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  5. KEITH J. BRADSHAW INSURANCE AGENCY, INC.

KEITH J. BRADSHAW INSURANCE AGENCY, INC.

Company Details

Entity Name: KEITH J. BRADSHAW INSURANCE AGENCY, INC.
Jurisdiction: FLORIDA
Filing Type: Florida Profit Corporation
Status: Inactive
Date Filed: 03 Dec 1993 (31 years ago)
Date of dissolution: 05 Sep 2018 (6 years ago)
Last Event: VOLUNTARY DISSOLUTION
Event Date Filed: 05 Sep 2018 (6 years ago)
Document Number: P93000084236
FEI/EIN Number 65-0459573
Address: 1306 S PINE AVENUE, OCALA, FL 34471
Mail Address: 1306 S PINE AVENUE, OCALA, FL 34471
ZIP code: 34471
County: Marion
Place of Formation: FLORIDA

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
KEITH J. BRADSHAW INSURANCE AGENCY, INC. PROFIT SHARING PLAN 2017 650459573 2018-10-15 KEITH J. BRADSHAW INSURANCE AGENCY, INC. 0
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1997-02-01
Business code 524210
Sponsor’s telephone number 3058954351
Plan sponsor’s address 701 W HALLANDALE BEACH BLVD #103, HALLANDALE BEACH, FL, 33009
KEITH J. BRADSHAW INSURANCE AGENCY, INC. PROFIT SHARING PLAN 2016 650459573 2017-06-29 KEITH J. BRADSHAW INSURANCE AGENCY, INC. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1997-02-01
Business code 524210
Sponsor’s telephone number 3058954351
Plan sponsor’s address 701 W HALLANDALE BEACH BLVD #103, HALLANDALE BEACH, FL, 33009

Signature of
Role Plan administrator
Date 2017-06-29
Name of individual signing KEITH J. BRADSHAW
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-06-29
Name of individual signing KEITH BRADSHAW
Valid signature Filed with authorized/valid electronic signature
KEITH J. BRADSHAW INSURANCE AGENCY, INC. PROFIT SHARING PLAN 2015 650459573 2016-10-15 KEITH J. BRADSHAW INSURANCE AGENCY, INC. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1997-02-01
Business code 524210
Sponsor’s telephone number 3058954351
Plan sponsor’s address 12892 BISCAYNE BLVD., NORTH MIAMI, FL, 33181

Signature of
Role Plan administrator
Date 2016-10-15
Name of individual signing KEITH J. BRADSHAW
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-10-15
Name of individual signing KEITH BRADSHAW
Valid signature Filed with authorized/valid electronic signature
KEITH J. BRADSHAW INSURANCE AGENCY, INC. PROFIT SHARING PLAN 2014 650459573 2016-10-17 KEITH J. BRADSHAW INSURANCE AGENCY, INC. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1997-02-01
Business code 524210
Sponsor’s telephone number 3058954351
Plan sponsor’s address 12892 BISCAYNE BLVD., NORTH MIAMI, FL, 33181

Signature of
Role Plan administrator
Date 2016-10-17
Name of individual signing KEITH J. BRADSHAW
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-10-17
Name of individual signing KEITH BRADSHAW
Valid signature Filed with authorized/valid electronic signature
KEITH J. BRADSHAW INSURANCE AGENCY, INC. PROFIT SHARING PLAN 2014 650459573 2015-06-22 KEITH J. BRADSHAW INSURANCE AGENCY, INC. 6
Three-digit plan number (PN) 001
Effective date of plan 1997-02-01
Business code 524210
Sponsor’s telephone number 3058954351
Plan sponsor’s address 12892 BISCAYNE BLVD., NORTH MIAMI, FL, 33181

Signature of
Role Plan administrator
Date 2015-06-22
Name of individual signing KEITH J. BRADSHAW
Valid signature Filed with authorized/valid electronic signature
KEITH J. BRADSHAW INSURANCE AGENCY, INC. PROFIT SHARING PLAN 2013 650459573 2014-05-19 KEITH J. BRADSHAW INSURANCE AGENCY, INC. 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1997-02-01
Business code 524210
Sponsor’s telephone number 3058954351
Plan sponsor’s address P.O. BOX 610248, NORTH MIAMI, FL, 33261

Signature of
Role Plan administrator
Date 2014-05-19
Name of individual signing KEITH BRADSHAW
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-05-19
Name of individual signing KEITH BRADSHAW
Valid signature Filed with authorized/valid electronic signature
KEITH J. BRADSHAW INSURANCE AGENCY, INC. PROFIT SHARING PLAN 2012 650459573 2013-06-21 KEITH J. BRADSHAW INSURANCE AGENCY, INC. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1997-02-01
Business code 524210
Sponsor’s telephone number 3058954351
Plan sponsor’s address P.O. BOX 610248, NORTH MIAMI, FL, 33261

