BOELTER INDUSTRIES INC HEALTH BENEFIT PLAN
|
2012
|
410954343
|
2013-07-15
|
BOELTER INDUSTRIES INC
|
183
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
2000-11-01
|
Business code |
322200
|
Sponsor’s telephone number |
5074522315
|
Plan sponsor’s mailing address |
202 GALEWSKI DRIVE, PO BOX 916, WINONA, MN, 55987
|
Plan sponsor’s
address |
202 GALEWSKI DRIVE, PO BOX 916, WINONA, MN, 55987
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2013-07-15 |
Name of individual signing |
DENNIS BOELTER |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BOELTER INDUSTRIES INC LONG TERM DISABILITY BENEFIT PLAN
|
2012
|
410954343
|
2013-07-15
|
BOELTER INDUSTRIES INC
|
110
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2002-01-01
|
Business code |
322200
|
Sponsor’s telephone number |
5074522315
|
Plan sponsor’s mailing address |
202 GALEWSKI DRIVE, PO BOX 916, WINONA, MN, 55987
|
Plan sponsor’s
address |
202 GALEWSKI DRIVE, PO BOX 916, WINONA, MN, 55987
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2013-07-15 |
Name of individual signing |
DENNIS BOELTER |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BOELTER INDUSTRIES INC LIFE AND AD&D BENEFIT PLAN
|
2012
|
410954343
|
2013-07-15
|
BOELTER INDUSTRIES INC
|
111
|
|
File |
View Page
|
Three-digit plan number (PN) |
503
|
Effective date of plan |
1994-10-01
|
Business code |
322200
|
Sponsor’s telephone number |
5074522315
|
Plan sponsor’s mailing address |
202 GALEWSKI DRIVE, PO BOX 916, WINONA, MN, 55987
|
Plan sponsor’s
address |
202 GALEWSKI DRIVE, PO BOX 916, WINONA, MN, 55987
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2013-07-15 |
Name of individual signing |
DENNIS BOELTER |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BOELTER INDUSTRIES INC HEALTH BENEFIT PLAN
|
2011
|
410954343
|
2012-08-01
|
BOELTER INDUSTRIES INC
|
107
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
2000-11-01
|
Business code |
322200
|
Sponsor’s telephone number |
5074522315
|
Plan sponsor’s mailing address |
202 GALEWSKI DRIVE, PO BOX 916, WINONA, MN, 559870916
|
Plan sponsor’s
address |
202 GALEWSKI DRIVE, PO BOX 916, WINONA, MN, 559870916
|
Plan administrator’s name and address
Administrator’s EIN |
410954343 |
Plan administrator’s name |
BOELTER INDUSTRIES INC |
Plan administrator’s
address |
202 GALEWSKI DRIVE, PO BOX 916, WINONA, MN, 559870916 |
Administrator’s telephone number |
5074522315 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2012-08-01 |
Name of individual signing |
DENNIS BOELTER |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BOELTER INDUSTRIES INC HEALTH BENEFIT PLAN
|
2011
|
410954343
|
2012-08-01
|
BOELTER INDUSTRIES INC
|
220
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
2000-11-01
|
Business code |
322200
|
Sponsor’s telephone number |
5074522315
|
Plan sponsor’s mailing address |
202 GALEWSKI DRIVE, PO BOX 916, WINONA, MN, 559870916
|
Plan sponsor’s
address |
202 GALEWSKI DRIVE, PO BOX 916, WINONA, MN, 559870916
|
Plan administrator’s name and address
Administrator’s EIN |
410954343 |
Plan administrator’s name |
BOELTER INDUSTRIES INC |
Plan administrator’s
address |
202 GALEWSKI DRIVE, PO BOX 916, WINONA, MN, 559870916 |
Administrator’s telephone number |
5074522315 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2012-08-01 |
Name of individual signing |
DENNIS BOELTER |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BOELTER INDUSTRIES INC HEALTH BENEFIT PLAN
|
2011
|
410954343
|
2012-08-01
|
BOELTER INDUSTRIES INC
|
183
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
2000-11-01
|
Business code |
322200
|
Sponsor’s telephone number |
5074522315
|
Plan sponsor’s mailing address |
202 GALEWSKI DRIVE, PO BOX 916, WINONA, MN, 559870916
|
Plan sponsor’s
address |
202 GALEWSKI DRIVE, PO BOX 916, WINONA, MN, 559870916
