VOLUNTARY GROUP DENTAL INSURANCE DEPENDENT VOLUNTARY DENTAL
|
2018
|
593357333
|
2019-08-06
|
ATLANTIC DEVELOPMENT OF COCOA, INC.
|
3
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2018-07-01
|
Business code |
221300
|
Sponsor’s telephone number |
3216398788
|
Plan sponsor’s mailing address |
2185 W KING ST, COCOA, FL, 329265131
|
Plan sponsor’s
address |
2185 W KING ST, COCOA, FL, 329265131
|
Number of participants as of the end of the plan year
Active participants |
2 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2019-08-06 |
Name of individual signing |
SUSAN MOORE |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
VOLUNTARY GROUP DENTAL INSURANCE DEPENDENT VOLUNTARY DENTAL
|
2017
|
593357333
|
2018-08-21
|
ATLANTIC DEVELOPMENT OF COCOA, INC.
|
4
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2017-07-01
|
Business code |
221300
|
Sponsor’s telephone number |
3216398788
|
Plan
sponsor’s DBA name |
BEACH ORGANICS SKIN CARE
|
Plan sponsor’s mailing address |
2185 KING ST, COCOA, FL, 329265131
|
Plan sponsor’s
address |
2185 KING ST, COCOA, FL, 329265131
|
Number of participants as of the end of the plan year
Active participants |
3 |
Retired or separated participants receiving
benefits |
4 |
Signature of
Role |
Plan administrator |
Date |
2018-08-21 |
Name of individual signing |
SUSAN MOORE |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
VOLUNTARY GROUP DENTAL INSURANCE DEPENDANT VOLUNTARY DENTAL
|
2016
|
593357333
|
2017-08-01
|
ATLANTIC DEVELOPMENT OF COCOA, INC.
|
8
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2016-07-01
|
Business code |
236200
|
Sponsor’s telephone number |
3216398788
|
Plan sponsor’s mailing address |
2185 KING ST, COCOA, FL, 329265131
|
Plan sponsor’s
address |
2185 KING ST, COCOA, FL, 329265131
|
Number of participants as of the end of the plan year
Retired or separated participants receiving
benefits |
8 |
Signature of
Role |
Plan administrator |
Date |
2017-08-01 |
Name of individual signing |
SUSAN MOORE |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
VOLUNTARY GROUP DENTAL INSURANCE DEPENDANT VOLUNTARY DENTAL
|
2011
|
593357333
|
2012-08-14
|
ATLANTIC DEVELOPMENT OF COCOA INC
|
4
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2011-07-01
|
Business code |
236200
|
Sponsor’s telephone number |
3216323655
|
Plan sponsor’s mailing address |
2185 WEST KING STREET, COCOA, FL, 32926
|
Plan sponsor’s
address |
2185 WEST KING STREET, COCOA, FL, 32926
|
Plan administrator’s name and address
Administrator’s EIN |
593357333 |
Plan administrator’s name |
ATLANTIC DEVELOPMENT OF COCOA INC |
Plan administrator’s
address |
2185 W KING ST, COCOA, FL, 32926 |
Administrator’s telephone number |
3216398788 |
Number of participants as of the end of the plan year
Active participants |
4 |
Retired or separated participants receiving
benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2012-08-14 |
Name of individual signing |
SUSAN MOORE |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
VOLUNTARY GROUP DENTAL INSURANCE DEPENDANT VOLUNTARY DENTAL
|
2010
|
593357333
|
2011-08-02
|
ATLANTIC DEVELOPMENT OF COCOA INC
|
4
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2010-07-01
|
Business code |
236200
|
Sponsor’s telephone number |
3216323655
|
Plan sponsor’s mailing address |
2185 WEST KING STREET, COCOA, FL, 32926
|
Plan sponsor’s
address |
2185 WEST KING STREET, COCOA, FL, 32926
|
Plan administrator’s name and address
Plan administrator’s name |
ERIC DAHLBERG |
Plan administrator’s
address |
POB 181892, CASSELBERRY, FL, 32718 |
Administrator’s telephone number |
4074967704 |
Number of participants as of the end of the plan year
Active participants |
4 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Employer/plan sponsor |
Date |
2011-08-02 |
Name of individual signing |
SUSAN MOORE |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
FORTUNE BUSINESS SOLUTIONS RETIREMENT SAVINGS PLAN
|
2009
|
593357333
|
2013-10-29
|
ATLANTIC DEVELOPMENT OF COCOA INC
|
12
|
|
File |
View Page
|
Three-digit plan number (PN) |
333
|
Effective date of plan |
2009-01-01
|
Business code |
238900
|
Sponsor’s telephone number |
3216394902
|
Plan sponsor’s mailing address |
2185 W. KING ST., COCOA, FL, 32926
|
Plan sponsor’s
address |
2185 W. KING ST., COCOA, FL, 32926
|
Plan administrator’s name and address
Administrator’s EIN |
593357333 |
Plan administrator’s name |
ATLANTIC DEVELOPMENT OF COCOA INC |
Plan administrator’s
address |
2185 W. KING ST., COCOA, FL, 32926 |
Administrator’s telephone number |
3216394902 |
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 |
Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
0 |
Number of
participants
with
account balances as of the end of the plan year |
0 |
Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
0 |
Signature of
Role |
Plan administrator |
Date |
2013-10-29 |
Name of individual signing |
ALVA M. MOORE |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2013-10-29 |
Name of individual signing |
ALVA M. MOORE |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
FORTUNE BUSINESS SOLUTIONS RETREMENT SAVINGS PLAN
|
2009
|
593357333
|
2010-06-17
|
ATLANTIC DEVELOPMENT OF COCOA INC
|
12
|
|
File |
View Page
|
Three-digit plan number (PN) |
333
|
Effective date of plan |
2009-01-01
|
Business code |
238900
|
Sponsor’s telephone number |
3216394902
|
Plan sponsor’s
address |
2185 W. KING ST., COCOA, FL, 32926
|
Plan administrator’s name and address
Administrator’s EIN |
593729371 |
Plan administrator’s name |
FORTUNE BUSINESS SOLUTIONS |
Plan administrator’s
address |
8875 HIDDEN RIVER PARKWAY STE 560, TAMPA, FL, 32926 |
Administrator’s telephone number |
8137078652 |
Signature of
Role |
Employer/plan sponsor |
Date |
2010-06-17 |
Name of individual signing |
SUSAN MOORE |
Valid signature |
Filed with authorized/valid electronic signature |
|
|