Signature of
Role Plan administrator
Date 2013-06-21
Name of individual signing KEITH BRADSHAW
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-06-21
Name of individual signing KEITH BRADSHAW
Valid signature Filed with authorized/valid electronic signature
KEITH J. BRADSHAW INSURANCE AGENCY, INC. PROFIT SHARING PLAN 2011 650459573 2012-05-10 KEITH J. BRADSHAW INSURANCE AGENCY, INC. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1997-02-01
Business code 524210
Sponsor’s telephone number 3058954351
Plan sponsor’s address P.O. BOX 610248, NORTH MIAMI, FL, 33261

Plan administrator’s name and address
Administrator’s EIN 650459573
Plan administrator’s name KEITH J. BRADSHAW INSURANCE AGENCY, INC.
Plan administrator’s address P.O. BOX 610248, NORTH MIAMI, FL, 33261
Administrator’s telephone number 3058954351

Signature of
Role Plan administrator
Date 2012-05-10
Name of individual signing KEITH BRADSHAW
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-05-10
Name of individual signing KEITH BRADSHAW
Valid signature Filed with authorized/valid electronic signature
KEITH J. BRADSHAW INSURANCE AGENCY, INC. PROFIT SHARING PLAN 2010 650459573 2011-06-01 KEITH J. BRADSHAW INSURANCE AGENCY, INC. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1997-02-01
Business code 524210
Sponsor’s telephone number 3058954351
Plan sponsor’s address P.O. BOX 610248, NORTH MIAMI, FL, 33261

Plan administrator’s name and address
Administrator’s EIN 650459573
Plan administrator’s name KEITH J. BRADSHAW INSURANCE AGENCY, INC.
Plan administrator’s address P.O. BOX 610248, NORTH MIAMI, FL, 33261
Administrator’s telephone number 3058954351

Signature of
Role Plan administrator
Date 2011-06-01
Name of individual signing KEITH J BRADSHAW
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-06-01
Name of individual signing KEITH J BRADSHAW
Valid signature Filed with authorized/valid electronic signature
KEITH J. BRADSHAW INSURANCE AGENCY, INC. PROFIT SHARING PLAN 2009 650459573 2010-07-21 KEITH J. BRADSHAW INSURANCE AGENCY, INC. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1997-02-01
Business code 524210
Sponsor’s telephone number 3058954351
Plan sponsor’s address P.O. BOX 610248, NORTH MIAMI, FL, 33261

Plan administrator’s name and address
Administrator’s EIN 650459573
Plan administrator’s name KEITH J. BRADSHAW INSURANCE AGENCY, INC.
Plan administrator’s address P.O. BOX 610248, NORTH MIAMI, FL, 33261
Administrator’s telephone number 3058954351

Signature of
Role Plan administrator
Date 2010-07-21
Name of individual signing KEITH BRADSHAW
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-07-21
Name of individual signing KEITH BRADSHAW
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
BRADSHAW, SCOTT DOUGLAS Agent 1306 S PINE AVENUE, OCALA, FL 34471

DPSC

Name Role Address
BRADSHAW, SCOTT DOUGLAS DPSC 1306 S PINE AVENUE, OCALA, FL 34471

Events

Event Type Filed Date Value Description
VOLUNTARY DISSOLUTION 2018-09-05 No data No data
AMENDMENT 2018-06-14 No data No data
CHANGE OF PRINCIPAL ADDRESS 2018-06-14 1306 S PINE AVENUE, OCALA, FL 34471 No data
CHANGE OF MAILING ADDRESS 2018-06-14 1306 S PINE AVENUE, OCALA, FL 34471 No data
REGISTERED AGENT NAME CHANGED 2018-06-14 BRADSHAW, SCOTT DOUGLAS No data
REGISTERED AGENT ADDRESS CHANGED 2006-04-20 1306 S PINE AVENUE, OCALA, FL 34471 No data

Documents

Name Date
VOLUNTARY DISSOLUTION 2018-09-05
Amendment 2018-06-14
ANNUAL REPORT 2018-01-10
ANNUAL REPORT 2017-01-14
AMENDED ANNUAL REPORT 2016-03-10
ANNUAL REPORT 2016-01-26
ANNUAL REPORT 2015-01-12
ANNUAL REPORT 2014-03-03
ANNUAL REPORT 2013-03-13
ANNUAL REPORT 2012-01-10

Related by officers

No related officers

Related by address

No related companies by address

Date of last update: 02 Feb 2025

Sources: Florida Department of State

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