UPPER LAKES FOOD, INC. EMPLOYEE HEALTH CARE PLAN
|
2015
|
411440251
|
2016-12-08
|
UPPER LAKES FOODS, INC.
|
161
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1989-12-01
|
Business code |
423990
|
Sponsor’s telephone number |
2188791265
|
Plan sponsor’s mailing address |
801 INDUSTRY AVENUE, CLOQUET, MN, 55720
|
Plan sponsor’s
address |
801 INDUSTRY AVENUE, CLOQUET, MN, 55720
|
Plan administrator’s name and address
Administrator’s EIN |
411440251 |
Plan administrator’s name |
UPPER LAKES FOODS, INC. |
Plan administrator’s
address |
801 INDUSTRY AVENUE, CLOQUET, MN, 55720 |
Administrator’s telephone number |
2188791265 |
Number of participants as of the end of the plan year
Active participants |
173 |
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 |
Number of
participants
with
account balances as of the end of the plan year |
0 |
Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
0 |
Signature of
Role |
Plan administrator |
Date |
2016-12-08 |
Name of individual signing |
KIRK WIMMER |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2016-12-08 |
Name of individual signing |
KIRK WIMMER |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
UPPER LAKES FOOD, INC. EMPLOYEE HEALTH CARE PLAN
|
2014
|
411440251
|
2015-12-18
|
UPPER LAKES FOODS, INC.
|
211
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1989-12-01
|
Business code |
423990
|
Sponsor’s telephone number |
2188791265
|
Plan sponsor’s mailing address |
801 INDUSTRY AVENUE, CLOQUET, MN, 55720
|
Plan sponsor’s
address |
801 INDUSTRY AVENUE, CLOQUET, MN, 55720
|
Plan administrator’s name and address
Administrator’s EIN |
411440251 |
Plan administrator’s name |
UPPER LAKES FOODS, INC. |
Plan administrator’s
address |
801 INDUSTRY AVENUE, CLOQUET, MN, 55720 |
Administrator’s telephone number |
2188791265 |
Number of participants as of the end of the plan year
Active participants |
161 |
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 |
Number of
participants
with
account balances as of the end of the plan year |
0 |
Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
0 |
Signature of
Role |
Plan administrator |
Date |
2015-12-17 |
Name of individual signing |
KIRK WIMMER |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2015-12-17 |
Name of individual signing |
KIRK WIMMER |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
UPPER LAKES FOOD, INC. EMPLOYEE HEALTH CARE PLAN
|
2013
|
411440251
|
2015-01-09
|
UPPER LAKES FOODS, INC.
|
177
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1989-12-01
|
Business code |
423990
|
Sponsor’s telephone number |
2188791265
|
Plan sponsor’s mailing address |
801 INDUSTRY AVENUE, CLOQUET, MN, 55720
|
Plan sponsor’s
address |
801 INDUSTRY AVENUE, CLOQUET, MN, 55720
|
Plan administrator’s name and address
Administrator’s EIN |
411440251 |
Plan administrator’s name |
UPPER LAKES FOODS, INC. |
Plan administrator’s
address |
801 INDUSTRY AVENUE, CLOQUET, MN, 55720 |
Administrator’s telephone number |
2188791265 |
Number of participants as of the end of the plan year
Active participants |
211 |
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 |
Number of
participants
with
account balances as of the end of the plan year |
0 |
Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
0 |
Signature of
Role |
Plan administrator |
Date |
2015-01-09 |
Name of individual signing |
KIRK WIMMER |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2015-01-09 |
Name of individual signing |
KIRK WIMMER |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
UPPER LAKES FOOD, INC. EMPLOYEE HEALTH CARE PLAN
|
2012
|
411440251
|
2014-01-06
|
UPPER LAKES FOODS, INC.
|
189
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1989-12-01
|
Business code |
423990
|
Sponsor’s telephone number |
2188791265
|
Plan sponsor’s mailing address |
801 INDUSTRY AVENUE, CLOQUET, MN, 55720
|
Plan sponsor’s
address |
801 INDUSTRY AVENUE, CLOQUET, MN, 55720
|
Plan administrator’s name and address
Administrator’s EIN |
411440251 |
Plan administrator’s name |
UPPER LAKES FOODS, INC. |
Plan administrator’s
address |
801 INDUSTRY AVENUE, CLOQUET, MN, 55720 |
Administrator’s telephone number |
2188791265 |
Number of participants as of the end of the plan year
Active participants |
177 |
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 |
Number of
participants
with
account balances as of the end of the plan year |
0 |
Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
0 |
Signature of
Role |
Plan administrator |
Date |
2014-01-06 |
Name of individual signing |
KIRK WIMMER |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2014-01-06 |
Name of individual signing |
KIRK WIMMER |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
UPPER LAKES FOOD, INC. EMPLOYEE HEALTH CARE PLAN
|
2011
|
411440251
|
2012-12-27
|
UPPER LAKES FOODS, INC.
