BLEND SMOOTHIE BAR LLC

form 5500

Plan Name

Plan Year

EIN/PN

Received

Sponsor

Total number of participants

BLEND SMOOTHIE BAR 401(K) PLAN

2023

465606010

2024-09-12

BLEND SMOOTHIE BAR LLC

18

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2022-01-03
Sponsor’s telephone number	3476032124
Plan sponsor’s address	325 WINDSOR HIGHWAY, NEW WINDSOR, NY, 12553

Signature of

Role	Plan administrator
Date	2024-09-12
Name of individual signing	SHIRLEY HORNER
Valid signature	Filed with authorized/valid electronic signature

Agent

Name	Role	Address
UNITED STATES CORPORATION AGENTS, INC.	Agent	7014 13TH AVENUE, SUITE 202, BROOKLYN, NY, 11228

DOS Process Agent

Name	Role	Address
BLEND SMOOTHIE BAR LLC	DOS Process Agent	325 WINDSOR HIGHWAY, NEW WINDSOR, NY, United States, 12553

History

Start date	End date	Type	Value
2023-06-14	2024-05-01	Address	7014 13TH AVENUE, SUITE 202, BROOKLYN, NY, 11228, USA (Type of address: Registered Agent)
2023-06-14	2024-05-01	Address	325 WINDSOR HIGHWAY, NEW WINDSOR, NY, 12553, USA (Type of address: Service of Process)
2021-06-14	2023-06-14	Address	325 WINDSOR HIGHWAY, NEW WINDSOR, NY, 12553, USA (Type of address: Service of Process)
2014-05-05	2023-06-14	Address	7014 13TH AVENUE, SUITE 202, BROOKLYN, NY, 11228, USA (Type of address: Registered Agent)
2014-05-05	2021-06-14	Address	7014 13TH AVENUE, SUITE 202, BROOKLYN, NY, 11228, USA (Type of address: Service of Process)

Filings

Filing Number	Date Filed	Type	Effective Date
240501035263	2024-05-01	BIENNIAL STATEMENT	2024-05-01
230614005382	2023-06-14	BIENNIAL STATEMENT	2022-05-01
210614000334	2021-06-14	CERTIFICATE OF CHANGE	2021-06-14
200518060411	2020-05-18	BIENNIAL STATEMENT	2020-05-01
160517006367	2016-05-17	BIENNIAL STATEMENT	2016-05-01
140807000583	2014-08-07	CERTIFICATE OF PUBLICATION	2014-08-07
140505000504	2014-05-05	ARTICLES OF ORGANIZATION	2014-05-05

