone number |
9544262970
|
Plan sponsor’s mailing address |
50 LOCK ROAD, DEERFIELD BEACH, FL, 33442
|
Plan sponsor’s
address |
50 LOCK ROAD, DEERFIELD BEACH, FL, 33442
|
Number of participants as of the end of the plan year
Active participants |
144 |
Retired or separated participants receiving
benefits |
1 |
Signature of
Role |
Plan administrator |
Date |
2014-10-31 |
Name of individual signing |
JOSEPH HORSFALL |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2014-10-31 |
Name of individual signing |
JOSEPH HORSFALL |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
HEALTH AND WELFARE PLAN
|
2012
|
592365790
|
2013-09-26
|
DOUBLE EAGLE DISTRIBUTING, INC.
|
145
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
1984-04-02
|
Business code |
424800
|
Sponsor’s telephone number |
9544262970
|
Plan sponsor’s mailing address |
50 LOCK ROAD, DEERFIELD BEACH, FL, 33442
|
Plan sponsor’s
address |
50 LOCK ROAD, DEERFIELD BEACH, FL, 33442
|
Number of participants as of the end of the plan year
Active participants |
144 |
Retired or separated participants receiving
benefits |
1 |
Signature of
Role |
Plan administrator |
Date |
2013-09-26 |
Name of individual signing |
JOSEPH HORSFALL |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2013-09-26 |
Name of individual signing |
JOSEPH HORSFALL |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
HEALTH AND WELFARE PLAN
|
2011
|
592365790
|
2012-10-23
|
DOUBLE EAGLE DISTRIBUTING, INC.
|
136
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
1984-04-02
|
Business code |
424800
|
Sponsor’s telephone number |
9544262970
|
Plan sponsor’s mailing address |
50 LOCK ROAD, DEERFIELD BEACH, FL, 33442
|
Plan sponsor’s
address |
50 LOCK ROAD, DEERFIELD BEACH, FL, 33442
|
Plan administrator’s name and address
Administrator’s EIN |
592365790 |
Plan administrator’s name |
DOUBLE EAGLE DISTRIBUTING, INC. |
Plan administrator’s
address |
50 LOCK ROAD, DEERFIELD BEACH, FL, 33442 |
Administrator’s telephone number |
9544262970 |
Number of participants as of the end of the plan year
Active participants |
144 |
Retired or separated participants receiving
benefits |
1 |
Signature of
Role |
Plan administrator |
Date |
2012-10-22 |
Name of individual signing |
JOSEPH HORSFALL |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
HEALTH AND WELFARE PLAN
|
2010
|
592365790
|
2011-10-24
|
DOUBLE EAGLE DISTRIBUTING, INC.
|
129
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
1984-04-02
|
Business code |
424800
|
Sponsor’s telephone number |
9544262970
|
Plan sponsor’s mailing address |
50 LOCK ROAD, DEERFIELD BEACH, FL, 33442
|
Plan sponsor’s
address |
50 LOCK ROAD, DEERFIELD BEACH, FL, 33442
|
Plan administrator’s name and address
Administrator’s EIN |
592365790 |
Plan administrator’s name |
DOUBLE EAGLE DISTRIBUTING, INC. |
Plan administrator’s
address |
50 LOCK ROAD, DEERFIELD BEACH, FL, 33442 |
Administrator’s telephone number |
9544262970 |
Number of participants as of the end of the plan year
Active participants |
133 |
Retired or separated participants receiving
benefits |
3 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2011-10-24 |
Name of individual signing |
JOSEPH HORSFALL |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
HEALTH AND WELFARE PLAN
|
2010
|
592365790
|
2011-10-24
|
DOUBLE EAGLE DISTRIBUTING, INC.
|
129
|
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
1984-04-02
|
Business code |
424800
|
Sponsor’s telephone number |
9544262970
|
Plan sponsor’s mailing address |
50 LOCK ROAD, DEERFIELD BEACH, FL, 33442
|
Plan sponsor’s
address |
50 LOCK ROAD, DEERFIELD BEACH, FL, 33442
|
Plan administrator’s name and address
Administrator’s EIN |
592365790 |
Plan administrator’s name |
DOUBLE EAGLE DISTRIBUTING, INC. |
Plan administrator’s
address |
50 LOCK ROAD, DEERFIELD BEACH, FL, 33442 |
Administrator’s telephone number |
9544262970 |
Number of participants as of the end of the plan year
Active participants |
133 |
Retired or separated participants receiving
benefits |
3 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Employer/plan sponsor |
Date |
2011-10-24 |
Name of individual signing |
JOSEPH HORSFALL |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
HEALTH AND WELFARE PLAN
|
2009
|
592365790
|
2010-10-04
|
DOUBLE EAGLE DISTRIBUTING, INC.
|
136
|
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
1984-04-02
|
Business code |
424800
|
Sponsor’s telephone number |
9544262970
|
Plan sponsor’s mailing address |
50 LOCK ROAD, DEERFIELD BEACH, FL, 33442
|
Plan sponsor’s
address |
50 LOCK ROAD, DEERFIELD BEACH, FL, 33442
|
Plan administrator’s name and address
Administrator’s EIN |
592365790 |
Plan administrator’s name |
DOUBLE EAGLE DISTRIBUTING, INC. |
Plan administrator’s
address |
50 LOCK ROAD, DEERFIELD BEACH, FL, 33442 |
Administrator’s telephone number |
9544262970 |
Number of participants as of the end of the plan year
Active participants |
126 |
Retired or separated participants receiving
benefits |
3 |
Signature of
Role |
Employer/plan sponsor |
Date |
2010-10-04 |
Name of individual signing |
JOSEPH HORSFALL |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
HEALTH AND WELFARE PLAN
|
2009
|
592365790
|
2010-10-04
|
DOUBLE EAGLE DISTRIBUTING, INC.
|
136
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
1984-04-02
|
Business code |
424800
|
Sponsor’s telephone number |
9544262970
|
Plan sponsor’s mailing address |
50 LOCK ROAD, DEERFIELD BEACH, FL, 33442
|
Plan sponsor’s
address |
50 LOCK ROAD, DEERFIELD BEACH, FL, 33442
|
Plan administrator’s name and address
Administrator’s EIN |
592365790 |
Plan administrator’s name |
DOUBLE EAGLE DISTRIBUTING, INC. |
Plan administrator’s
address |
50 LOCK ROAD, DEERFIELD BEACH, FL, 33442 |
Administrator’s telephone number |
9544262970 |
Number of participants as of the end of the plan year
Active participants |
126 |
Retired or separated participants receiving
benefits |
3 |
Signature of
Role |
Plan administrator |
Date |
2010-10-04 |
Name of individual signing |
JOSEPH HORSFALL |
Valid signature |
Filed with authorized/valid electronic signature |
|
|