|
SUMMIT HEALTHCARE CBS BENEFIT PLAN
|
2023
|
873487057
|
2024-04-29
|
SUMMIT HEALTHCARE
|
4
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
501
|
| Effective date of plan |
2022-08-01
|
| Business code |
621491
|
| Sponsor’s telephone number |
6063034389
|
| Plan sponsor’s
address |
124 DANIEL DRIVE, DANVILLE, KY, 40422
|
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 |
2024-04-29 |
| Name of individual signing |
SHAWNA BURTON |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
SUMMIT HEALTHCARE CBS BENEFIT PLAN
|
2022
|
873487057
|
2023-12-27
|
SUMMIT HEALTHCARE
|
3
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
501
|
| Effective date of plan |
2022-08-01
|
| Business code |
621491
|
| Sponsor’s telephone number |
6063034389
|
| Plan sponsor’s
address |
124 DANIEL DRIVE, DANVILLE, KY, 40422
|
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 |
|
|
