MPD LONG TERM DISABILITY
|
2015
|
611108817
|
2016-07-20
|
MPD INC.
|
274
|
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1986-12-31
|
Business code |
335900
|
Sponsor’s telephone number |
2706856589
|
Plan sponsor’s mailing address |
316 E 9TH ST, OWENSBORO, KY, 423033511
|
Plan sponsor’s
address |
316 E 9TH ST, OWENSBORO, KY, 423033511
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2016-07-19 |
Name of individual signing |
CHARLES SCHAUT |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2016-07-18 |
Name of individual signing |
RANDY ROOS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MPD HEALTH, DENTAL & VISION
|
2015
|
611108817
|
2016-07-20
|
MPD INC.
|
265
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
1986-12-31
|
Business code |
335900
|
Sponsor’s telephone number |
2706856589
|
Plan sponsor’s mailing address |
316 E 9TH ST, OWENSBORO, KY, 423033511
|
Plan sponsor’s
address |
316 E 9TH ST, OWENSBORO, KY, 423033511
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2016-07-19 |
Name of individual signing |
CHARLES SCHAUT |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2016-07-19 |
Name of individual signing |
RANDY ROOS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MPD SPECIAL AD&D
|
2015
|
611108817
|
2016-07-20
|
MPD INC.
|
314
|
|
Three-digit plan number (PN) |
504
|
Effective date of plan |
1986-12-31
|
Business code |
335900
|
Sponsor’s telephone number |
2706856589
|
Plan sponsor’s mailing address |
316 E 9TH ST, OWENSBORO, KY, 423033511
|
Plan sponsor’s
address |
316 E 9TH ST, OWENSBORO, KY, 423033511
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2016-07-19 |
Name of individual signing |
CHARLES SCHAUT |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2016-07-19 |
Name of individual signing |
RANDY ROOS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MPD LIFE INSURANCE
|
2015
|
611108817
|
2016-07-20
|
MPD INC.
|
543
|
|
Three-digit plan number (PN) |
503
|
Effective date of plan |
1986-12-31
|
Business code |
335900
|
Sponsor’s telephone number |
2706856589
|
Plan sponsor’s mailing address |
316 E 9TH ST, OWENSBORO, KY, 423033511
|
Plan sponsor’s
address |
316 E 9TH ST, OWENSBORO, KY, 423033511
|
Number of participants as of the end of the plan year
Active participants |
314 |
Retired or separated participants receiving
benefits |
230 |
Signature of
Role |
Plan administrator |
Date |
2016-07-19 |
Name of individual signing |
CHARLES SCHAUT |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2016-07-19 |
Name of individual signing |
RANDY ROOS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MPD HEALTH, DENTAL & VISION
|
2014
|
611108817
|
2015-07-30
|
MPD INC
|
199
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
1986-12-31
|
Business code |
335900
|
Sponsor’s telephone number |
2706856589
|
Plan sponsor’s mailing address |
316 EAST NINTH STREET, OWENSBORO, KY, 42303
|
Plan sponsor’s
address |
316 EAST NINTH STREET, OWENSBORO, KY, 42303
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2015-07-29 |
Name of individual signing |
CHARLES SCHAUT |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2015-07-30 |
Name of individual signing |
RANDY ROOS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MPD LIFE INSURANCE
|
2014
|
611108817
|
2015-07-30
|
MPD INC.
|
455
|
|
File |
View Page
|
Three-digit plan number (PN) |
503
|
Effective date of plan |
1986-12-31
|
Business code |
335900
|
Sponsor’s telephone number |
2706856589
|
Plan sponsor’s mailing address |
316 EAST NINTH STREET, OWENSBORO, KY, 42303
|
Plan sponsor’s
address |
316 EAST NINTH STREET, OWENSBORO, KY, 42303
|
Number of participants as of the end of the plan year
Active participants |
313 |
Retired or separated participants receiving
benefits |
230 |
Signature of
Role |
Plan administrator |
Date |
2015-07-29 |
Name of individual signing |
CHARLES SCHAUT |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2015-07-30 |
Name of individual signing |
RANDY ROOS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MPD SPECIAL AD&D
|
2014
|
611108817
|
2015-07-30
|
MPD INC.
