CROOKHAM COMPANY HEALTH REIMBURSEMENT ARRANGEMENT
|
2014
|
820186906
|
2015-10-15
|
CROOKHAM COMPANY
|
81
|
|
File |
View Page
|
Three-digit plan number (PN) |
503
|
Effective date of plan |
2010-01-01
|
Business code |
111900
|
Sponsor’s telephone number |
2084597451
|
Plan sponsor’s mailing address |
P O BOX 520, CALDWELL, ID, 836060520
|
Plan sponsor’s
address |
301 W WAREHOUSE, CALDWELL, ID, 836060520
|
Plan administrator’s name and address
Administrator’s EIN |
820186906 |
Plan administrator’s name |
CROOKHAM COMPANY |
Plan administrator’s
address |
P O BOX 520, CALDWELL, ID, 836060520 |
Administrator’s telephone number |
2084597451 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2015-10-15 |
Name of individual signing |
LISA LARROCEA-COWGER |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2015-10-15 |
Name of individual signing |
TERRI KELLEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
CROOKHAM COMPANY EMPLOYEE BENEFIT TRUST
|
2014
|
820186906
|
2015-06-05
|
CROOKHAM COMPANY
|
100
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1994-01-01
|
Business code |
111900
|
Sponsor’s telephone number |
2084597451
|
Plan sponsor’s mailing address |
PO BOX 520, 301 W WAREHOUSE, CALDWELL, ID, 83605
|
Plan sponsor’s
address |
301 W WAREHOUSE, CALDWELL, ID, 83605
|
Plan administrator’s name and address
Administrator’s EIN |
820186906 |
Plan administrator’s name |
CROOKHAM COMPANY |
Plan administrator’s
address |
PO BOX 520, 301 W WAREHOUSE, CALDWELL, ID, 83605 |
Administrator’s telephone number |
2084597451 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2015-05-19 |
Name of individual signing |
LISA LARROCEA-COWGER |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2015-05-20 |
Name of individual signing |
MARY CROOKHAM |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
CROOKHAM COMPANY HEALTH REIMBURSEMENT ARRANGEMENT
|
2013
|
820186906
|
2014-06-17
|
CROOKHAM COMPANY
|
78
|
|
File |
View Page
|
Three-digit plan number (PN) |
503
|
Effective date of plan |
2010-01-01
|
Business code |
111900
|
Sponsor’s telephone number |
2084597451
|
Plan sponsor’s mailing address |
P O BOX 520, CALDWELL, ID, 836060520
|
Plan sponsor’s
address |
301 W WAREHOUSE, CALDWELL, ID, 836060520
|
Plan administrator’s name and address
Administrator’s EIN |
820186906 |
Plan administrator’s name |
CROOKHAM COMPANY |
Plan administrator’s
address |
P O BOX 520, CALDWELL, ID, 836060520 |
Administrator’s telephone number |
2084597451 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2014-06-16 |
Name of individual signing |
LISA LARROCEA-COWGER |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2014-06-17 |
Name of individual signing |
MARY CROOKHAM |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
CROOKHAM COMPANY EMPLOYEE BENEFIT TRUST
|
2013
|
820186906
|
2014-06-17
|
CROOKHAM COMPANY
|
89
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1994-01-01
|
Business code |
111900
|
Sponsor’s telephone number |
2084597451
|
Plan sponsor’s mailing address |
PO BOX 520, 301 W WAREHOUSE, CALDWELL, ID, 83605
|
Plan sponsor’s
address |
301 W WAREHOUSE, CALDWELL, ID, 83605
|
Plan administrator’s name and address
Administrator’s EIN |
820186906 |
Plan administrator’s name |
CROOKHAM COMPANY |
Plan administrator’s
address |
PO BOX 520, 301 W WAREHOUSE, CALDWELL, ID, 83605 |
Administrator’s telephone number |
2084597451 |
Number of participants as of the end of the plan year
Active participants |
92 |
Other
retired or separated participants entitled to future benefits |
2 |
Signature of
Role |
Plan administrator |
Date |
2014-06-16 |
Name of individual signing |
LISA LARROCEA-COWGER |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2014-06-17 |
Name of individual signing |
MARY CROOKHAM |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
CROOKHAM COMPANY HEALTH REIMBURSEMENT ARRANGEMENT
|
2012
|
820186906
|
2013-08-20
|
CROOKHAM COMPANY
|
77
|
|
File |
View Page
|
Three-digit plan number (PN) |
503
|
Effective date of plan |
2010-01-01
|
Business code |
111900
|
Sponsor’s telephone number |
2084597451
|
Plan sponsor’s mailing address |
P O BOX 520, CALDWELL, ID, 836060520
|
Plan sponsor’s
address |
301 W WAREHOUSE, CALDWELL, ID, 836060520
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2013-08-20 |
Name of individual signing |
LISA LARROCEA-COWGER |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2013-08-20 |
Name of individual signing |
MARY CROOKHAM |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
CROOKHAM COMPANY EMPLOYEE BENEFIT TRUST
|
2012
|
820186906
|
2013-08-14
|
