|
BLUEGRASS SUPPLY CHAIN SERVICES 401(K) PROFIT SHARING PLAN AND TRUST
|
2023
|
205761969
|
2024-09-18
|
BLUEGRASS SUPPLY CHAIN SERVICES, LLC
|
352
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2012-01-01
|
| Business code |
484200
|
| Sponsor’s telephone number |
2702822211
|
| Plan sponsor’s
address |
360 E 8TH AVE, STE 400, BOWLING GREEN, KY, 42101
|
Signature of
| Role |
Plan administrator |
| Date |
2024-09-18 |
| Name of individual signing |
CINDY LAWRENCE |
| Valid signature |
Filed with authorized/valid electronic signature |
|
| Role |
Employer/plan sponsor |
| Date |
2024-09-18 |
| Name of individual signing |
CINDY LAWRENCE |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
BLUEGRASS SUPPLY CHAIN SERVICES MEDOVA LIFESTYLE HEALTH PLAN
|
2022
|
205761969
|
2023-11-01
|
BLUEGRASS SUPPLY CHAIN SERVICES
|
0
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
502
|
| Effective date of plan |
2018-05-01
|
| Business code |
484200
|
| Sponsor’s telephone number |
2702820011
|
| Plan sponsor’s mailing address |
350 SCOTTYS WAY, BOWLING GREEN, KY, 421019549
|
| Plan sponsor’s
address |
350 SCOTTYS WAY, BOWLING GREEN, KY, 421019549
|
Plan administrator’s name and address
| Administrator’s EIN |
200200514 |
| Plan administrator’s name |
RECEIVERSHIP MANAGEMENT INC |
| Plan administrator’s
address |
510 HOSPITAL DR STE 490, MADISON, TN, 371155049 |
| Administrator’s telephone number |
6153700051 |
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 |
Signature of
| Role |
Plan administrator |
| Date |
2023-11-01 |
| Name of individual signing |
ROBERT MOORE |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
BLUEGRASS SUPPLY CHAIN SERVICES MEDOVA LIFESTYLE HEALTH PLAN
|
2021
|
205761969
|
2023-02-15
|
BLUEGRASS SUPPLY CHAIN SERVICES
|
578
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
502
|
| Effective date of plan |
2018-05-01
|
| Business code |
484200
|
| Sponsor’s telephone number |
2702820011
|
| Plan sponsor’s mailing address |
350 SCOTTYS WAY, BOWLING GREEN, KY, 421019549
|
| Plan sponsor’s
address |
350 SCOTTYS WAY, BOWLING GREEN, KY, 421019549
|
Plan administrator’s name and address
| Administrator’s EIN |
200200514 |
| Plan administrator’s name |
RECEIVERSHIP MANAGEMENT INC |
| Plan administrator’s
address |
510 HOSPITAL DR STE 490, MADISON, TN, 371155049 |
| Administrator’s telephone number |
6153700051 |
Number of participants as of the end of the plan year
Signature of
| Role |
Plan administrator |
| Date |
2023-02-15 |
| Name of individual signing |
ROBERT MOORE |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
BLUEGRASS SUPPLY CHAIN SERVICES 401(K) PROFIT SHARING PLAN AND TRUST
|
2015
|
205761969
|
2016-09-16
|
BLUEGRASS SUPPLY CHAIN SERVICES, LLC
|
119
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2012-01-01
|
| Business code |
484200
|
| Sponsor’s telephone number |
2702822211
|
| Plan sponsor’s
address |
350 SCOTTY'S WAY, BOWLING GREEN, KY, 42101
|
Signature of
| Role |
Plan administrator |
| Date |
2016-09-16 |
| Name of individual signing |
CINDY LAWRENCE |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
BLUEGRASS SUPPLY CHAIN SERVICES 401(K) PROFIT SHARING PLAN AND TRUST
|
2014
|
205761969
|
2015-09-24
|
BLUEGRASS SUPPLY CHAIN SERVICES, LLC
|
85
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2012-01-01
|
| Business code |
484200
|
| Sponsor’s telephone number |
2702822211
|
| Plan sponsor’s
address |
350 SCOTTY'S WAY, BOWLING GREEN, KY, 42101
|
Signature of
| Role |
Plan administrator |
| Date |
2015-09-24 |
| Name of individual signing |
HOLLY WALLACE |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
BLUEGRASS SUPPLY CHAIN SERVICES 401(K) PROFIT SHARING PLAN AND TRUST
|
2013
|
205761969
|
2014-09-10
|
BLUEGRASS SUPPLY CHAIN SERVICES, LLC
|
94
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2012-01-01
|
| Business code |
484200
|
| Sponsor’s telephone number |
2702822211
|
| Plan sponsor’s
address |
350 SCOTTY'S WAY, BOWLING GREEN, KY, 42101
|
Signature of
| Role |
Plan administrator |
| Date |
2014-09-10 |
| Name of individual signing |
HOLLY WALLACE |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
BLUEGRASS SUPPLY CHAIN SERVICES 401(K) PROFIT SHARING PLAN AND TRUST
|
2012
|
205761969
|
2013-10-11
|
BLUEGRASS SUPPLY CHAIN SERVICES, LLC
|
40
|
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2012-01-01
|
| Business code |
484200
|
| Sponsor’s telephone number |
2702822211
|
| Plan sponsor’s
address |
1136 SOUTH PARK DRIVE, SUITE 202, BOWLING GREEN, KY, 42103
|
Signature of
| Role |
Plan administrator |
| Date |
2013-10-11 |
| Name of individual signing |
JOHN HIGGINS |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