|
161
|
|
File |
View Page
|
Three-digit plan number (PN) |
504
|
Effective date of plan |
1986-12-31
|
Business code |
335900
|
Sponsor’s telephone number |
2706856589
|
Plan sponsor’s mailing address |
316 EAST NINTH STREET, OWENSBORO, KY, 42303
|
Plan sponsor’s
address |
316 EAST NINTH STREET, OWENSBORO, KY, 42303
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2015-07-29 |
Name of individual signing |
CHARLES SCHAUT |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2015-07-30 |
Name of individual signing |
RANDY ROOS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MPD LONG TERN DISABILITY
|
2014
|
611108817
|
2015-07-30
|
MPD INC.
|
184
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1986-12-31
|
Business code |
335900
|
Sponsor’s telephone number |
2706856589
|
Plan sponsor’s mailing address |
316 EAST NINTH STREET, OWENSBORO, KY, 42303
|
Plan sponsor’s
address |
316 EAST NINTH STREET, OWENSBORO, KY, 42303
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2015-07-29 |
Name of individual signing |
CHARLES SCHAUT |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2015-07-30 |
Name of individual signing |
RANDY ROOS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MPD HEALTH, DENTAL & VISION
|
2013
|
611108817
|
2014-07-29
|
MPD, INC.
|
199
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
1986-12-31
|
Business code |
335900
|
Sponsor’s telephone number |
2706856589
|
Plan sponsor’s mailing address |
316 EAST NINTH STREET, OWENSBORO, KY, 42303
|
Plan sponsor’s
address |
316 EAST NINTH STREET, OWENSBORO, KY, 42303
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2014-07-29 |
Name of individual signing |
CHARLES SCHAUT |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2014-07-29 |
Name of individual signing |
RANDY ROOS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MPD LIFE INSURANCE
|
2013
|
611108817
|
2014-07-29
|
MPD, INC.
|
463
|
|
File |
View Page
|
Three-digit plan number (PN) |
503
|
Effective date of plan |
1986-12-31
|
Business code |
335900
|
Sponsor’s telephone number |
2706856589
|
Plan sponsor’s mailing address |
316 EAST NINTH STREET, OWENSBORO, KY, 42303
|
Plan sponsor’s
address |
316 EAST NINTH STREET, OWENSBORO, KY, 42303
|
Number of participants as of the end of the plan year
Active participants |
220 |
Retired or separated participants receiving
benefits |
235 |
Signature of
Role |
Plan administrator |
Date |
2014-07-29 |
Name of individual signing |
CHARLES SCHAUT |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2014-07-29 |
Name of individual signing |
RANDY ROOS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MPD SPECIAL AD&D
|
2013
|
611108817
|
2014-07-29
|
MPD INC.
|
172
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2014/07/29/20140729105538P040061349575001.pdf |
Three-digit plan number (PN) |
504 |
Effective date of plan |
1986-12-31 |
Business code |
335900 |
Sponsor’s telephone number |
2706856589 |
Plan sponsor’s mailing address |
316 EAST NINTH STREET, OWENSBORO, KY, 42303 |
Plan sponsor’s
address |
316 EAST NINTH STREET, OWENSBORO, KY, 42303 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2014-07-29 |
Name of individual signing |
CHARLES SCHAUT |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2014-07-29 |
Name of individual signing |
RANDY ROOS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MPD LONG TERM DISABILITY
|
2013
|
611108817
|
2014-07-29
|
MPD, INC.
