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CUSTOM MOBILITY, INC.

Company Details

Entity Name: CUSTOM MOBILITY, INC.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 25 Jan 1989 (36 years ago)
Document Number: K60932
FEI/EIN Number 592924116
Address: 7199 BRYAN DAIRY RD., LARGO, FL, 33777-1502, US
Mail Address: 7199 BRYAN DAIRY RD., LARGO, FL, 33777-1502, US
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1609858752 2005-11-15 2020-08-22 7199 BRYAN DAIRY ROAD, LARGO, FL, 337771502, US 7199 BRYAN DAIRY ROAD, LARGO, FL, 337771502, US

Contacts

Phone +1 727-539-8119
Fax 7275396372

Authorized person

Name MR. BRUCE D BAYES
Role PRESIDENT CEO
Phone 7275398119

Taxonomy

Taxonomy Code 332B00000X - Durable Medical Equipment & Medical Supplies
License Number 62 CERTIFICATE 8809
State FL
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
CUSTOM MOBILITY, INC. 401(K) PROFIT SHARING PLAN & TRUST 2023 592924116 2024-05-24 CUSTOM MOBILITY INC 76
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1998-01-01
Business code 339110
Sponsor’s telephone number 7275398119
Plan sponsor’s address 7199 BRYAN DAIRY RD, LARGO, FL, 33777

Signature of

Role Plan administrator
Date 2024-05-24
Name of individual signing JUDITH BAYES
Valid signature Filed with authorized/valid electronic signature
CUSTOM MOBILITY, INC. 401(K) PROFIT SHARING PLAN & TRUST 2022 592924116 2023-06-27 CUSTOM MOBILITY INC 78
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1998-01-01
Business code 339110
Sponsor’s telephone number 7275398119
Plan sponsor’s address 7199 BRYAN DAIRY RD, LARGO, FL, 33777

Signature of

Role Plan administrator
Date 2023-06-27
Name of individual signing JUDITH E. BAYES
Valid signature Filed with authorized/valid electronic signature
CUSTOM MOBILITY, INC. 401(K) PROFIT SHARING PLAN & TRUST 2021 592924116 2022-05-19 CUSTOM MOBILITY INC 79
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1998-01-01
Business code 339110
Sponsor’s telephone number 7275398119
Plan sponsor’s address 7199 BRYAN DAIRY RD, LARGO, FL, 33777

Signature of

Role Plan administrator
Date 2022-05-19
Name of individual signing JUDITH E. BAYES
Valid signature Filed with authorized/valid electronic signature
CUSTOM MOBILITY, INC. 401(K) PROFIT SHARING PLAN & TRUST 2020 592924116 2021-06-11 CUSTOM MOBILITY INC 82
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1998-01-01
Business code 339110
Sponsor’s telephone number 7275398119
Plan sponsor’s address 7199 BRYAN DAIRY RD, LARGO, FL, 33777

Signature of

Role Plan administrator
Date 2021-06-11
Name of individual signing JUDITH E BAYES
Valid signature Filed with authorized/valid electronic signature
CUSTOM MOBILITY, INC 401(K) PROFIT SHARING PLAN & TRUST 2019 592924116 2020-05-29 CUSTOM MOBILITY, INC 83
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1998-01-01
Business code 812990
Sponsor’s telephone number 7275398119
Plan sponsor’s address 7199 BRYAN DAIRY RD., LARGO, FL, 33777

Signature of

Role Plan administrator
Date 2020-05-29
Name of individual signing JUDITH E. BAYES
Valid signature Filed with authorized/valid electronic signature
CUSTOM MOBILITY, INC 401 K PROFIT SHARING PLAN TRUST 2018 592924116 2019-05-28 CUSTOM MOBILITY, INC 80
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1998-01-01
Business code 812990
Sponsor’s telephone number 7275398119
Plan sponsor’s address 7199 BRYAN DAIRY RD., LARGO, FL, 33777

Signature of

Role Plan administrator
Date 2019-05-28
Name of individual signing JUDITH E. BAYES
Valid signature Filed with authorized/valid electronic signature
CUSTOM MOBILITY, INC 401 K PROFIT SHARING PLAN TRUST 2017 592924116 2018-06-21 CUSTOM MOBILITY, INC 76
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1998-01-01
Business code 812990
Sponsor’s telephone number 7275398119
Plan sponsor’s address 7199 BRYAN DAIRY RD., LARGO, FL, 33777

Signature of

Role Plan administrator
Date 2018-06-21
Name of individual signing JUDITH E. BAYES
Valid signature Filed with authorized/valid electronic signature
CUSTOM MOBILITY, INC 401 K PROFIT SHARING PLAN TRUST 2016 592924116 2017-05-24 CUSTOM MOBILITY, INC 73
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1998-01-01
Business code 812990
Sponsor’s telephone number 7275398119
Plan sponsor’s address 7199 BRYAN DAIRY RD., LARGO, FL, 33777

Signature of

Role Plan administrator
Date 2017-05-24
Name of individual signing JUDITH E. BAYES
Valid signature Filed with authorized/valid electronic signature
CUSTOM MOBILITY, INC 401 K PROFIT SHARING PLAN TRUST 2015 592924116 2016-06-10 CUSTOM MOBILITY, INC 74
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1998-01-01
Business code 812990
Sponsor’s telephone number 7275398119
Plan sponsor’s address 7199 BRYAN DAIRY RD., LARGO, FL, 33777

