DOUG ANDRUS DISTRIBUTION WELFARE BENEFIT PLAN
|
2016
|
412048541
|
2017-07-13
|
DOUG ANDRUS DISTRIBUTING
|
218
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2010-01-01
|
Business code |
484200
|
Sponsor’s telephone number |
2085231034
|
Plan sponsor’s mailing address |
6300 S 45TH W, IDAHO FALLS, ID, 834025771
|
Plan sponsor’s
address |
6300 S 45TH W, IDAHO FALLS, ID, 834025771
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2017-07-13 |
Name of individual signing |
TRENT BELNAP |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DOUG ANDRUS DISTRIBUTION WELFARE BENEFIT PLAN
|
2015
|
412048541
|
2016-07-21
|
DOUG ANDRUS DISTRIBUTING
|
197
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2010-01-01
|
Business code |
484200
|
Sponsor’s telephone number |
2085231034
|
Plan sponsor’s mailing address |
6300 S 45TH W, IDAHO FALLS, ID, 834025771
|
Plan sponsor’s
address |
6300 S 45TH W, IDAHO FALLS, ID, 834025771
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2016-07-21 |
Name of individual signing |
TRENT BELNAP |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2016-07-21 |
Name of individual signing |
TRENT BELNAP |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DOUG ANDRUS DISTRIBUTING WELFARE BENEFIT PLAN
|
2014
|
412048541
|
2015-10-13
|
DOUG ANDRUS DISTRIBUTING
|
190
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2010-01-01
|
Business code |
484200
|
Sponsor’s telephone number |
2085231034
|
Plan sponsor’s mailing address |
6300 SOUTH 45 WEST, IDAHO FALLS, ID, 83402
|
Plan sponsor’s
address |
6300 SOUTH 45 WEST, IDAHO FALLS, ID, 83402
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2015-10-13 |
Name of individual signing |
TRENT BELNAP |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2015-10-13 |
Name of individual signing |
TRENT BELNAP |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DOUG ANDRUS DISTRIBUTION WELFARE BENEFIT PLAN
|
2014
|
412048541
|
2015-10-13
|
DOUG ANDRUS DISTRIBUTING
|
191
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2010-01-01
|
Business code |
484200
|
Sponsor’s telephone number |
2085231034
|
Plan sponsor’s mailing address |
6300 SOUTH 45 WEST, IDAHO FALLS, ID, 83402
|
Plan sponsor’s
address |
6300 SOUTH 45 WEST, IDAHO FALLS, ID, 83402
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2015-10-13 |
Name of individual signing |
TRENT BELNAP |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2015-10-13 |
Name of individual signing |
TRENT BELNAP |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DOUG ANDRUS DISTRIBUTION WELFARE BENEFIT PLAN
|
2013
|
412048541
|
2015-10-13
|
DOUG ANDRUS DISTRIBUTING
|
196
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2010-01-01
|
Business code |
484200
|
Sponsor’s telephone number |
2085231034
|
Plan sponsor’s mailing address |
6300 SOUTH 45 WEST, IDAHO FALLS, ID, 83402
|
Plan sponsor’s
address |
6300 SOUTH 45 WEST, IDAHO FALLS, ID, 83402
|
Plan administrator’s name and address
Administrator’s EIN |
412048541 |
Plan administrator’s name |
DOUG ANDRUS DISTRIBUTING |
Plan administrator’s
address |
6300 SOUTH 45 WEST, IDAHO FALLS, ID, 83402 |
Administrator’s telephone number |
2085231034 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2015-10-13 |
Name of individual signing |
TRENT BELNAP |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2015-10-13 |
Name of individual signing |
TRENT BELNAP |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DOUG ANDRUS DISTRIBUTION WELFARE BENEFIT PLAN
|
2012
|
412048541
|
2015-10-13
|
DOUG ANDRUS DISTRIBUTING
|
189
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2010-01-01
|
Business code |
484200
|
Sponsor’s telephone number |
2085231034
|
Plan sponsor’s mailing address |
6300 SOUTH 45 WEST, IDAHO FALLS, ID, 83402
|
Plan sponsor’s
address |
6300 SOUTH 45 WEST, IDAHO FALLS, ID, 83402
|
Plan administrator’s name and address
Administrator’s EIN |
412048541 |
Plan administrator’s name |
DOUG ANDRUS DISTRIBUTING |
Plan administrator’s
address |
6300 SOUTH 45 WEST, IDAHO FALLS, ID, 83402 |
Administrator’s telephone number |
2085231034 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2015-10-13 |
Name of individual signing |
TRENT BELNAP |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2015-10-13 |
Name of individual signing |
TRENT BELNAP |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DOUG ANDRUS DISTRIBUTION WELFARE BENEFIT PLAN
|
2011
|
412048541
|
2015-10-13
|
DOUG ANDRUS DISTRIBUTING
|
189
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2010-01-01
|
Business code |
484200
|
Sponsor’s telephone number |
2085231034
|
Plan sponsor’s mailing address |
6300 SOUTH 45 WEST, IDAHO FALLS, ID, 83402
|
Plan sponsor’s
address |
6300 SOUTH 45 WEST, IDAHO FALLS, ID, 83402
|
Plan administrator’s name and address
Administrator’s EIN |
412048541 |
Plan administrator’s name |
DOUG ANDRUS DISTRIBUTING |
Plan administrator’s
address |
6300 SOUTH 45 WEST, IDAHO FALLS, ID, 83402 |
Administrator’s telephone number |
2085231034 |
Number of participants as of the end of the plan year
Active participants |
189 |
Retired or separated participants receiving
benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2015-10-13 |
Name of individual signing |
TRENT BELNAP |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2015-10-13 |
Name of individual signing |
TRENT BELNAP |
Valid signature |
Filed with authorized/valid electronic signature |
|
|