|
138
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2014/07/29/20140729105457P040061347447001.pdf |
Three-digit plan number (PN) |
501 |
Effective date of plan |
1986-12-31 |
Business code |
335900 |
Sponsor’s telephone number |
2706856589 |
Plan sponsor’s mailing address |
316 EAST NINTH STREET, OWENSBORO, KY, 42303 |
Plan sponsor’s
address |
316 EAST NINTH STREET, OWENSBORO, KY, 42303 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2014-07-29 |
Name of individual signing |
CHARLES SCHAUT |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2014-07-29 |
Name of individual signing |
RANDY ROOS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MPD SPECIAL AD&D
|
2012
|
611108817
|
2013-07-18
|
MPD, INC.
|
173
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2013/07/18/20130718075308P040112351989001.pdf |
Three-digit plan number (PN) |
504 |
Effective date of plan |
1986-12-31 |
Business code |
335900 |
Sponsor’s telephone number |
2706856589 |
Plan sponsor’s mailing address |
316 EAST NINTH STREET, OWENSBORO, KY, 42303 |
Plan sponsor’s
address |
316 EAST NINTH STREET, OWENSBORO, KY, 42303 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2013-07-17 |
Name of individual signing |
CHARLES SCHAUT |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2013-07-17 |
Name of individual signing |
RANDY ROOS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MPD LONG TERM DISABILITY
|
2012
|
611108817
|
2013-07-17
|
MPD, INC.
|
136
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2013/07/17/20130717115454P030392632049001.pdf |
Three-digit plan number (PN) |
501 |
Effective date of plan |
1986-12-31 |
Business code |
335900 |
Sponsor’s telephone number |
2706856589 |
Plan sponsor’s mailing address |
316 EAST NINTH STREET, OWENSBORO, KY, 42303 |
Plan sponsor’s
address |
316 EAST NINTH STREET, OWENSBORO, KY, 42303 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2013-07-17 |
Name of individual signing |
CHARLES SCHAUT |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2013-07-16 |
Name of individual signing |
RANDY ROOS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MPD HEALTH, DENTAL & VISION
|
2012
|
611108817
|
2013-07-17
|
MPD, INC.
|
203
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2013/07/17/20130717114613P040307670659001.pdf |
Three-digit plan number (PN) |
502 |
Effective date of plan |
1986-12-31 |
Business code |
335900 |
Sponsor’s telephone number |
2706856589 |
Plan sponsor’s mailing address |
316 EAST NINTH STREET, OWENSBORO, KY, 42303 |
Plan sponsor’s
address |
316 EAST NINTH STREET, OWENSBORO, KY, 42303 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2013-07-17 |
Name of individual signing |
CHARLES SCHAUT |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2013-07-16 |
Name of individual signing |
RANDY ROOS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MPD LIFE INSURANCE
|
2012
|
611108817
|
2013-07-17
|
MPD, INC.
|
470
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2013/07/17/20130717114515P030110509877001.pdf |
Three-digit plan number (PN) |
503 |
Effective date of plan |
1986-12-31 |
Business code |
335900 |
Sponsor’s telephone number |
2706856589 |
Plan sponsor’s mailing address |
316 EAST NINTH STREET, OWENSBORO, KY, 42303 |
Plan sponsor’s
address |
316 EAST NINTH STREET, OWENSBORO, KY, 42303 |
Number of participants as of the end of the plan year
Active participants |
221 |
Retired or separated participants receiving
benefits |
242 |
Signature of
Role |
Plan administrator |
Date |
2013-07-17 |
Name of individual signing |
CHARLES SCHAUT |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2013-07-16 |
Name of individual signing |
RANDY ROOS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MPD LONG TERM DISABILITY
|
2011
|
611108817
|
2012-07-20
|
MPD, INC.
