MESA ASSOCIATES GROUP HEALTH EMPLOYEE BENEFIT PLAN AND TRUST
|
2019
|
631029698
|
2020-10-14
|
MESA ASSOCIATES, INC.
|
567
|
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
2000-01-01
|
Business code |
541330
|
Sponsor’s telephone number |
2562582100
|
Plan sponsor’s mailing address |
P.O. BOX 196, MADISON, AL, 35758
|
Plan sponsor’s
address |
480 PRODUCTION AVENUE, MADISON, AL, 35758
|
Number of participants as of the end of the plan year
Active participants |
682 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2020-10-14 |
Name of individual signing |
DESTINIE SAVANT |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2020-10-14 |
Name of individual signing |
DESTINIE SAVANT |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MESA ASSOCIATES GROUP HEALTH EMPLOYEE BENEFIT PLAN AND TRUST
|
2019
|
631029698
|
2021-04-28
|
MESA ASSOCIATES, INC.
|
567
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
2000-01-01
|
Business code |
541330
|
Sponsor’s telephone number |
2562582100
|
Plan sponsor’s mailing address |
P.O. BOX 196, MADISON, AL, 35758
|
Plan sponsor’s
address |
480 PRODUCTION AVENUE, MADISON, AL, 35758
|
Number of participants as of the end of the plan year
Active participants |
682 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2021-04-28 |
Name of individual signing |
DESTINIE SAVANT |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2021-04-28 |
Name of individual signing |
DESTINIE SAVANT |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MESA ASSOCIATES GROUP HEALTH EMPLOYEE BENEFIT PLAN AND TRUST
|
2018
|
631029698
|
2019-10-15
|
MESA ASSOCIATES, INC.
|
503
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
2000-01-01
|
Business code |
541330
|
Sponsor’s telephone number |
2562582100
|
Plan sponsor’s mailing address |
P.O. BOX 196, MADISON, AL, 35758
|
Plan sponsor’s
address |
480 PRODUCTION AVENUE, MADISON, AL, 35758
|
Number of participants as of the end of the plan year
Active participants |
567 |
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 |
Signature of
Role |
Plan administrator |
Date |
2019-10-15 |
Name of individual signing |
DESTINIE SAVANT |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2019-10-15 |
Name of individual signing |
DESTINIE SAVANT |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MESA ASSOCIATES GROUP HEALTH EMPLOYEE BENEFIT PLAN AND TRUST
|
2017
|
631029698
|
2018-10-12
|
MESA ASSOCIATES, INC.
|
459
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
2000-01-01
|
Business code |
541330
|
Sponsor’s telephone number |
2562582100
|
Plan sponsor’s mailing address |
P.O. BOX 196, MADISON, AL, 35758
|
Plan sponsor’s
address |
480 PRODUCTION AVENUE, MADISON, AL, 35758
|
Number of participants as of the end of the plan year
Active participants |
503 |
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 |
Signature of
Role |
Plan administrator |
Date |
2018-10-12 |
Name of individual signing |
DESTINIE SAVANT |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2018-10-12 |
Name of individual signing |
DESTINIE SAVANT |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MESA ASSOCIATES GROUP HEALTH EMPLOYEE BENEFIT PLAN AND TRUST
|
2016
|
631029698
|
2017-10-16
|
MESA ASSOCIATES, INC.
|
442
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
2000-01-01
|
Business code |
541330
|
Sponsor’s telephone number |
2562582100
|
Plan sponsor’s mailing address |
P.O. BOX 196, MADISON, AL, 35758
|
Plan sponsor’s
address |
9238 MADISON BLVD, BLDG 2 SUITE 116, MADISON, AL, 35758
|
Number of participants as of the end of the plan year
Active participants |
459 |
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 |
Signature of
Role |
Plan administrator |
Date |
2017-10-16 |
Name of individual signing |
DESTINIE SAVANT |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2017-10-16 |
Name of individual signing |
DESTINIE SAVANT |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MESA ASSOCIATES GROUP HEALTH EMPLOYEE BENEFIT PLAN AND TRUST
|
2015
|
631029698
|
2016-10-17
|
MESA ASSOCIATES, INC.
