EMPLOYEE WELFARE BENEFITS PLAN
|
2014
|
030591679
|
2015-06-04
|
ALGENOL BIOFUELS INC
|
107
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2012-01-01
|
Business code |
541700
|
Sponsor’s telephone number |
2394982000
|
Plan
sponsor’s DBA name |
ALGENOL
|
Plan sponsor’s mailing address |
16121 LEE ROAD, #110, FORT MYERS, FL, 33912
|
Plan sponsor’s
address |
16121 LEE ROAD, #110, FORT MYERS, FL, 33912
|
Number of participants as of the end of the plan year
Active participants |
154 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2015-06-04 |
Name of individual signing |
BRIELLE WARE |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
ALGENOL BIOFUELS DENTAL & LIFE INSURANCE
|
2013
|
030591679
|
2015-06-04
|
ALGENOL BIOFUELS INC
|
110
|
|
File |
View Page
|
Three-digit plan number (PN) |
511
|
Effective date of plan |
2012-01-01
|
Business code |
541700
|
Sponsor’s telephone number |
2394982000
|
Plan
sponsor’s DBA name |
ALGENOL BIOFUELS
|
Plan sponsor’s mailing address |
16121 LEE ROAD, FORT MYERS, FL, 33912
|
Plan sponsor’s
address |
16121 LEE ROAD, FORT MYERS, FL, 33912
|
Number of participants as of the end of the plan year
Active participants |
0 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2015-06-04 |
Name of individual signing |
BRIELLE WARE |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BLUE CROSS BLUE SHIELD FLORIDA
|
2013
|
030591679
|
2014-06-10
|
ALGENOL BIOFUELS INC
|
105
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2012-01-01
|
Business code |
541700
|
Sponsor’s telephone number |
2394982000
|
Plan
sponsor’s DBA name |
ALGENOL
|
Plan sponsor’s mailing address |
16121 LEE ROAD, #110, FORT MYERS, FL, 33912
|
Plan sponsor’s
address |
16121 LEE ROAD, #110, FORT MYERS, FL, 33912
|
Number of participants as of the end of the plan year
Active participants |
107 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2014-06-10 |
Name of individual signing |
SABRA SMITH |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
ALGENOL BIOFUELS DENTAL & LIFE INSURANCE
|
2013
|
030591679
|
2014-06-10
|
ALGENOL BIOFUELS INC
|
110
|
|
Three-digit plan number (PN) |
511
|
Effective date of plan |
2012-01-01
|
Business code |
541700
|
Sponsor’s telephone number |
2394982000
|
Plan
sponsor’s DBA name |
ALGENOL BIOFUELS
|
Plan sponsor’s mailing address |
16121 LEE ROAD, FORT MYERS, FL, 33912
|
Plan sponsor’s
address |
16121 LEE ROAD, FORT MYERS, FL, 33912
|
Number of participants as of the end of the plan year
Active participants |
0 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2014-06-10 |
Name of individual signing |
SABRA SMITH |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
NW MUTUAL DI PLAN
|
2013
|
030591679
|
2014-06-10
|
ALGENOL BIOFUELS INC
|
110
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
2012-01-01
|
Business code |
541700
|
Sponsor’s telephone number |
2394982000
|
Plan
sponsor’s DBA name |
ALGENOL
|
Plan sponsor’s mailing address |
16121 LEE ROAD, #110, FORT MYERS, FL, 33912
|
Plan sponsor’s
address |
16121 LEE ROAD, #110, FORT MYERS, FL, 33912
|
Number of participants as of the end of the plan year
Active participants |
0 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2014-06-10 |
Name of individual signing |
SABRA SMITH |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
ALGENOL BIOFUELS INC. 401(K)
|
2013
|
030591679
|
2014-04-10
|
ALGENOL BIOFUELS INC.
