KENTUCKY CHAMBER OF COMMERCE CBS BENEFIT PLAN
|
2022
|
610405718
|
2023-12-27
|
KENTUCKY CHAMBER OF COMMERCE
|
40
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2021-01-01
|
Business code |
813000
|
Sponsor’s telephone number |
5026954700
|
Plan sponsor’s
address |
464 CHENAULT ROAD, FRANKFORT, KY, 40601
|
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 |
2023-12-27 |
Name of individual signing |
SHAWNA BURTON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
KENTUCKY CHAMBER OF COMMERCE MEDOVA LIFESTYLE HEALTH PLAN
|
2022
|
610405718
|
2024-08-29
|
KENTUCKY CHAMBER OF COMMERCE
|
0
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
2021-01-01
|
Business code |
813000
|
Sponsor’s telephone number |
5026954700
|
Plan sponsor’s
address |
464 CHENAULT RD, FRANKFORT, KY, 406019260
|
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 |
Signature of
Role |
Plan administrator |
Date |
2024-08-29 |
Name of individual signing |
ROBERT MOORE |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
KENTUCKY CHAMBER OF COMMERCE MEDOVA LIFESTYLE HEALTH PLAN
|
2021
|
610405718
|
2022-09-30
|
KENTUCKY CHAMBER OF COMMERCE
|
23
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
2021-01-01
|
Business code |
813000
|
Sponsor’s telephone number |
5026954700
|
Plan sponsor’s
address |
464 CHENAULT RD, FRANKFORT, KY, 406019260
|
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 |
Signature of
Role |
Plan administrator |
Date |
2022-09-29 |
Name of individual signing |
ROBERT MOORE |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
KENTUCKY CHAMBER OF COMMERCE CBS BENEFIT PLAN
|
2021
|
610405718
|
2022-12-29
|
KENTUCKY CHAMBER OF COMMERCE
|
33
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2021-01-01
|
Business code |
813000
|
Sponsor’s telephone number |
5026954700
|
Plan sponsor’s
address |
464 CHENAULT ROAD, FRANKFORT, KY, 40601
|
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 |
|
|
KENTUCKY CHAMBER OF COMMERCE CBS BENEFIT PLAN
|
2020
|
610405718
|
2021-12-14
|
KENTUCKY CHAMBER OF COMMERCE
|
31
|
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2021-01-01
|
Business code |
813000
|
Sponsor’s telephone number |
5026954700
|
Plan sponsor’s
address |
464 CHENAULT ROAD, FRANKFORT, KY, 40601
|
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 |
|
|
KENTUCKY CHAMBER OF COMMERCE 401(K) PLAN
|
2012
|
610405718
|
2013-01-29
|
KENTUCKY CHAMBER OF COMMERCE
|
36
|
|
Three-digit plan number (PN) |
003
|
Effective date of plan |
1997-01-01
|
Business code |
813000
|
Sponsor’s telephone number |
5026954700
|
Plan sponsor’s
address |
464 CHENAULT RD, FRANKFORT, KY, 406019260
|
Signature of
Role |
Plan administrator |
Date |
2013-01-29 |
Name of individual signing |
PATRICK MERCHAK |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2013-01-29 |
Name of individual signing |
PATRICK MERCHAK |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
KENTUCKY CHAMBER OF COMMERCE 401(K) PLAN
|
2012
|
610405718
|
2013-02-05
|
KENTUCKY CHAMBER OF COMMERCE
|
36
|
|
File |
View Page
|
Three-digit plan number (PN) |
003
|
Effective date of plan |
1997-01-01
|
Business code |
813000
|
Sponsor’s telephone number |
5026954700
|
Plan sponsor’s
address |
464 CHENAULT RD, FRANKFORT, KY, 406019260
|
Signature of
Role |
Plan administrator |
Date |
2013-02-05 |
Name of individual signing |
PATRICK MERCHAK |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2013-02-05 |
Name of individual signing |
PATRICK MERCHAK |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
KENTUCKY CHAMBER OF COMMERCE 401(K) PLAN
|
2011
|
610405718
|
2012-06-22
|
KENTUCKY CHAMBER OF COMMERCE
|
35
|
|
File |
View Page
|
Three-digit plan number (PN) |
003
|
Effective date of plan |
1997-01-01
|
Business code |
813000
|
Sponsor’s telephone number |
5026954700
|
Plan sponsor’s
address |
464 CHENAULT RD, FRANKFORT, KY, 406019260
|
Plan administrator’s name and address
Administrator’s EIN |
610405718 |
Plan administrator’s name |
KENTUCKY CHAMBER OF COMMERCE |
Plan administrator’s
address |
464 CHENAULT RD, FRANKFORT, KY, 406019260 |
Administrator’s telephone number |
5026954700 |
Signature of
Role |
Plan administrator |
Date |
2012-06-22 |
Name of individual signing |
DAVID ADKISSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2012-06-22 |
Name of individual signing |
DAVID ADKISSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
KENTUCKY CHAMBER OF COMMERCE 401(K) PLAN
|
2010
|
610405718
|
2011-05-31
|
KENTUCKY CHAMBER OF COMMERCE
|
33
|
|
File |
View Page
|
Three-digit plan number (PN) |
003
|
Effective date of plan |
1997-01-01
|
Business code |
813000
|
Sponsor’s telephone number |
5026954700
|
Plan sponsor’s
address |
464 CHENAULT RD, FRANKFORT, KY, 406019260
|
Plan administrator’s name and address
Administrator’s EIN |
610405718 |
Plan administrator’s name |
KENTUCKY CHAMBER OF COMMERCE |
Plan administrator’s
address |
464 CHENAULT RD, FRANKFORT, KY, 406019260 |
Administrator’s telephone number |
5026954700 |
Signature of
Role |
Plan administrator |
Date |
2011-05-31 |
Name of individual signing |
PATRICK MERCHAK |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2011-05-31 |
Name of individual signing |
PATRICK MERCHAK |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
KENTUCKY CHAMBER OF COMMERCE 401(K) PLAN
|
2009
|
610405718
|
2010-07-19
|
KENTUCKY CHAMBER OF COMMERCE
|
33
|
|
File |
View Page
|
Three-digit plan number (PN) |
003
|
Effective date of plan |
1997-01-01
|
Business code |
813000
|
Sponsor’s telephone number |
5026954700
|
Plan sponsor’s
address |
464 CHENAULT RD, FRANKFORT, KY, 406019260
|
Plan administrator’s name and address
Administrator’s EIN |
610405718 |
Plan administrator’s name |
KENTUCKY CHAMBER OF COMMERCE |
Plan administrator’s
address |
464 CHENAULT RD, FRANKFORT, KY, 406019260 |
Administrator’s telephone number |
5026954700 |
Signature of
Role |
Plan administrator |
Date |
2010-07-19 |
Name of individual signing |
PATRICK MERCHAK |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2010-07-19 |
Name of individual signing |
PATRICK MERCHAK |
Valid signature |
Filed with authorized/valid electronic signature |
|
|