|
BLUE DOG CBS BENEFIT PLAN
|
2021
|
842648911
|
2022-12-29
|
BLUE DOG
|
22
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
501
|
| Effective date of plan |
2021-03-01
|
| Business code |
722300
|
| Sponsor’s telephone number |
5027776275
|
| Plan sponsor’s
address |
2868 FRANKFORT AVENUE, LOUISVILLE, KY, 40206
|
Plan administrator’s name and address
| Administrator’s EIN |
846429706 |
| Plan administrator’s name |
SHAWNA BURTON |
| Plan administrator’s
address |
464 CHENAULT RD, FRANKFORT, KY, 40601 |
| Administrator’s telephone number |
5026954700 |
Signature of
| Role |
Plan administrator |
| Date |
2022-12-29 |
| Name of individual signing |
SHAWNA BURTON |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
BLUE DOG CBS BENEFIT PLAN
|
2020
|
842648911
|
2021-12-14
|
BLUE DOG
|
21
|
|
| Three-digit plan number (PN) |
501
|
| Effective date of plan |
2021-03-01
|
| Business code |
722300
|
| Sponsor’s telephone number |
5027776275
|
| Plan sponsor’s
address |
2868 FRANKFORT AVENUE, LOUISVILLE, KY, 40206
|
Plan administrator’s name and address
| Administrator’s EIN |
846429706 |
| Plan administrator’s name |
SHAWNA BURTON |
| Plan administrator’s
address |
464 CHENAULT RD, FRANKFORT, KY, 40601 |
| Administrator’s telephone number |
5026954700 |
Signature of
| Role |
Plan administrator |
| Date |
2021-12-14 |
| Name of individual signing |
SHAWNA BURTON |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
