SUMMIT CARE II WELFARE BENEFIT PLAN
|
2022
|
593734290
|
2024-03-25
|
SUMMIT CARE II INC.
|
1481
|
|
File |
View Page
|
Three-digit plan number (PN) |
504
|
Effective date of plan |
2022-10-31
|
Business code |
623000
|
Sponsor’s telephone number |
8503862831
|
Plan sponsor’s mailing address |
2123 CENTRE POINTE BLVD, TALLAHASSEE, FL, 323084930
|
Plan sponsor’s
address |
2123 CENTRE POINTE BLVD, TALLAHASSEE, FL, 323084930
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2024-03-25 |
Name of individual signing |
JOSEPH MITCHELL |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2024-03-25 |
Name of individual signing |
JOSEPH MITCHELL |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SUMMIT CARE II, INC. WELFARE BENEFIT PLAN
|
2019
|
593734290
|
2021-04-08
|
SUMMIT CARE II INC.
|
1225
|
|
File |
View Page
|
Three-digit plan number (PN) |
504
|
Effective date of plan |
2019-10-01
|
Business code |
623000
|
Sponsor’s telephone number |
8503862831
|
Plan sponsor’s mailing address |
2123 CENTRE POINTE BLVD, TALLAHASSEE, FL, 323084930
|
Plan sponsor’s
address |
2123 CENTRE POINTE BLVD, TALLAHASSEE, FL, 323084930
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2021-04-08 |
Name of individual signing |
JOSEPH MITCHELL |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2021-04-08 |
Name of individual signing |
JOSEPH MITCHELL |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SUMMIT CARE II,INC. WELFARE BENEFIT PLAN
|
2018
|
593734290
|
2020-02-17
|
SUMMIT CARE II,INC.
|
1123
|
|
File |
View Page
|
Three-digit plan number (PN) |
504
|
Effective date of plan |
2018-10-01
|
Business code |
623000
|
Sponsor’s telephone number |
8503862831
|
Plan sponsor’s mailing address |
2123 CENTRE POINTE BLVD, TALLAHASSEE, FL, 323084930
|
Plan sponsor’s
address |
2123 CENTRE POINTE BLVD, TALLAHASSEE, FL, 323084930
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2020-02-17 |
Name of individual signing |
JOSEPH MITCHELL |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2020-02-17 |
Name of individual signing |
JOSEPH MITCHELL |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SUMMIT CARE II, INC. WELFARE BENEFIT PLAN
|
2017
|
593734290
|
2019-04-11
|
SUMMIT CARE II, INC.
|
1511
|
|
File |
View Page
|
Three-digit plan number (PN) |
504
|
Effective date of plan |
2017-10-01
|
Business code |
623000
|
Sponsor’s telephone number |
8503862831
|
Plan sponsor’s mailing address |
2123 CENTRE POINTE BLVD, TALLAHASSEE, FL, 323084930
|
Plan sponsor’s
address |
2123 CENTRE POINTE BLVD, TALLAHASSEE, FL, 323084930
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2019-04-11 |
Name of individual signing |
JOSEPH MITCHELL |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2019-04-11 |
Name of individual signing |
JOSEPH MITCHELL |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SUMMIT CARE II, INC. WELFARE BENEFIT PLAN
|
2016
|
593734290
|
2018-03-22
|
SUMMIT CARE II,INC.
|
1391
|
|
File |
View Page
|
Three-digit plan number (PN) |
504
|
Effective date of plan |
2016-10-01
|
Business code |
623000
|
Sponsor’s telephone number |
8503862831
|
Plan sponsor’s mailing address |
2123 CENTRE POINTE BLVD, TALLAHASSEE, FL, 323084930
|
Plan sponsor’s
address |
2123 CENTRE POINTE BLVD, TALLAHASSEE, FL, 323084930
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2018-03-21 |
Name of individual signing |
JOSEPH MITCHELL |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2018-03-21 |
Name of individual signing |
JOSEPH MITCHELL |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SUMMIT CARE II, INC.
|
2016
|
593734290
|
2018-03-22
|
SUMMIT CARE II,INC.
|
0
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
2016-10-01
|
Business code |
623000
|
Sponsor’s telephone number |
8503862831
|
Plan sponsor’s mailing address |
2123 CENTRE POINTE BLVD, TALLAHASSEE, FL, 323084930
|
Plan sponsor’s
address |
2123 CENTRE POINTE BLVD, TALLAHASSEE, FL, 323084930
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2018-03-21 |
Name of individual signing |
JOSEPH MITCHELL |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2018-03-21 |
Name of individual signing |
JOSEPH MITCHELL |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SUMMIT CARE II
|
2016
|
593734290
|
2018-03-22
|
SUMMIT CARE II,INC.
|
0
|
|
File |
View Page
|
Three-digit plan number (PN) |
503
|
Effective date of plan |
2016-10-01
|
Business code |
623000
|
Sponsor’s telephone number |
8503862831
|
Plan sponsor’s mailing address |
2123 CENTRE POINTE BLVD, TALLAHASSEE, FL, 323084930
|
Plan sponsor’s
address |
2123 CENTRE POINTE BLVD, TALLAHASSEE, FL, 323084930
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2018-03-21 |
Name of individual signing |
JOSEPH MITCHELL |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2018-03-21 |
Name of individual signing |
JOSEPH MITCHELL |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SUMMIT CARE II
|
2016
|
593734290
|
2018-03-22
|
SUMMIT CARE II,INC.
|
0
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2016-10-01
|
Business code |
623000
|
Sponsor’s telephone number |
8503862831
|
Plan sponsor’s mailing address |
2123 CENTRE POINTE BLVD, TALLAHASSEE, FL, 323084930
|
Plan sponsor’s
address |
2123 CENTRE POINTE BLVD, TALLAHASSEE, FL, 323084930
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2018-03-21 |
Name of individual signing |
JOSEPH MITCHELL |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2018-03-21 |
Name of individual signing |
JOSEPH MITCHELL |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SUMMIT CARE II, INC.
|
2015
|
593734290
|
2017-04-17
|
SUMMIT CARE II, INC.
|
1364
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
2015-10-01
|
Business code |
623000
|
Sponsor’s telephone number |
8503862831
|
Plan sponsor’s mailing address |
2123 CENTRE POINTE BLVD, TALLAHASSEE, FL, 323084930
|
Plan sponsor’s
address |
2123 CENTRE POINTE BLVD, TALLAHASSEE, FL, 323084930
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2017-04-17 |
Name of individual signing |
JOSEPH MITCHELL |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2017-04-17 |
Name of individual signing |
JOSEPH MITCHELL |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SUMMIT CARE II
|
2015
|
593734290
|
2017-04-17
|
SUMMIT CARE II,INC.
|
804
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2015-10-01
|
Business code |
623000
|
Sponsor’s telephone number |
8503862831
|
Plan sponsor’s mailing address |
2123 CENTRE POINTE BLVD, TALLAHASSEE, FL, 323084930
|
Plan sponsor’s
address |
2123 CENTRE POINTE BLVD, TALLAHASSEE, FL, 323084930
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2017-04-17 |
Name of individual signing |
JOSEPH MITCHELL |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2017-04-17 |
Name of individual signing |
JOSEPH MITCHELL |
Valid signature |
Filed with authorized/valid electronic signature |
|
|