CROOKHAM COMPANY
|
82
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1994-01-01
|
Business code |
111900
|
Sponsor’s telephone number |
2084597451
|
Plan sponsor’s mailing address |
PO BOX 520, 301 W WAREHOUSE, CALDWELL, ID, 83605
|
Plan sponsor’s
address |
301 W WAREHOUSE, CALDWELL, ID, 83605
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2013-08-14 |
Name of individual signing |
LISA LARROCEA-COWGER |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2013-08-14 |
Name of individual signing |
MARY CROOKHAM |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
CROOKHAM COMPANY EMPLOYEE BENEFIT TRUST
|
2011
|
820186906
|
2012-07-06
|
CROOKHAM COMPANY
|
79
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1994-01-01
|
Business code |
111900
|
Sponsor’s telephone number |
2084597451
|
Plan sponsor’s mailing address |
PO BOX 520, 301 W WAREHOUSE, CALDWELL, ID, 83605
|
Plan sponsor’s
address |
301 W WAREHOUSE, CALDWELL, ID, 83605
|
Plan administrator’s name and address
Administrator’s EIN |
820186906 |
Plan administrator’s name |
CROOKHAM COMPANY |
Plan administrator’s
address |
PO BOX 520, 301 W WAREHOUSE, CALDWELL, ID, 83605 |
Administrator’s telephone number |
2084597451 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2012-07-05 |
Name of individual signing |
LISA LARROCEA-COWGER |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2012-07-06 |
Name of individual signing |
MARY CROOKHAM |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
CROOKHAM COMPANY HEALTH REIMBURSEMENT ARRANGEMENT
|
2011
|
820186906
|
2012-07-06
|
CROOKHAM COMPANY
|
77
|
|
File |
View Page
|
Three-digit plan number (PN) |
503
|
Effective date of plan |
2010-01-01
|
Business code |
111900
|
Sponsor’s telephone number |
2084597451
|
Plan sponsor’s mailing address |
P O BOX 520, CALDWELL, ID, 836060520
|
Plan sponsor’s
address |
301 W WAREHOUSE, CALDWELL, ID, 836060520
|
Plan administrator’s name and address
Administrator’s EIN |
820186906 |
Plan administrator’s name |
CROOKHAM COMPANY |
Plan administrator’s
address |
P O BOX 520, CALDWELL, ID, 836060520 |
Administrator’s telephone number |
2084597451 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2012-07-06 |
Name of individual signing |
LISA LARROCEA-COWGER |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2012-07-03 |
Name of individual signing |
MARY CROOKHAM |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
CROOKHAM COMPANY PROFIT SHARING PLAN
|
2010
|
820186906
|
2012-01-31
|
CROOKHAM COMPANY
|
230
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1966-07-01
|
Business code |
111900
|
Sponsor’s telephone number |
2084597451
|
Plan sponsor’s mailing address |
301 W WAREHOUSE, CALDWELL, ID, 83605
|
Plan sponsor’s
address |
P O BOX 520, CALDWELL, ID, 836060520
|
Plan administrator’s name and address
Administrator’s EIN |
820186906 |
Plan administrator’s name |
CROOKHAM COMPANY |
Plan administrator’s
address |
301 W WAREHOUSE, CALDWELL, ID, 83605 |
Administrator’s telephone number |
2084597451 |
Number of participants as of the end of the plan year
Active participants |
216 |
Number of
participants
with
account balances as of the end of the plan year |
210 |
Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
6 |
Signature of
Role |
Plan administrator |
Date |
2012-01-31 |
Name of individual signing |
TERRI KELLEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2012-01-31 |
Name of individual signing |
MARY CROOKHAM |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
CROOKHAM COMPANY HEALTH REIMBURSEMENT ARRANGEMENT
|
2010
|
820186906
|
2011-07-26
|
CROOKHAM COMPANY
|
82
|
|
File |
View Page
|
Three-digit plan number (PN) |
503
|
Effective date of plan |
2010-01-01
|
Business code |
111900
|
Sponsor’s telephone number |
2084597451
|
Plan sponsor’s mailing address |
P O BOX 520, CALDWELL, ID, 836060520
|
Plan sponsor’s
address |
301 W WAREHOUSE, CALDWELL, ID, 836060520
|
Plan administrator’s name and address
Administrator’s EIN |
820186906 |
Plan administrator’s name |
CROOKHAM COMPANY |
Plan administrator’s
address |
P O BOX 520, CALDWELL, ID, 836060520 |
Administrator’s telephone number |
2084597451 |
Number of participants as of the end of the plan year
Active participants |
77 |
Other
retired or separated participants entitled to future benefits |
3 |
Signature of
Role |
Plan administrator |
Date |
2011-07-26 |
Name of individual signing |
TERRI KELLEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2011-07-26 |
Name of individual signing |
MARY CROOKHAM |
Valid signature |
Filed with authorized/valid electronic signature |
|
|