|
413
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
2000-01-01
|
Business code |
541330
|
Sponsor’s telephone number |
2562582100
|
Plan sponsor’s mailing address |
P.O. BOX 196, MADISON, AL, 35758
|
Plan sponsor’s
address |
9238 MADISON BLVD, BLDG 2 SUITE 116, MADISON, AL, 35758
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2016-10-17 |
Name of individual signing |
DESTINIE SAVANT |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2016-10-17 |
Name of individual signing |
DESTINIE SAVANT |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MESA ASSOCIATES GROUP HEALTH EMPLOYEE BENEFIT PLAN AND TRUST
|
2014
|
631029698
|
2015-10-13
|
MESA ASSOCIATES, INC.
|
388
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
2000-01-01
|
Business code |
541330
|
Sponsor’s telephone number |
2562582100
|
Plan sponsor’s mailing address |
P.O. BOX 196, MADISON, AL, 35758
|
Plan sponsor’s
address |
9238 MADISON BLVD, BLDG 2 SUITE 116, MADISON, AL, 35758
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2015-10-13 |
Name of individual signing |
DESTINIE SAVANT |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2015-10-13 |
Name of individual signing |
DESTINIE SAVANT |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MESA ASSOCIATES GROUP HEALTH EMPLOYEE BENEFIT PLAN AND TRUST
|
2013
|
631029698
|
2014-10-13
|
MESA ASSOCIATES, INC.
|
362
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
2000-01-01
|
Business code |
541330
|
Sponsor’s telephone number |
2567727025
|
Plan sponsor’s mailing address |
P.O. BOX 196, MADISON, AL, 35758
|
Plan sponsor’s
address |
9238 MADISON BLVD, BLDG 2 SUITE 116, MADISON, AL, 35758
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2014-10-13 |
Name of individual signing |
DESTINIE SAVANT |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2014-10-13 |
Name of individual signing |
DESTINIE SAVANT |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MESA ASSOCIATES GROUP HEALTH EMPLOYEE BENEFIT PLAN AND TRUST
|
2012
|
631029698
|
2013-10-13
|
MESA ASSOCIATES, INC.
|
355
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
2000-01-01
|
Business code |
541330
|
Sponsor’s telephone number |
2567727025
|
Plan sponsor’s mailing address |
P.O. BOX 196, MADISON, AL, 35758
|
Plan sponsor’s
address |
9238 MADISON BLVD, BLDG 2 SUITE 116, MADISON, AL, 35758
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2013-10-13 |
Name of individual signing |
DESTINIE SAVANT |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2013-10-13 |
Name of individual signing |
DESTINIE SAVANT |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MESA ASSOCIATES GROUP HEALTH EMPLOYEE BENEFIT PLAN AND TRUST
|
2011
|
631029698
|
2012-10-11
|
MESA ASSOCIATES, INC.
|
325
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
2000-01-01
|
Business code |
541330
|
Sponsor’s telephone number |
2567727025
|
Plan sponsor’s mailing address |
P.O. BOX 196, MADISON, AL, 35758
|
Plan sponsor’s
address |
9238 MADISON BLVD, BLDG 2 SUITE 116, MADISON, AL, 35758
|
Plan administrator’s name and address
Administrator’s EIN |
631029698 |
Plan administrator’s name |
MESA ASSOCIATES, INC. |
Plan administrator’s
address |
P.O. BOX 196, MADISON, AL, 35758 |
Administrator’s telephone number |
2567727025 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2012-10-11 |
Name of individual signing |
DESTINIE SAVANT |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2012-10-11 |
Name of individual signing |
DESTINIE SAVANT |
Valid signature |
Filed with authorized/valid electronic signature |
|
|