WESTERN SUPERMARKETS INC, MEDICAL BENEFITS PLAN EMPLOYEE BENEFIT PLAN
|
2018
|
630957626
|
2020-06-02
|
WESTERN SUPERMARKETS, INC.
|
58
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1980-10-01
|
Business code |
445110
|
Sponsor’s telephone number |
2052664650
|
Plan sponsor’s mailing address |
416 GOLF DRIVE, BIRMINGHAM, AL, 35226
|
Plan sponsor’s
address |
416 GOLF DRIVE, BIRMINGHAM, AL, 35226
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2020-05-19 |
Name of individual signing |
KENNETH HUBBARD |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2020-05-19 |
Name of individual signing |
KENNETH HUBBARD |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
WESTERN SUPERMARKETS INC, MEDICAL BENEFITS PLAN EMPLOYEE BENEFIT PLAN
|
2017
|
630957626
|
2019-04-26
|
WESTERN SUPERMARKETS, INC.
|
68
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1980-10-01
|
Business code |
445110
|
Sponsor’s telephone number |
2058793471
|
Plan sponsor’s mailing address |
2614 19TH STREET SOUTH, BIRMINGHAM, AL, 35209
|
Plan sponsor’s
address |
2614 19TH STREET SOUTH, BIRMINGHAM, AL, 35209
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2019-04-17 |
Name of individual signing |
KENNETH HUBBARD |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2019-04-17 |
Name of individual signing |
KENNETH HUBBARD |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
WESTERN SUPERMARKETS INC, MEDICAL BENEFITS PLAN EMPLOYEE BENEFIT PLAN
|
2016
|
630957626
|
2018-04-27
|
WESTERN SUPERMARKETS, INC.
|
78
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1980-10-01
|
Business code |
445110
|
Sponsor’s telephone number |
2058793471
|
Plan sponsor’s mailing address |
2614 19TH STREET SOUTH, BIRMINGHAM, AL, 35209
|
Plan sponsor’s
address |
2614 19TH STREET SOUTH, BIRMINGHAM, AL, 35209
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2018-04-17 |
Name of individual signing |
KENNETH HUBBARD |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2018-04-17 |
Name of individual signing |
KENNETH HUBBARD |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
WESTERN SUPERMARKETS INC, MEDICAL BENEFITS PLAN EMPLOYEE BENEFIT PLAN
|
2015
|
630957626
|
2017-04-26
|
WESTERN SUPERMARKETS, INC.
|
82
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1980-10-01
|
Business code |
445110
|
Sponsor’s telephone number |
2058793471
|
Plan sponsor’s mailing address |
2614 19TH STREET SOUTH, BIRMINGHAM, AL, 35209
|
Plan sponsor’s
address |
2614 19TH STREET SOUTH, BIRMINGHAM, AL, 35209
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2017-04-25 |
Name of individual signing |
KENNETH HUBBARD |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2017-04-25 |
Name of individual signing |
KENNETH HUBBARD |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
WESTERN SUPERMARKETS INC, MEDICAL BENEFITS PLAN EMPLOYEE BENEFIT PLAN
|
2014
|
630957626
|
2016-04-28
|
WESTERN SUPERMARKETS, INC.
|
74
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1980-10-01
|
Business code |
445110
|
Sponsor’s telephone number |
2058793471
|
Plan sponsor’s mailing address |
2614 19TH STREET SOUTH, BIRMINGHAM, AL, 35209
|
Plan sponsor’s
address |
2614 19TH STREET SOUTH, BIRMINGHAM, AL, 35209
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2016-04-28 |
Name of individual signing |
KENNETH HUBBARD |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2016-04-28 |
Name of individual signing |
KENNETH HUBBARD |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
WESTERN SUPERMARKETS INC, MEDICAL BENEFITS PLAN EMPLOYEE BENEFIT PLAN
|
2013
|
630957626
|
2015-05-20
|
WESTERN SUPERMARKETS, INC.
