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Pellco Machine, Inc.

Company Details

Name: Pellco Machine, Inc.
Jurisdiction: Minnesota
Legal type: Business Corporation (Domestic)
Status: Active / In Good Standing
Date formed: 01 Apr 2002 (23 years ago)
Company Number: 08c14c1e-a7d4-e011-a886-001ec94ffe7f
File Number: 12C-69
Registered Office Address: 13045 43rd Str NE, St Michael, MN 55376, USA
Principal Executive Office Address: 4185 MACKENZIE COURT NE, SUITE 100, St. Michael, MN 55376, USA
ZIP code: 55376
County: Wright County
Place of Formation: Minnesota

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
PELLCO MACHINE, INC. 401(K) PROFIT SHARING PLAN 2023 753039288 2024-03-13 PELLCO MACHINE, INC. 30
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-04-01
Business code 332700
Sponsor’s telephone number 7634973585
Plan sponsor’s address 4185 MACKENZIE COURT NE, ST. MICHAEL, MN, 553764551

Signature of

Role Plan administrator
Date 2024-03-12
Name of individual signing RANDY PELLETIER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2024-03-12
Name of individual signing RANDY PELLETIER
Valid signature Filed with authorized/valid electronic signature
PELLCO MACHINE, INC. 401(K) PROFIT SHARING PLAN 2022 753039288 2023-06-27 PELLCO MACHINE, INC. 28
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-04-01
Business code 332700
Sponsor’s telephone number 7634973585
Plan sponsor’s address 4185 MACKENZIE COURT NE, ST. MICHAEL, MN, 553764551

Signature of

Role Plan administrator
Date 2023-06-27
Name of individual signing RANDY PELLETIER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2023-06-27
Name of individual signing RANDY PELLETIER
Valid signature Filed with authorized/valid electronic signature
PELLCO MACHINE, INC. 401(K) PROFIT SHARING PLAN 2021 753039288 2022-06-29 PELLCO MACHINE, INC. 29
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-04-01
Business code 332700
Sponsor’s telephone number 7634973585
Plan sponsor’s address 4185 MACKENZIE COURT NE, ST. MICHAEL, MN, 553764551

Signature of

Role Plan administrator
Date 2022-06-24
Name of individual signing RANDY PELLETIER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2022-06-24
Name of individual signing RANDY PELLETIER
Valid signature Filed with authorized/valid electronic signature
PELLCO MACHINE, INC. 401(K) PROFIT SHARING PLAN 2020 753039288 2021-04-12 PELLCO MACHINE, INC. 29
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-04-01
Business code 332700
Sponsor’s telephone number 7634973585
Plan sponsor’s address 4185 MACKENZIE COURT NE, ST. MICHAEL, MN, 553764551

Signature of

Role Plan administrator
Date 2021-04-09
Name of individual signing RANDY PELLETIER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2021-04-09
Name of individual signing RANDY PELLETIER
Valid signature Filed with authorized/valid electronic signature
PELLCO MACHINE, INC. 401(K) PROFIT SHARING PLAN 2019 753039288 2020-06-30 PELLCO MACHINE, INC. 31
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-04-01
Business code 332700
Sponsor’s telephone number 7634973585
Plan sponsor’s address 4185 MACKENZIE COURT NE, ST. MICHAEL, MN, 553764551

Signature of

Role Plan administrator
Date 2020-06-30
Name of individual signing RANDY PELLETIER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-06-30
Name of individual signing RANDY PELLETIER
Valid signature Filed with authorized/valid electronic signature
PELLCO MACHINE, INC. 401(K) PROFIT SHARING PLAN 2018 753039288 2019-05-02 PELLCO MACHINE, INC. 28
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-04-01
Business code 332700
Sponsor’s telephone number 7634973585
Plan sponsor’s address 4185 MACKENZIE COURT NE, SUITE 100, ST. MICHAEL, MN, 553764551

Signature of

Role Plan administrator
Date 2019-05-02
Name of individual signing RANDY PELLETIER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-05-02
Name of individual signing RANDY PELLETIER
Valid signature Filed with authorized/valid electronic signature
PELLCO MACHINE, INC. 401(K) PROFIT SHARING PLAN 2017 753039288 2018-10-08 PELLCO MACHINE, INC. 25
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-04-01
Business code 332700
Sponsor’s telephone number 7634973585
Plan sponsor’s address 4185 MACKENZIE COURT NE, SUITE 100, ST. MICHAEL, MN, 553764551

Signature of

Role Plan administrator
Date 2018-10-08
Name of individual signing RANDY PELLETIER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-10-08
Name of individual signing RANDY PELLETIER
Valid signature Filed with authorized/valid electronic signature
PELLCO MACHINE, INC. 401(K) PROFIT SHARING PLAN 2016 753039288 2017-08-08 PELLCO MACHINE, INC. 33
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-04-01
Business code 332700
Sponsor’s telephone number 7634973585
Plan sponsor’s address 4185 MACKENZIE COURT NE, SUITE 100, ST. MICHAEL, MN, 553764551

Signature of

Role Plan administrator
Date 2017-08-08
Name of individual signing RANDY PELLETIER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-08-08
Name of individual signing RANDY PELLETIER
Valid signature Filed with authorized/valid electronic signature
PELLCO MACHINE, INC. 401(K) PROFIT SHARING PLAN 2015 753039288 2016-05-24 PELLCO MACHINE, INC. 32
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-04-01
Business code 332700
Sponsor’s telephone number 7634973585
Plan sponsor’s address 4185 MACKENZIE COURT NE, SUITE 100, ST. MICHAEL, MN, 553764551

Signature of

Role Plan administrator
Date 2016-05-24
Name of individual signing RAND Y PELLETIER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-05-24
Name of individual signing RAND Y PELLETIER
Valid signature Filed with authorized/valid electronic signature
PELLCO MACHINE, INC. 401(K) PROFIT SHARING PLAN 2014 753039288 2015-10-28 PELLCO MACHINE, INC. 29
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-04-01
Business code 332700
Sponsor’s telephone number 7634973585
Plan sponsor’s address 4185 MACKENZIE COURT NE, SUITE 100, ST. MICHAEL, MN, 553764551

Signature of

Role Plan administrator
Date 2015-10-28
Name of individual signing RANDY PELLETIER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-10-28
Name of individual signing RANDY PELLETIER
Valid signature Filed with authorized/valid electronic signature

Chief Executive Officer

Name Role Address
Randall J. Pelletier Chief Executive Officer 4185 MACKENZIE COURT NE, SUITE 100, St. Michael, MN 55376, USA

Filing

Filing Name Filing date
Merger Survivor - Business Corporation (Domestic) 2015-12-22
Original Filing - Business Corporation (Domestic) (Business Name: Pellco Machine, Inc.) 2002-04-01

Date of last update: 27 Sep 2024

Sources: Minnesota's Official State Website