Signature of

Role Plan administrator
Date 2016-06-10
Name of individual signing JUDITH E. BAYES
Valid signature Filed with authorized/valid electronic signature
CUSTOM MOBILITY, INC 401 K PROFIT SHARING PLAN TRUST 2014 592924116 2015-06-09 CUSTOM MOBILITY, INC 74
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1998-01-01
Business code 812990
Sponsor’s telephone number 7275398119
Plan sponsor’s address 7199 BRYAN DAIRY RD., LARGO, FL, 33777

Signature of

Role Plan administrator
Date 2015-06-09
Name of individual signing JUDITH E. BAYES
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
BAYES BRUCE D Agent 11085 4TH STREET EAST, TREASURE ISLAND, FL, 33706

Director

Name Role Address
BAYES BRUCE D Director 11085 4TH ST. E., TREASURE ISLAND, FL, 33706
BAYES JUDITH E Director 11085 4TH ST. E., TREASURE ISLAND, FL, 33706
KOLLEN MICHAEL JDT Director 7531 75th Way N, Pinellas Park, FL, 33781
BAYES GARY W Director 9217 118TH WAY N, SEMINOLE, FL, 33772

President

Name Role Address
BAYES BRUCE D President 11085 4TH ST. E., TREASURE ISLAND, FL, 33706

Secretary

Name Role Address
BAYES JUDITH E Secretary 11085 4TH ST. E., TREASURE ISLAND, FL, 33706

Treasurer

Name Role Address
KOLLEN MICHAEL JDT Treasurer 7531 75th Way N, Pinellas Park, FL, 33781

Vice President

Name Role Address
BAYES GARY W Vice President 9217 118TH WAY N, SEMINOLE, FL, 33772

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G09000145161 MITS @ CUSTOM MOBILITY EXPIRED 2009-08-12 2014-12-31 No data 7199 BRYAN DAIRY ROAD, LARGO, FL, 33777

Events

Event Type Filed Date Value Description
NAME CHANGE AMENDMENT 1989-12-04 CUSTOM MOBILITY, INC. No data

Awards

Contract Type Award or IDV Flag PIID Start Date Current End Date Potential End Date
PURCHASE ORDER AWARD 36C24724P0706 2024-04-12 2024-07-31 2024-07-31
Unique Award Key CONT_AWD_36C24724P0706_3600_-NONE-_-NONE-
Awarding Agency Department of Veterans Affairs
Link View Page

Award Amounts

Obligated Amount 28540.84
Current Award Amount 28540.84
Potential Award Amount 28540.84

Description

Title STAIRLIFT
NAICS Code 339113: SURGICAL APPLIANCE AND SUPPLIES MANUFACTURING
Product and Service Codes 6515: MEDICAL AND SURGICAL INSTRUMENTS, EQUIPMENT, AND SUPPLIES

Recipient Details

Recipient CUSTOM MOBILITY INC
UEI WA4UCXJAS9F6
Recipient Address UNITED STATES, 7199 BRYAN DAIRY RD, SEMINOLE, PINELLAS, FLORIDA, 337771502
PURCHASE ORDER AWARD 36C24724P0409 2024-01-19 2024-06-14 2024-06-14
Unique Award Key CONT_AWD_36C24724P0409_3600_-NONE-_-NONE-
Awarding Agency Department of Veterans Affairs
Link View Page

Award Amounts

Obligated Amount 17782.63
Current Award Amount 17782.63
Potential Award Amount 17782.63

Description

Title BRUNO ELITE CURVED RAIL STAIRLIFT
NAICS Code 339113: SURGICAL APPLIANCE AND SUPPLIES MANUFACTURING
Product and Service Codes 6515: MEDICAL AND SURGICAL INSTRUMENTS, EQUIPMENT, AND SUPPLIES

Recipient Details

Recipient CUSTOM MOBILITY INC
UEI WA4UCXJAS9F6
Recipient Address UNITED STATES, 7199 BRYAN DAIRY RD, SEMINOLE, PINELLAS, FLORIDA, 337771502
PURCHASE ORDER AWARD 36C24724P0410 2024-01-19 2024-06-14 2024-06-14
Unique Award Key CONT_AWD_36C24724P0410_3600_-NONE-_-NONE-
Awarding Agency Department of Veterans Affairs
Link View Page

Award Amounts

Obligated Amount 20237.05
Current Award Amount 20237.05
Potential Award Amount 20237.05

Description

Title STAIRLIFT
NAICS Code 339113: SURGICAL APPLIANCE AND SUPPLIES MANUFACTURING
Product and Service Codes 6515: MEDICAL AND SURGICAL INSTRUMENTS, EQUIPMENT, AND SUPPLIES

Recipient Details

Recipient CUSTOM MOBILITY INC
UEI WA4UCXJAS9F6
Recipient Address UNITED STATES, 7199 BRYAN DAIRY RD, SEMINOLE, PINELLAS, FLORIDA, 337771502
PURCHASE ORDER AWARD 36C24724P0402 2024-01-02 2024-07-16 2024-07-16
Unique Award Key CONT_AWD_36C24724P0402_3600_-NONE-_-NONE-
Awarding Agency Department of Veterans Affairs
Link View Page

Award Amounts

Obligated Amount 22061.54
Current Award Amount 22061.54
Potential Award Amount 22061.54

Description

Title VERTICAL PLATFORM LIFT
NAICS Code 339113: SURGICAL APPLIANCE AND SUPPLIES MANUFACTURING
Product and Service Codes 6515: MEDICAL AND SURGICAL INSTRUMENTS, EQUIPMENT, AND SUPPLIES

Recipient Details

Recipient CUSTOM MOBILITY INC
UEI WA4UCXJAS9F6
Recipient Address UNITED STATES, 7199 BRYAN DAIRY RD, SEMINOLE, PINELLAS, FLORIDA, 337771502

Date of last update: 01 Feb 2025

Sources: Florida Department of State