|
141
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2012/07/20/20120720082826P040008287058001.pdf |
Three-digit plan number (PN) |
501 |
Effective date of plan |
1986-12-31 |
Business code |
335900 |
Sponsor’s telephone number |
2706856285 |
Plan sponsor’s mailing address |
316 E NINTH STREET, OWENSBORO, KY, 42303 |
Plan sponsor’s
address |
316 E NINTH STREET, OWENSBORO, KY, 42303 |
Plan administrator’s name and address
Administrator’s EIN |
611108817 |
Plan administrator’s name |
MPD, INC. |
Plan administrator’s
address |
316 E NINTH STREET, OWENSBORO, KY, 42303 |
Administrator’s telephone number |
2706856285 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2012-07-19 |
Name of individual signing |
CHARLES SCHAUT |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2012-07-20 |
Name of individual signing |
RANDY ROOS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MPD SPECIAL AD&D
|
2011
|
611108817
|
2012-07-20
|
MPD, INC.
|
183
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2012/07/20/20120720082811P040008286674001.pdf |
Three-digit plan number (PN) |
504 |
Effective date of plan |
1986-12-31 |
Business code |
335900 |
Sponsor’s telephone number |
2706856285 |
Plan sponsor’s mailing address |
316 EAST NINTH STREET, OWENSBORO, KY, 42303 |
Plan sponsor’s
address |
316 EAST NINTH STREET, OWENSBORO, KY, 42303 |
Plan administrator’s name and address
Administrator’s EIN |
611108817 |
Plan administrator’s name |
MPD, INC. |
Plan administrator’s
address |
316 EAST NINTH STREET, OWENSBORO, KY, 42303 |
Administrator’s telephone number |
2706856285 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2012-07-19 |
Name of individual signing |
CHARLES SCHAUT |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2012-07-20 |
Name of individual signing |
RANDY ROOS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MPD HEALTH, DENTAL & VISION
|
2011
|
611108817
|
2012-07-20
|
MPD, INC.
|
207
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2012/07/20/20120720082753P040008286274001.pdf |
Three-digit plan number (PN) |
502 |
Effective date of plan |
1986-12-31 |
Business code |
335900 |
Sponsor’s telephone number |
2706856285 |
Plan sponsor’s mailing address |
316 E NINTH STREET, OWENSBORO, KY, 42303 |
Plan sponsor’s
address |
316 E NINTH STREET, OWENSBORO, KY, 42303 |
Plan administrator’s name and address
Administrator’s EIN |
611108817 |
Plan administrator’s name |
MPD, INC. |
Plan administrator’s
address |
316 E NINTH STREET, OWENSBORO, KY, 42303 |
Administrator’s telephone number |
2706856285 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2012-07-19 |
Name of individual signing |
CHARLES SCHAUT |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2012-07-20 |
Name of individual signing |
RANDY ROOS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MPD LIFE INSURANCE
|
2011
|
611108817
|
2012-07-20
|
MPD, INC.
|
473
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2012/07/20/20120720082625P040008284370001.pdf |
Three-digit plan number (PN) |
503 |
Effective date of plan |
1986-12-31 |
Business code |
335900 |
Sponsor’s telephone number |
2706856285 |
Plan sponsor’s mailing address |
316 EAST NINTH STREET, OWENSBORO, KY, 42303 |
Plan sponsor’s
address |
316 EAST NINTH STREET, OWENSBORO, KY, 42303 |
Plan administrator’s name and address
Administrator’s EIN |
611108817 |
Plan administrator’s name |
MPD, INC. |
Plan administrator’s
address |
316 EAST NINTH STREET, OWENSBORO, KY, 42303 |
Administrator’s telephone number |
2706856285 |
Number of participants as of the end of the plan year
Active participants |
223 |
Retired or separated participants receiving
benefits |
247 |
Signature of
Role |
Plan administrator |
Date |
2012-07-19 |
Name of individual signing |
CHARLES SCHAUT |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2012-07-20 |
Name of individual signing |
RANDY ROOS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MPD HEALTH, DENTAL & VISION
|
2010
|
611108817
|
2011-07-21
|
MPD, INC.
