| Entity Name: | PONTE VEDRA INSURANCE, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 02 Feb 2000 (25 years ago) |
| Date of dissolution: | 02 Mar 2021 (4 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 02 Mar 2021 (4 years ago) |
| Document Number: | P00000011922 |
| FEI/EIN Number | 593622236 |
| Address: | 816 HIGHWAY A1A NORTH, SUITE 206, PONTE VEDRA BEACH, FL, 32082, US |
| Mail Address: | P.O. BOX 3140, PONTE VEDRA BEACH, FL, 32004, US |
| ZIP code: | 32082 |
| County: | St. Johns |
| Place of Formation: | FLORIDA |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| PONTE VEDRA INSURANCE, INC. 401(K) PROFIT SHARING PLAN | 2012 | 593622236 | 2013-07-25 | PONTE VEDRA INSURANCE, INC. | 13 | |||||||||||||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2013-07-25 |
| Name of individual signing | CHARLES BUSHONG |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 002 |
| Effective date of plan | 2008-01-01 |
| Business code | 524210 |
| Sponsor’s telephone number | 9042856469 |
| Plan sponsor’s address | P.O. BOX 3140, PONTE VEDRA BEACH, FL, 32004 |
Plan administrator’s name and address
| Administrator’s EIN | 593622236 |
| Plan administrator’s name | PONTE VEDRA INSURANCE, INC. |
| Plan administrator’s address | P.O. BOX 3140, PONTE VEDRA BEACH, FL, 32004 |
| Administrator’s telephone number | 9042856469 |
Signature of
| Role | Plan administrator |
| Date | 2012-10-05 |
| Name of individual signing | CHARLES BUSHONG |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| BUSHONG CHARLES R | Agent | 816 HIGHWAY A1A ,NORTH,, PONTE VEDRA BEACH, FL, 32082 |
| Name | Role | Address |
|---|---|---|
| BUSHONG CHARLES R | Director | 816 N HIGHWAY A1A, SUITE 206, PONTE VEDRA BEACH, FL, 32082 |
| Name | Role | Address |
|---|---|---|
| BUSHONG CHARLES R | President | 816 N HIGHWAY A1A, SUITE 206, PONTE VEDRA BEACH, FL, 32082 |
| Name | Role | Address |
|---|---|---|
| LETO FAYE M | Vice President | 816 A1A N STE 206, PONTE VEDRA BEACH, FL, 32082 |
| Name | Role | Address |
|---|---|---|
| LETO FAYE | Secretary | 816 HIGHWAY A1A NORTH, SUITE 206, PONTE VEDRA BEACH, FL, 32082 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2021-03-02 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2011-08-02 | 816 HIGHWAY A1A NORTH, SUITE 206, PONTE VEDRA BEACH, FL 32082 | No data |
| NAME CHANGE AMENDMENT | 2011-06-15 | PONTE VEDRA INSURANCE, INC. | No data |
| AMENDMENT | 2009-06-08 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2008-02-06 | 816 HIGHWAY A1A NORTH, SUITE 206, PONTE VEDRA BEACH, FL 32082 | No data |
| REGISTERED AGENT NAME CHANGED | 2008-02-06 | BUSHONG, CHARLES RPRES | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2008-02-06 | 816 HIGHWAY A1A ,NORTH,, SUITE 206, PONTE VEDRA BEACH, FL 32082 | No data |
| Name | Date |
|---|---|
| VOLUNTARY DISSOLUTION | 2021-03-02 |
| ANNUAL REPORT | 2020-02-18 |
| ANNUAL REPORT | 2019-03-04 |
| ANNUAL REPORT | 2018-03-13 |
| ANNUAL REPORT | 2017-02-14 |
| ANNUAL REPORT | 2016-01-25 |
| AMENDED ANNUAL REPORT | 2015-11-10 |
| ANNUAL REPORT | 2015-01-19 |
| ANNUAL REPORT | 2014-02-04 |
| ANNUAL REPORT | 2013-01-16 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