|
191
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1989-12-01
|
Business code |
423990
|
Sponsor’s telephone number |
2188791265
|
Plan sponsor’s mailing address |
801 INDUSTRY AVENUE, CLOQUET, MN, 55720
|
Plan sponsor’s
address |
801 INDUSTRY AVENUE, CLOQUET, MN, 55720
|
Plan administrator’s name and address
Administrator’s EIN |
411440251 |
Plan administrator’s name |
UPPER LAKES FOODS, INC. |
Plan administrator’s
address |
801 INDUSTRY AVENUE, CLOQUET, MN, 55720 |
Administrator’s telephone number |
2188791265 |
Number of participants as of the end of the plan year
Active participants |
189 |
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 |
Number of
participants
with
account balances as of the end of the plan year |
0 |
Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
0 |
Signature of
Role |
Plan administrator |
Date |
2012-12-27 |
Name of individual signing |
JEFF LAABS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
UPPER LAKES FOOD, INC. EMPLOYEE HEALTH CARE PLAN
|
2010
|
411440251
|
2011-10-25
|
UPPER LAKES FOODS, INC.
|
196
|
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1989-12-01
|
Business code |
423990
|
Sponsor’s telephone number |
2188791265
|
Plan sponsor’s mailing address |
801 INDUSTRY AVENUE, CLOQUET, MN, 55720
|
Plan sponsor’s
address |
801 INDUSTRY AVENUE, CLOQUET, MN, 55720
|
Plan administrator’s name and address
Administrator’s EIN |
411440251 |
Plan administrator’s name |
UPPER LAKES FOODS, INC. |
Plan administrator’s
address |
801 INDUSTRY AVENUE, CLOQUET, MN, 55720 |
Administrator’s telephone number |
2188791265 |
Number of participants as of the end of the plan year
Active participants |
191 |
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 |
Number of
participants
with
account balances as of the end of the plan year |
0 |
Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
0 |
Signature of
Role |
Employer/plan sponsor |
Date |
2011-10-25 |
Name of individual signing |
JEFF LAABS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
UPPER LAKES FOOD, INC. EMPLOYEE HEALTH CARE PLAN
|
2010
|
411440251
|
2011-10-25
|
UPPER LAKES FOODS, INC.
|
196
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1989-12-01
|
Business code |
423990
|
Sponsor’s telephone number |
2188791265
|
Plan sponsor’s mailing address |
801 INDUSTRY AVENUE, CLOQUET, MN, 55720
|
Plan sponsor’s
address |
801 INDUSTRY AVENUE, CLOQUET, MN, 55720
|
Plan administrator’s name and address
Administrator’s EIN |
411440251 |
Plan administrator’s name |
UPPER LAKES FOODS, INC. |
Plan administrator’s
address |
801 INDUSTRY AVENUE, CLOQUET, MN, 55720 |
Administrator’s telephone number |
2188791265 |
Number of participants as of the end of the plan year
Active participants |
191 |
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 |
Number of
participants
with
account balances as of the end of the plan year |
0 |
Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
0 |
Signature of
Role |
Plan administrator |
Date |
2011-10-25 |
Name of individual signing |
JEFF LAABS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
UPPER LAKES FOOD, INC. EMPLOYEE HEALTH CARE PLAN
|
2009
|
411440251
|
2011-01-04
|
UPPER LAKES FOODS, INC.
|
175
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1989-12-01
|
Business code |
423990
|
Sponsor’s telephone number |
2188791265
|
Plan sponsor’s mailing address |
801 INDUSTRY AVENUE, CLOQUET, MN, 55720
|
Plan sponsor’s
address |
801 INDUSTRY AVENUE, CLOQUET, MN, 55720
|
Plan administrator’s name and address
Administrator’s EIN |
411440251 |
Plan administrator’s name |
UPPER LAKES FOODS, INC. |
Plan administrator’s
address |
801 INDUSTRY AVENUE, CLOQUET, MN, 55720 |
Administrator’s telephone number |
2188791265 |
Number of participants as of the end of the plan year
Active participants |
196 |
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 |
Number of
participants
with
account balances as of the end of the plan year |
0 |
Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
0 |
Signature of
Role |
Plan administrator |
Date |
2011-01-04 |
Name of individual signing |
JEFF LAABS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|