|
201
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2011/07/21/20110721092409P030458329168001.pdf |
Three-digit plan number (PN) |
502 |
Effective date of plan |
1986-12-31 |
Business code |
335900 |
Sponsor’s telephone number |
2706856285 |
Plan sponsor’s mailing address |
316 E NINTH STREET, OWENSBORO, KY, 42303 |
Plan sponsor’s
address |
316 E NINTH STREET, OWENSBORO, KY, 42303 |
Plan administrator’s name and address
Administrator’s EIN |
611108817 |
Plan administrator’s name |
MPD, INC. |
Plan administrator’s
address |
316 E NINTH STREET, OWENSBORO, KY, 42303 |
Administrator’s telephone number |
2706856285 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2011-07-20 |
Name of individual signing |
JANICE TOMBLINSONS |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2011-07-21 |
Name of individual signing |
RANDY ROOS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MPD SPECIAL AD&D
|
2010
|
611108817
|
2011-07-21
|
MPD, INC.
|
169
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2011/07/21/20110721151810P030014312754001.pdf |
Three-digit plan number (PN) |
504 |
Effective date of plan |
1986-12-31 |
Business code |
335900 |
Sponsor’s telephone number |
2706856285 |
Plan sponsor’s mailing address |
316 EAST NINTH STREET, OWENSBORO, KY, 42303 |
Plan sponsor’s
address |
316 EAST NINTH STREET, OWENSBORO, KY, 42303 |
Plan administrator’s name and address
Administrator’s EIN |
611108817 |
Plan administrator’s name |
MPD, INC. |
Plan administrator’s
address |
316 EAST NINTH STREET, OWENSBORO, KY, 42303 |
Administrator’s telephone number |
2706856285 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2011-07-21 |
Name of individual signing |
JANICE TOMBLINSONS |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2011-07-21 |
Name of individual signing |
RANDY ROOS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MPD LONG TERM DISABILITY
|
2010
|
611108817
|
2011-07-21
|
MPD, INC.
|
132
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2011/07/21/20110721092642P030002870963001.pdf |
Three-digit plan number (PN) |
501 |
Effective date of plan |
1986-12-31 |
Business code |
335900 |
Sponsor’s telephone number |
2706856285 |
Plan sponsor’s mailing address |
316 E NINTH STREET, OWENSBORO, KY, 42303 |
Plan sponsor’s
address |
316 E NINTH STREET, OWENSBORO, KY, 42303 |
Plan administrator’s name and address
Administrator’s EIN |
611108817 |
Plan administrator’s name |
MPD, INC. |
Plan administrator’s
address |
316 E NINTH STREET, OWENSBORO, KY, 42303 |
Administrator’s telephone number |
2706856285 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2011-07-20 |
Name of individual signing |
JANICE TOMBLINSONS |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2011-07-21 |
Name of individual signing |
RANDY ROOS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MPD LIFE INSURANCE
|
2010
|
611108817
|
2011-07-21
|
MPD, INC.
|
471
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2011/07/21/20110721092556P040454116688001.pdf |
Three-digit plan number (PN) |
503 |
Effective date of plan |
1986-12-31 |
Business code |
335900 |
Sponsor’s telephone number |
2706856285 |
Plan sponsor’s mailing address |
316 EAST NINTH STREET, OWENSBORO, KY, 42303 |
Plan sponsor’s
address |
316 EAST NINTH STREET, OWENSBORO, KY, 42303 |
Plan administrator’s name and address
Administrator’s EIN |
611108817 |
Plan administrator’s name |
MPD, INC. |
Plan administrator’s
address |
316 EAST NINTH STREET, OWENSBORO, KY, 42303 |
Administrator’s telephone number |
2706856285 |
Number of participants as of the end of the plan year
Active participants |
227 |
Retired or separated participants receiving
benefits |
246 |
Signature of
Role |
Plan administrator |
Date |
2011-07-20 |
Name of individual signing |
JANICE TOMBLINSONS |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2011-07-21 |
Name of individual signing |
RANDY ROOS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MPD HEALTH, DENTAL & VISION
|
2009
|
611108817
|
2010-07-29
|
MPD, INC.
