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  5. XS SUPPLY LLC

XS SUPPLY LLC

Company Details

Entity Name: XS SUPPLY LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.
Status: Active
Date Filed: 27 Oct 2015 (9 years ago)
Last Event: LC AMENDMENT
Event Date Filed: 30 May 2023 (2 years ago)
Document Number: L15000182563
FEI/EIN Number 47-5446025
Address: 10360 72nd Street, Unit 820, Largo, FL, 33777, US
Mail Address: 10360 72nd Street, Unit 820, Largo, FL, 33777, US
ZIP code: 33777
County: Pinellas
Place of Formation: FLORIDA

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
XS SUPPLY LLC 401(K) PROFIT SHARING PLAN & TRUST 2023 475446025 2024-04-11 XS SUPPLY LLC 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-10-01
Business code 541990
Sponsor’s telephone number 8447903897
Plan sponsor’s address 10360 72ND ST - STE 820, LARGO, FL, 33777

Signature of
Role Plan administrator
Date 2024-04-11
Name of individual signing TYLER BERGER
Valid signature Filed with authorized/valid electronic signature
XS SUPPLY LLC 401(K) PROFIT SHARING PLAN & TRUST 2022 475446025 2023-04-04 XS SUPPLY LLC 18
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-10-01
Business code 541990
Sponsor’s telephone number 8447903897
Plan sponsor’s address 10360 72ND ST - STE 820, LARGO, FL, 33777

Signature of
Role Plan administrator
Date 2023-04-04
Name of individual signing TYLER BERGER
Valid signature Filed with authorized/valid electronic signature
XS SUPPLY LLC 401(K) PROFIT SHARING PLAN & TRUST 2021 475446025 2022-04-07 XS SUPPLY LLC 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-10-01
Business code 541990
Sponsor’s telephone number 8447903897
Plan sponsor’s address 10360 72ND ST - STE 820, LARGO, FL, 33777

Signature of
Role Plan administrator
Date 2022-04-07
Name of individual signing TYLER BERGER
Valid signature Filed with authorized/valid electronic signature
XS SUPPLY LLC 401(K) PROFIT SHARING PLAN & TRUST 2020 475446025 2021-06-04 XS SUPPLY LLC 0
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-10-01
Business code 541990
Sponsor’s telephone number 8447903897
Plan sponsor’s address 10360 72ND ST - STE 820, LARGO, FL, 33777

Signature of
Role Plan administrator
Date 2021-06-04
Name of individual signing TYLER BERGER
Valid signature Filed with authorized/valid electronic signature
XS SUPPLY, LLC 401(K) PLAN 2019 475446025 2020-04-03 XS SUPPLY, LLC 18
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-10-01
Business code 339110
Sponsor’s telephone number 8447903897
Plan sponsor’s address 10360 72ND STREET STE.820, LARGO, FL, 337771546

Signature of
Role Plan administrator
Date 2020-04-03
Name of individual signing DAVID LONGDUE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-04-03
Name of individual signing DAVID LONGDUE
Valid signature Filed with authorized/valid electronic signature
XS SUPPLY, LLC 401(K) PLAN 2018 475446025 2019-02-01 XS SUPPLY, LLC 18
Three-digit plan number (PN) 001
Effective date of plan 2018-10-01
Business code 339110
Sponsor’s telephone number 8447903897
Plan sponsor’s address 10360 72ND STREET STE.820, LARGO, FL, 337771546

Signature of
Role Plan administrator
Date 2019-02-01
Name of individual signing DAVID LONGDUEIII
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-02-01
Name of individual signing DAVID LONGDUEIII
Valid signature Filed with authorized/valid electronic signature
XS SUPPLY, LLC 401(K) PLAN 2018 475446025 2019-05-23 XS SUPPLY, LLC 18
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-10-01
Business code 339110
Sponsor’s telephone number 8447903897
Plan sponsor’s address 10360 72ND STREET STE.820, LARGO, FL, 337771546

Signature of
Role Plan administrator
Date 2019-05-23
Name of individual signing DAVID LONGDUE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-05-23
Name of individual signing DAVID LONGDUE
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
Centrone Gus M Agent 100 S. Ashley Dr., Tampa, FL, 33602

Authorized Person

Name Role Address
Rodimushkin Ivan Authorized Person 10360 72nd Street, Largo, FL, 33777

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G19000115305 TRIUM SOURCING EXPIRED 2019-10-24 2024-12-31 No data 10360 72ND STREET, UNIT 820, LARGO, FL, 33777
G17000024662 MY SURGICAL INDEX EXPIRED 2017-03-08 2022-12-31 No data 10360 72ND STREET, UNIT 820, LARGO, FL
G17000019864 THE SURGICAL INDEX EXPIRED 2017-02-23 2022-12-31 No data 10360 72ND STREET, UNIT 820, LARGO, FL, 33777

Events

Event Type Filed Date Value Description
LC AMENDMENT 2023-05-30 No data No data
REGISTERED AGENT NAME CHANGED 2023-04-04 Centrone, Gus M No data
REGISTERED AGENT ADDRESS CHANGED 2023-04-04 100 S. Ashley Dr., Suite 1450, Tampa, FL 33602 No data
LC AMENDMENT 2022-07-05 No data No data
CHANGE OF PRINCIPAL ADDRESS 2016-06-13 10360 72nd Street, Unit 820, Largo, FL 33777 No data
CHANGE OF MAILING ADDRESS 2016-06-13 10360 72nd Street, Unit 820, Largo, FL 33777 No data

Documents

Name Date
ANNUAL REPORT 2024-04-24
LC Amendment 2023-05-30
ANNUAL REPORT 2023-04-04
LC Amendment 2022-07-05
ANNUAL REPORT 2022-04-04
ANNUAL REPORT 2021-03-17
ANNUAL REPORT 2020-02-15
ANNUAL REPORT 2019-04-11
ANNUAL REPORT 2018-01-31
ANNUAL REPORT 2017-02-24

Related by officers

Centrone Gus M

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Related by address

10360 72nd Street, Unit 820, Largo, FL, 33777, US

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10360 72nd Street, Unit 820, Largo, FL, 33777, US

BIRD'S EYE SOLUTIONS, LLC MTECT INNOVATIONS, LLC

Date of last update: 01 Feb 2025

Sources: Florida Department of State

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