|
Plan administrator’s name and address
Administrator’s EIN |
410954343 |
Plan administrator’s name |
BOELTER INDUSTRIES INC |
Plan administrator’s
address |
202 GALEWSKI DRIVE, PO BOX 916, WINONA, MN, 559870916 |
Administrator’s telephone number |
5074522315 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2012-08-01 |
Name of individual signing |
DENNIS BOELTER |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BOELTER INDUSTRIES INC HEALTH BENEFIT PLAN
|
2011
|
410954343
|
2012-08-01
|
BOELTER INDUSTRIES INC
|
204
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
2000-11-01
|
Business code |
322200
|
Sponsor’s telephone number |
5074522315
|
Plan sponsor’s mailing address |
202 GALEWSKI DRIVE, PO BOX 916, WINONA, MN, 559870916
|
Plan sponsor’s
address |
202 GALEWSKI DRIVE, PO BOX 916, WINONA, MN, 559870916
|
Plan administrator’s name and address
Administrator’s EIN |
410954343 |
Plan administrator’s name |
BOELTER INDUSTRIES INC |
Plan administrator’s
address |
202 GALEWSKI DRIVE, PO BOX 916, WINONA, MN, 559870916 |
Administrator’s telephone number |
5074522315 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2012-08-01 |
Name of individual signing |
DENNIS BOELTER |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BOELTER INDUSTRIES INC HEALTH BENEFIT PLAN
|
2011
|
410954343
|
2012-08-01
|
BOELTER INDUSTRIES INC
|
196
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
2000-11-01
|
Business code |
322200
|
Sponsor’s telephone number |
5074522315
|
Plan sponsor’s mailing address |
202 GALEWSKI DRIVE, PO BOX 916, WINONA, MN, 559870916
|
Plan sponsor’s
address |
202 GALEWSKI DRIVE, PO BOX 916, WINONA, MN, 559870916
|
Plan administrator’s name and address
Administrator’s EIN |
410954343 |
Plan administrator’s name |
BOELTER INDUSTRIES INC |
Plan administrator’s
address |
202 GALEWSKI DRIVE, PO BOX 916, WINONA, MN, 559870916 |
Administrator’s telephone number |
5074522315 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2012-08-01 |
Name of individual signing |
DENNIS BOELTER |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BOELTER INDUSTRIES INC HEALTH BENEFIT PLAN
|
2011
|
410954343
|
2012-08-01
|
BOELTER INDUSTRIES INC
|
199
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
2000-11-01
|
Business code |
322200
|
Sponsor’s telephone number |
5074522315
|
Plan sponsor’s mailing address |
202 GALEWSKI DRIVE, PO BOX 916, WINONA, MN, 559870916
|
Plan sponsor’s
address |
202 GALEWSKI DRIVE, PO BOX 916, WINONA, MN, 559870916
|
Plan administrator’s name and address
Administrator’s EIN |
410954343 |
Plan administrator’s name |
BOELTER INDUSTRIES INC |
Plan administrator’s
address |
202 GALEWSKI DRIVE, PO BOX 916, WINONA, MN, 559870916 |
Administrator’s telephone number |
5074522315 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2012-08-01 |
Name of individual signing |
DENNIS BOELTER |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BOELTER INDUSTRIES INC HEALTH BENEFIT PLAN
|
2011
|
410954343
|
2012-08-01
|
BOELTER INDUSTRIES INC
|
220
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
2000-11-01
|
Business code |
322200
|
Sponsor’s telephone number |
5074522315
|
Plan sponsor’s mailing address |
202 GALEWSKI DRIVE, PO BOX 916, WINONA, MN, 559870916
|
Plan sponsor’s
address |
202 GALEWSKI DRIVE, PO BOX 916, WINONA, MN, 559870916
|
Plan administrator’s name and address
Administrator’s EIN |
410954343 |
Plan administrator’s name |
BOELTER INDUSTRIES INC |
Plan administrator’s
address |
202 GALEWSKI DRIVE, PO BOX 916, WINONA, MN, 559870916 |
Administrator’s telephone number |
5074522315 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2012-08-01 |
Name of individual signing |
DENNIS BOELTER |
Valid signature |
Filed with authorized/valid electronic signature |
|
|