BOCA WEST COUNTRY CLUB HEALTH & WELFARE PLAN
|
2022
|
592596122
|
2023-05-16
|
BOCA WEST COUNTRY CLUB, INC
|
319
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1994-01-01
|
Business code |
713900
|
Sponsor’s telephone number |
5614886933
|
Plan
sponsor’s DBA name |
BOCA WEST COUNTRY CLUB
|
Plan sponsor’s mailing address |
PO BOX 3070, BOCA RATON, FL, 334310970
|
Plan sponsor’s
address |
20583 BOCA WEST DRIVE, BOCA RATON, FL, 33434
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2023-05-16 |
Name of individual signing |
BARBARA CROWLEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BOCA WEST COUNTRY CLUB HEALTH & WELFARE PLAN
|
2020
|
592596122
|
2021-04-08
|
BOCA WEST COUNTRY CLUB, INC.
|
359
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1994-01-01
|
Business code |
713900
|
Sponsor’s telephone number |
5614886933
|
Plan sponsor’s mailing address |
PO BOX 3070, BOCA RATON, FL, 334310970
|
Plan sponsor’s
address |
20583 BOCA WEST DRIVE, BOCA RATON, FL, 33434
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2021-04-08 |
Name of individual signing |
BARBARA CROWLEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2021-04-08 |
Name of individual signing |
BARBARA CROWLEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BOCA WEST COUNTRY CLUB HEALTH & WELFARE PLAN
|
2019
|
592596122
|
2020-06-15
|
BOCA WEST COUNTRY CLUB, INC.
|
350
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1994-01-01
|
Business code |
713900
|
Sponsor’s telephone number |
5614886933
|
Plan sponsor’s mailing address |
P.O. BOX 3070, 20583 BOCA WEST DR, BOCA RATON, FL, 334344708
|
Plan sponsor’s
address |
20583 BOCA WEST DRIVE, BOCA RATON, FL, 33434
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2020-06-15 |
Name of individual signing |
BARBARA CROWLEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2020-06-15 |
Name of individual signing |
BARBARA CROWLEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BOCA WEST COUNTRY CLUB HEALTH & WELFARE PLAN
|
2018
|
592596122
|
2019-06-12
|
BOCA WEST COUNTRY CLUB, INC.
|
353
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1994-01-01
|
Business code |
713900
|
Sponsor’s telephone number |
5614886933
|
Plan sponsor’s mailing address |
PO BOX 3070, BOCA RATON, FL, 334310970
|
Plan sponsor’s
address |
20583 BOCA WEST DRIVE, BOCA RATON, FL, 33434
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2019-06-12 |
Name of individual signing |
BARBARA CROWLEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2019-06-12 |
Name of individual signing |
BARBARA CROWLEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BOCA WEST COUNTRY CLUB HEALTH & WELFARE PLAN
|
2017
|
592596122
|
2018-06-29
|
BOCA WEST COUNTRY CLUB, INC.
|
330
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1994-01-01
|
Business code |
713900
|
Sponsor’s telephone number |
5614886933
|
Plan sponsor’s mailing address |
PO BOX 3070, BOCA RATON, FL, 334310970
|
Plan sponsor’s
address |
20583 BOCA WEST DRIVE, BOCA RATON, FL, 33434
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2018-06-29 |
Name of individual signing |
BARBARA CROWLEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2018-06-29 |
Name of individual signing |
BARBARA CROWLEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BOCA WEST COUNTRY CLUB HEALTH & WELFARE PLAN
|
2016
|
592596122
|
2017-05-16
|
BOCA WEST COUNTRY CLUB, INC.
|
341
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1994-01-01
|
Business code |
713900
|
Sponsor’s telephone number |
5614886990
|
Plan sponsor’s mailing address |
PO BOX 3070, BOCA RATON, FL, 334310970
|
Plan sponsor’s
address |
20583 BOCA WEST DRIVE, BOCA RATON, FL, 33434
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2017-05-16 |
Name of individual signing |
BARBARA CROWLEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2017-05-16 |
Name of individual signing |
BARBARA CROWLEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BOCA WEST COUNTRY CLUB HEALTH & WELFARE PLAN
|
2015
|
592596122
|
2016-07-01
|
BOCA WEST COUNTRY CLUB, INC.
|
337
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1994-01-01
|
Business code |
713900
|
Sponsor’s telephone number |
5614886990
|
Plan sponsor’s mailing address |
PO BOX 3070, BOCA RATON, FL, 334310970
|
Plan sponsor’s
address |
20583 BOCA WEST DRIVE, BOCA RATON, FL, 33434
|
Number of participants as of the end of the plan year
Active participants |
341 |
Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2016-07-01 |
Name of individual signing |
BARBARA CROWLEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2016-07-01 |
Name of individual signing |
BARBARA CROWLEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BOCA WEST COUNTRY CLUB HEALTH & WELFARE PLAN
|
2014
|
592596122
|
2015-05-20
|
BOCA WEST COUNTRY CLUB, INC.
|
318
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1994-01-01
|
Business code |
713900
|
Sponsor’s telephone number |
5614886990
|
Plan sponsor’s mailing address |
P.O. BOX 3070, BOCA RATON, FL, 33431
|
Plan sponsor’s
address |
20583 BOCA WEST DRIVE, BOCA RATON, FL, 33434
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2015-05-20 |
Name of individual signing |
BARBARA CROWLEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2015-05-20 |
Name of individual signing |
BARBARA CROWLEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BOCA WEST COUNTRY CLUB HEALTH & WELFARE PLAN
|
2013
|
592596122
|
2014-05-30
|
BOCA WEST COUNTRY CLUB, INC.
|
343
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1994-01-01
|
Business code |
713900
|
Sponsor’s telephone number |
5614886990
|
Plan sponsor’s mailing address |
P.O. BOX 3070, BOCA RATON, FL, 33431
|
Plan sponsor’s
address |
20583 BOCA WEST DRIVE, BOCA RATON, FL, 33434
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2014-05-30 |
Name of individual signing |
BARBARA CROWLEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2014-05-30 |
Name of individual signing |
BARBARA CROWLEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BOCA WEST COUNTRY CLUB HEALTH & WELFARE PLAN
|
2012
|
592596122
|
2013-06-20
|
BOCA WEST COUNTRY CLUB, INC.
|
330
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1994-01-01
|
Business code |
713900
|
Sponsor’s telephone number |
5614886990
|
Plan sponsor’s mailing address |
P.O. BOX 3070, BOCA RATON, FL, 33431
|
Plan sponsor’s
address |
20583 BOCA WEST DRIVE, BOCA RATON, FL, 33434
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2013-06-20 |
Name of individual signing |
BARBARA CROWLEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2013-06-20 |
Name of individual signing |
BARBARA CROWLEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|