|
112
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2009-04-01
|
Business code |
541700
|
Sponsor’s telephone number |
2394446327
|
Plan sponsor’s
address |
16121 LEE ROAD STE 110, FORT MYERS, FL, 339122512
|
Signature of
Role |
Plan administrator |
Date |
2014-04-10 |
Name of individual signing |
SABRA SMITH |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2014-04-10 |
Name of individual signing |
SABRA SMITH |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PINCIPAL FINANCIAL GROUP DENTA LIFE
|
2012
|
030591679
|
2013-07-16
|
ALGENOL BIOFUELS INC
|
102
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
2012-01-01
|
Business code |
541700
|
Sponsor’s telephone number |
2394982000
|
Plan
sponsor’s DBA name |
ALGENOL
|
Plan sponsor’s mailing address |
16121 LEE ROAD, #110, FORT MYERS, FL, 33912
|
Plan sponsor’s
address |
16121 LEE ROAD, #110, FORT MYERS, FL, 33912
|
Number of participants as of the end of the plan year
Active participants |
110 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2013-07-16 |
Name of individual signing |
SABRA SMITH |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2013-07-16 |
Name of individual signing |
SABRA SMITH |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
ALGENOL BIOFUELS DENTAL & LIFE INSURANCE
|
2012
|
030591679
|
2013-07-16
|
ALGENOL BIOFUELS INC
|
102
|
|
File |
View Page
|
Three-digit plan number (PN) |
511
|
Effective date of plan |
2012-01-01
|
Business code |
541700
|
Sponsor’s telephone number |
2394982000
|
Plan
sponsor’s DBA name |
ALGENOL BIOFUELS
|
Plan sponsor’s mailing address |
28100 BONITA GRANDE DRIVE, BONITA SPRINGS, FL, 34135
|
Plan sponsor’s
address |
28100 BONITA GRANDE DRIVE, BONITA SPRINGS, FL, 34135
|
Plan administrator’s name and address
Administrator’s EIN |
030591679 |
Plan administrator’s name |
ALGENOL BIOFUELS INC |
Plan administrator’s
address |
28100 BONITA GRANDE DRIVE, BONITA SPRINGS, FL, 34135 |
Administrator’s telephone number |
2394982000 |
Number of participants as of the end of the plan year
Active participants |
110 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2013-07-16 |
Name of individual signing |
SABRA SMITH |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2013-07-16 |
Name of individual signing |
SABRA SMITH |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BLUE CROSS BLUE SHIELD FLORIDA
|
2012
|
030591679
|
2013-06-27
|
ALGENOL BIOFUELS INC
|
106
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2012-01-01
|
Business code |
541700
|
Sponsor’s telephone number |
2394982000
|
Plan
sponsor’s DBA name |
ALGENOL
|
Plan sponsor’s mailing address |
16121 LEE ROAD, #110, FORT MYERS, FL, 33912
|
Plan sponsor’s
address |
16121 LEE ROAD, #110, FORT MYERS, FL, 33912
|
Number of participants as of the end of the plan year
Active participants |
104 |
Retired or separated participants receiving
benefits |
1 |
Signature of
Role |
Plan administrator |
Date |
2013-06-27 |
Name of individual signing |
SABRA SMITH |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2013-06-27 |
Name of individual signing |
SABRA SMITH |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
ALGENOL BIOFUELS INC
|
2012
|
420127290
|
2013-03-08
|
ALGENOL BIOFUELS INC
|
102
|
|
File |
View Page
|
Three-digit plan number (PN) |
511
|
Effective date of plan |
2012-01-01
|
Business code |
541700
|
Sponsor’s telephone number |
2394982000
|
Plan
sponsor’s DBA name |
ALGENOL BIOFUELS
|
Plan sponsor’s mailing address |
28100 BONITA GRANDE DRIVE, BONITA SPRINGS, FL, 34135
|
Plan sponsor’s
address |
28100 BONITA GRANDE DRIVE, BONITA SPRINGS, FL, 34135
|
Number of participants as of the end of the plan year
Active participants |
110 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2013-03-08 |
Name of individual signing |
SABRA SMITH |
Valid signature |
Filed with authorized/valid electronic signature |
|
|