|
GRACE FLOORING INC 401K PLAN
|
2011
|
203238166
|
2012-05-10
|
GRACE FLOORING INC
|
2
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2009-01-01
|
| Business code |
238300
|
| Sponsor’s telephone number |
6123666229
|
| Plan sponsor’s
address |
15653 73RD CIR N, MAPLE GROVE, MN, 553112506
|
Plan administrator’s name and address
| Administrator’s EIN |
203238166 |
| Plan administrator’s name |
GRACE FLOORING INC |
| Plan administrator’s
address |
15653 73RD CIR N, MAPLE GROVE, MN, 553112506 |
| Administrator’s telephone number |
6123666229 |
Signature of
| Role |
Plan administrator |
| Date |
2012-05-10 |
| Name of individual signing |
TOM CHILD |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
GRACE FLOORING INC 401K PLAN
|
2010
|
203238166
|
2011-07-26
|
GRACE FLOORING INC
|
2
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2009-01-01
|
| Business code |
238300
|
| Sponsor’s telephone number |
6123666229
|
| Plan sponsor’s
address |
15653 73RD CIR N, MAPLE GROVE, MN, 553112506
|
Plan administrator’s name and address
| Administrator’s EIN |
203238166 |
| Plan administrator’s name |
GRACE FLOORING INC |
| Plan administrator’s
address |
15653 73RD CIR N, MAPLE GROVE, MN, 553112506 |
| Administrator’s telephone number |
6123666229 |
Signature of
| Role |
Plan administrator |
| Date |
2011-07-26 |
| Name of individual signing |
TOM CHILD |
| Valid signature |
Filed with authorized/valid electronic signature |
|
| Role |
Employer/plan sponsor |
| Date |
2011-07-26 |
| Name of individual signing |
TOM CHILD |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
GRACE FLOORING INC 401K PLAN
|
2009
|
203238166
|
2010-08-26
|
GRACE FLOORING INC
|
2
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2009-01-01
|
| Business code |
238300
|
| Sponsor’s telephone number |
9527075882
|
| Plan sponsor’s
address |
15653 73RD CIR N, MAPLE GROVE, MN, 553112506
|
Plan administrator’s name and address
| Administrator’s EIN |
203238166 |
| Plan administrator’s name |
GRACE FLOORING INC |
| Plan administrator’s
address |
15653 73RD CIR N, MAPLE GROVE, MN, 553112506 |
| Administrator’s telephone number |
9527075882 |
Signature of
| Role |
Plan administrator |
| Date |
2010-08-26 |
| Name of individual signing |
TOM CHILD |
| Valid signature |
Filed with authorized/valid electronic signature |
|
| Role |
Employer/plan sponsor |
| Date |
2010-08-26 |
| Name of individual signing |
TOM CHILD |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
