|
CAFE FRESKA LLC (WELFARE PLAN)
|
2023
|
473749945
|
2024-07-18
|
CAFE FRESKA LLC
|
11
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
951
|
| Effective date of plan |
2021-01-01
|
| Business code |
722513
|
| Sponsor’s telephone number |
2059148040
|
| Plan sponsor’s
address |
13846 ATLANTIC BLVD 614, JACKSONVILLE, FL, 32225
|
Plan administrator’s name and address
| Administrator’s EIN |
472506773 |
| Plan administrator’s name |
KENNION & CO LLC |
| Plan administrator’s
address |
2828 OLD 280 COURT, SUITE 110, VESTAVIA, AL, 35243 |
| Administrator’s telephone number |
8669665457 |
Signature of
| Role |
Plan administrator |
| Date |
2024-06-17 |
| Name of individual signing |
W. HAL SHEPHERD |
| Valid signature |
Filed with authorized/valid electronic signature |
|
| Role |
Employer/plan sponsor |
| Date |
2024-06-17 |
| Name of individual signing |
W. HAL SHEPHERD |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
CAFE FRESKA LLC (WELFARE PLAN)
|
2022
|
473749945
|
2023-07-27
|
CAFE FRESKA LLC
|
14
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
951
|
| Effective date of plan |
2021-01-01
|
| Business code |
722513
|
| Sponsor’s telephone number |
2059148040
|
| Plan sponsor’s
address |
13846 ATLANTIC BLVD 614, JACKSONVILLE, FL, 32225
|
Plan administrator’s name and address
| Administrator’s EIN |
472506773 |
| Plan administrator’s name |
KENNION & CO LLC |
| Plan administrator’s
address |
2828 OLD 280 COURT, SUITE 110, VESTAVIA, AL, 35243 |
| Administrator’s telephone number |
8669665457 |
Signature of
| Role |
Plan administrator |
| Date |
2023-07-19 |
| Name of individual signing |
W. HAL SHEPHERD |
| Valid signature |
Filed with authorized/valid electronic signature |
|
| Role |
Employer/plan sponsor |
| Date |
2023-07-19 |
| Name of individual signing |
W. HAL SHEPHERD |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
CAFE FRESKA LLC (WELFARE PLAN)
|
2021
|
473749945
|
2022-07-29
|
CAFE FRESKA LLC
|
0
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
951
|
| Effective date of plan |
2021-01-01
|
| Business code |
722513
|
| Sponsor’s telephone number |
2059148040
|
| Plan sponsor’s
address |
13846 ATLANTIC BLVD 614, JACKSONVILLE, FL, 32225
|
Plan administrator’s name and address
| Administrator’s EIN |
472506773 |
| Plan administrator’s name |
KENNION & CO LLC |
| Plan administrator’s
address |
2828 OLD 280 COURT, SUITE 110, VESTAVIA, AL, 35243 |
| Administrator’s telephone number |
8669665457 |
Signature of
| Role |
Plan administrator |
| Date |
2022-07-27 |
| Name of individual signing |
W. HAL SHEPHERD |
| Valid signature |
Filed with authorized/valid electronic signature |
|
| Role |
Employer/plan sponsor |
| Date |
2022-07-27 |
| Name of individual signing |
W. HAL SHEPHERD |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
