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Caribou Insurance Agency, Inc.

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Entity Number 000-083-744

Register Number000083744

Status Dissolved

NameCaribou Insurance Agency, Inc.

Historical Names Harris Office Service, Inc.
Truckwriters of Alabama, Inc.

CountyJefferson

Date of registration 14 Aug 1981 (43 years ago)

Date of dissolution 30 Sep 2014

Legal typeDomestic Corporation

Principal Address BIRMINGHAM, AL

Registered Office Street Address 2820 COLUMBIANA ROADBIRMINGHAM, AL 35216

Registered Office Street Address ZIP code 35216

Authorized Capital $10,000

Activities SECRETARIAL SERVICES

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants File

CARIBOU 401(K) RETIREMENT PLAN

2014

630815295

2016-09-19

CARIBOU INSURANCE AGENCY, INC.

5

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Three-digit plan number (PN)001
Effective date of plan1998-01-01
Business code524210
Sponsor’s telephone number2057062703
Plan sponsor’s address2820 COLUMBIANA ROAD, STE 116, BIRMINGHAM, AL, 352162565

Signature of

RolePlan administrator
Date2016-09-19
Name of individual signingGARY MATTINGLY

CARIBOU 401(K) RETIREMENT PLAN

2013

680815295

2014-03-20

CARIBOU INSURANCE AGENCY, INC.

7

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Three-digit plan number (PN)001
Effective date of plan1998-01-01
Business code524210
Sponsor’s telephone number2058227577
Plan sponsor’s address2820 COLUMBIANA RD STE 116, BIRMINGHAM, AL, 352162565

Signature of

RolePlan administrator
Date2014-03-20
Name of individual signingGARY MATTINGLY
RoleEmployer/plan sponsor
Date2014-03-20
Name of individual signingGARY MATTINGLY

CARIBOU 401(K) RETIREMENT PLAN

2012

680815295

2013-07-30

CARIBOU INSURANCE AGENCY, INC.

9

View Page

Three-digit plan number (PN)001
Effective date of plan1998-01-01
Business code524210
Sponsor’s telephone number2058227577
Plan sponsor’s address2820 COLUMBIANA RD STE 116, BIRMINGHAM, AL, 352162565

Signature of

RolePlan administrator
Date2013-07-30
Name of individual signingGARY MATTINGLY
RoleEmployer/plan sponsor
Date2013-07-30
Name of individual signingGARY MATTINGLY

CARIBOU 401(K) RETIREMENT PLAN

2011

680815295

2012-07-31

CARIBOU INSURANCE AGENCY, INC.

9

View Page

Three-digit plan number (PN)001
Effective date of plan1998-01-01
Business code524210
Sponsor’s telephone number2058227577
Plan sponsor’s address2820 COLUMBIANA RD STE 116, BIRMINGHAM, AL, 352162565

Plan administrator’s name and address

Administrator’s EIN680815295
Plan administrator’s nameCARIBOU INSURANCE AGENCY, INC.
Plan administrator’s address2820 COLUMBIANA RD STE 116, BIRMINGHAM, AL, 352162565
Administrator’s telephone number2058227577

Signature of

RolePlan administrator
Date2012-07-31
Name of individual signingGARY MATTINGLY
RoleEmployer/plan sponsor
Date2012-07-31
Name of individual signingGARY MATTINGLY

CARIBOU 401(K) RETIREMENT PLAN

2010

680815295

2011-07-26

CARIBOU INSURANCE AGENCY, INC.

8

View Page

Three-digit plan number (PN)001
Effective date of plan1998-01-01
Business code524210
Sponsor’s telephone number2058227577
Plan sponsor’s address2820 COLUMBIANA RD STE 116, BIRMINGHAM, AL, 352162565

Plan administrator’s name and address

Administrator’s EIN680815295
Plan administrator’s nameCARIBOU INSURANCE AGENCY, INC.
Plan administrator’s address2820 COLUMBIANA RD STE 116, BIRMINGHAM, AL, 352162565
Administrator’s telephone number2058227577

Signature of

RolePlan administrator
Date2011-07-26
Name of individual signingGARY MATTINGLY
RoleEmployer/plan sponsor
Date2011-07-26
Name of individual signingGARY MATTINGLY

CARIBOU 401(K) RETIREMENT PLAN

2009

680815295

2010-10-11

CARIBOU INSURANCE AGENCY, INC

11

View Page

Three-digit plan number (PN)001
Effective date of plan1998-01-01
Business code524210
Sponsor’s telephone number2058227577
Plan sponsor’s address2820 COLUMBIANA ROAD, SUITE 116, HOOVER, AL, 35236

Plan administrator’s name and address

Administrator’s EIN680815295
Plan administrator’s nameCARIBOU INSURANCE AGENCY, INC
Plan administrator’s address2820 COLUMBIANA ROAD, SUITE 116, HOOVER, AL, 35236
Administrator’s telephone number2058227577

Signature of

RolePlan administrator
Date2010-10-11
Name of individual signingGARY MATTINGLY

Agent

Name Role

MATTINGLY, GARY L

Agent

Incorporator

Name Role

PALMER, JARVIS W

Incorporator

Events

Event Date Event Type Old Value New Value

1983-07-01

Name Change

Truckwriters of Alabama, Inc.

Caribou Insurance Agency, Inc.

1983-02-01

Name Change

Harris Office Service, Inc.

Truckwriters of Alabama, Inc.

Date of last update: 31 Jul 2024

Sources: Alabama Secretary of State