|
82
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1980-10-01
|
Business code |
445110
|
Sponsor’s telephone number |
2058793471
|
Plan sponsor’s mailing address |
2614 19TH STREET SOUTH, BIRMINGHAM, AL, 35209
|
Plan sponsor’s
address |
2614 19TH STREET SOUTH, BIRMINGHAM, AL, 35209
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2015-04-20 |
Name of individual signing |
KENNETH HUBBARD |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2015-04-20 |
Name of individual signing |
KENNETH HUBBARD |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
WESTERN SUPERMARKETS INC, MEDICAL BENEFITS PLAN EMPLOYEE BENEFIT PLAN
|
2012
|
630957626
|
2014-05-01
|
WESTERN SUPERMARKETS, INC.
|
81
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1980-10-01
|
Business code |
445110
|
Sponsor’s telephone number |
2058793471
|
Plan sponsor’s mailing address |
2614 19TH STREET SOUTH, BIRMINGHAM, AL, 35209
|
Plan sponsor’s
address |
2614 19TH STREET SOUTH, BIRMINGHAM, AL, 35209
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2014-04-28 |
Name of individual signing |
KENNETH HUBBARD |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2014-04-28 |
Name of individual signing |
KENNETH HUBBARD |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
WESTERN SUPERMARKETS INC, MEDICAL BENEFITS PLAN EMPLOYEE BENEFIT PLAN
|
2011
|
630957626
|
2013-07-08
|
WESTERN SUPERMARKETS, INC.
|
88
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1980-10-01
|
Business code |
445110
|
Sponsor’s telephone number |
2058793471
|
Plan sponsor’s mailing address |
2614 19TH STREET SOUTH, BIRMINGHAM, AL, 35209
|
Plan sponsor’s
address |
2614 19TH STREET SOUTH, BIRMINGHAM, AL, 35209
|
Plan administrator’s name and address
Administrator’s EIN |
630957626 |
Plan administrator’s name |
KENNETH HUBBARD |
Plan administrator’s
address |
2614 19TH STREET SOUTH, BIRMINGHAM, AL, 35209 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2013-07-15 |
Name of individual signing |
KENNETH HUBBARD |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2013-07-15 |
Name of individual signing |
KENNETH HUBBARD |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
WESTERN SUPERMARKETS INC, MEDICAL BENEFITS PLAN EMPLOYEE BENEFIT PLAN
|
2010
|
630957626
|
2012-05-14
|
WESTERN SUPERMARKETS, INC.
|
90
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1980-10-01
|
Business code |
445110
|
Sponsor’s telephone number |
2058793471
|
Plan sponsor’s mailing address |
2614 19TH STREET SOUTH, BIRMINGHAM, AL, 35209
|
Plan sponsor’s
address |
2614 19TH STREET SOUTH, BIRMINGHAM, AL, 35209
|
Plan administrator’s name and address
Administrator’s EIN |
630957626 |
Plan administrator’s name |
KENNETH HUBBARD |
Plan administrator’s
address |
2614 19TH STREET SOUTH, BIRMINGHAM, AL, 35209 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2012-07-15 |
Name of individual signing |
KENNETH HUBBARD |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2012-07-15 |
Name of individual signing |
KENNETH HUBBARD |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
WESTERN SUPERMARKETS INC, MEDICAL BENEFITS PLAN EMPLOYEE BENEFIT PLAN
|
2009
|
630957626
|
2011-07-12
|
WESTERN SUPERMARKETS, INC.
|
90
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1980-10-01
|
Business code |
445110
|
Sponsor’s telephone number |
2058793471
|
Plan sponsor’s mailing address |
2614 19TH STREET SOUTH, BIRMINGHAM, AL, 35209
|
Plan sponsor’s
address |
2614 19TH STREET SOUTH, BIRMINGHAM, AL, 35209
|
Plan administrator’s name and address
Administrator’s EIN |
630957626 |
Plan administrator’s name |
WESTERN SUPERMARKETS, INC. |
Plan administrator’s
address |
2614 19TH STREET SOUTH, BIRMINGHAM, AL, 35209 |
Administrator’s telephone number |
2058793471 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2011-07-15 |
Name of individual signing |
KENNETH HUBBARD |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2011-07-15 |
Name of individual signing |
KENNETH HUBBARD |
Valid signature |
Filed with authorized/valid electronic signature |
|
|