|
206
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2010/07/29/20100729084243P030043707939001.pdf |
Three-digit plan number (PN) |
502 |
Effective date of plan |
1986-12-31 |
Business code |
335900 |
Sponsor’s telephone number |
2706856285 |
Plan sponsor’s mailing address |
316 E NINTH STREET, OWENSBORO, KY, 42303 |
Plan sponsor’s
address |
316 E NINTH STREET, OWENSBORO, KY, 42303 |
Plan administrator’s name and address
Administrator’s EIN |
611108817 |
Plan administrator’s name |
MPD, INC. |
Plan administrator’s
address |
316 E NINTH STREET, OWENSBORO, KY, 42303 |
Administrator’s telephone number |
2706856285 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2010-07-28 |
Name of individual signing |
JANICE TOMBLINSONS |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2010-07-28 |
Name of individual signing |
RANDY ROOS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MPD LIFE INSURANCE
|
2009
|
611108817
|
2010-07-29
|
MPD, INC.
|
493
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2010/07/29/20100729084225P030038731655001.pdf |
Three-digit plan number (PN) |
503 |
Effective date of plan |
1986-12-31 |
Business code |
335900 |
Sponsor’s telephone number |
2706856285 |
Plan sponsor’s mailing address |
316 EAST NINTH STREET, OWENSBORO, KY, 42303 |
Plan sponsor’s
address |
316 EAST NINTH STREET, OWENSBORO, KY, 42303 |
Plan administrator’s name and address
Administrator’s EIN |
611108817 |
Plan administrator’s name |
MPD, INC. |
Plan administrator’s
address |
316 EAST NINTH STREET, OWENSBORO, KY, 42303 |
Administrator’s telephone number |
2706856285 |
Number of participants as of the end of the plan year
Active participants |
219 |
Retired or separated participants receiving
benefits |
252 |
Signature of
Role |
Plan administrator |
Date |
2010-07-28 |
Name of individual signing |
JANICE TOMBLINSONS |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2010-07-28 |
Name of individual signing |
RANDY ROOS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MPD LONG TERM DISABILITY
|
2009
|
611108817
|
2010-07-29
|
MPD, INC.
|
129
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2010/07/29/20100729084206P030043707827001.pdf |
Three-digit plan number (PN) |
501 |
Effective date of plan |
1986-12-31 |
Business code |
335900 |
Sponsor’s telephone number |
2706856285 |
Plan sponsor’s mailing address |
316 E NINTH STREET, OWENSBORO, KY, 42303 |
Plan sponsor’s
address |
316 E NINTH STREET, OWENSBORO, KY, 42303 |
Plan administrator’s name and address
Administrator’s EIN |
611108817 |
Plan administrator’s name |
MPD, INC. |
Plan administrator’s
address |
316 E NINTH STREET, OWENSBORO, KY, 42303 |
Administrator’s telephone number |
2706856285 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2010-07-28 |
Name of individual signing |
JANICE TOMBLINSONS |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2010-07-28 |
Name of individual signing |
RANDY ROOS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MPD SPECIAL AD&D
|
2009
|
611108817
|
2010-07-29
|
MPD, INC.
|
167
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2010/07/29/20100729084108P030038731511001.pdf |
Three-digit plan number (PN) |
504 |
Effective date of plan |
1986-12-31 |
Business code |
335900 |
Sponsor’s telephone number |
2706856285 |
Plan sponsor’s mailing address |
316 EAST NINTH STREET, OWENSBORO, KY, 42303 |
Plan sponsor’s
address |
316 EAST NINTH STREET, OWENSBORO, KY, 42303 |
Plan administrator’s name and address
Administrator’s EIN |
611108817 |
Plan administrator’s name |
MPD, INC. |
Plan administrator’s
address |
316 EAST NINTH STREET, OWENSBORO, KY, 42303 |
Administrator’s telephone number |
2706856285 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2010-07-28 |
Name of individual signing |
JANICE TOMBLINSONS |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2010-07-28 |
Name of individual signing |
RANDY ROOS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|