Inspections

Date	Inspection Object	Address	Grade	Type	Institution	Desctiption
2025-02-10	No data	320 SAW MILL RIVER ROAD, ELMSFORD	Not Critical Violation	Food Service Establishment Inspections	New York State Department of Health	16 - Miscellaneous, Economic Violation, Choking Poster, Training.
2025-02-07	No data	39 NORTH PLANK ROAD, NEWBURGH	Not Critical Violation	Food Service Establishment Inspections	New York State Department of Health	No data
2025-01-14	No data	325 WINDSOR HIGHWAY, NEW WINDSOR	Not Critical Violation	Food Service Establishment Inspections	New York State Department of Health	No data
2025-01-07	No data	325 WINDSOR HIGHWAY, NEW WINDSOR	Not Critical Violation	Food Service Establishment Inspections	New York State Department of Health	16 - Miscellaneous, Economic Violation, Choking Poster, Training.
2024-10-28	No data	39 NORTH PLANK ROAD, NEWBURGH	Not Critical Violation	Food Service Establishment Inspections	New York State Department of Health	No data
2024-10-17	No data	325 WINDSOR HIGHWAY, NEW WINDSOR	Not Critical Violation	Food Service Establishment Inspections	New York State Department of Health	8E - Accurate thermometers not available or used to evaluate refrigerated or heated storage temperatures
2024-09-24	No data	475 17M ROUTE, Monroe	Not Critical Violation	Food Service Establishment Inspections	New York State Department of Health	9B - Tobacco is used; eating, drinking in food preparation, dishwashing food storage areas
2024-09-24	No data	325 WINDSOR HIGHWAY, NEW WINDSOR	Not Critical Violation	Food Service Establishment Inspections	New York State Department of Health	12A - Hot, cold running water not provided, pressure inadequate
2024-06-10	No data	39 NORTH PLANK ROAD, NEWBURGH	Not Critical Violation	Food Service Establishment Inspections	New York State Department of Health	12E - Handwashing facilities inaccessible, improperly located, dirty, in disrepair, improper fixtures, soap, and single service towels or hand drying devices missing
2024-04-19	No data	475 17M ROUTE, Monroe	Not Critical Violation	Food Service Establishment Inspections	New York State Department of Health	16 - Miscellaneous, Economic Violation, Choking Poster, Training.
2024-01-30	No data	320 SAW MILL RIVER ROAD, ELMSFORD	Not Critical Violation	Food Service Establishment Inspections	New York State Department of Health	15A - Floors, walls, ceilings, not smooth, properly constructed, in disrepair, dirty surfaces
2024-01-18	No data	325 WINDSOR HIGHWAY, NEW WINDSOR	Not Critical Violation	Food Service Establishment Inspections	New York State Department of Health	8E - Accurate thermometers not available or used to evaluate refrigerated or heated storage temperatures
2024-01-10	No data	75 GRASSLANDS ROAD, VALHALLA	Not Critical Violation	Food Service Establishment Inspections	New York State Department of Health	11C - Food contact surfaces not washed, rinsed and sanitized after each use and following any time of operations when contamination may have occurred
2023-10-11	No data	475 17M ROUTE, Monroe	Not Critical Violation	Food Service Establishment Inspections	New York State Department of Health	8E - Accurate thermometers not available or used to evaluate refrigerated or heated storage temperatures
2023-10-10	No data	475 17M ROUTE, Monroe	Not Critical Violation	Food Service Establishment Inspections	New York State Department of Health	12A - Hot, cold running water not provided, pressure inadequate
2023-06-16	No data	325 WINDSOR HIGHWAY, NEW WINDSOR	Not Critical Violation	Food Service Establishment Inspections	New York State Department of Health	15A - Floors, walls, ceilings, not smooth, properly constructed, in disrepair, dirty surfaces
2023-04-25	No data	475 17M ROUTE, Monroe	Not Critical Violation	Food Service Establishment Inspections	New York State Department of Health	No data
2023-01-05	No data	325 WINDSOR HIGHWAY, NEW WINDSOR	Not Critical Violation	Food Service Establishment Inspections	New York State Department of Health	No data
2022-11-21	No data	475 17M ROUTE, Monroe	Not Critical Violation	Food Service Establishment Inspections	New York State Department of Health	No data
2022-11-14	No data	475 17M ROUTE, Monroe	Critical Violation	Food Service Establishment Inspections	New York State Department of Health	5E - Enough refrigerated storage equipment is not present, properly designed, maintained or operated so that all potentially hazardous foods are cooled properly and stored below 45°F as required.
2022-09-21	No data	325 WINDSOR HIGHWAY, NEW WINDSOR	Not Critical Violation	Food Service Establishment Inspections	New York State Department of Health	No data
2022-09-20	No data	475 17M ROUTE, Monroe	Critical Violation	Food Service Establishment Inspections	New York State Department of Health	5E - Enough refrigerated storage equipment is not present, properly designed, maintained or operated so that all potentially hazardous foods are cooled properly and stored below 45°F as required.
2022-08-31	No data	475 17M ROUTE, Monroe	Not Critical Violation	Food Service Establishment Inspections	New York State Department of Health	8A - Food not protected during storage, preparation, display, transportation and service, from potential sources of contamination (e.g., food uncovered, mislabeled, stored on floor, missing or inadequate sneeze guards, food containers double stacked)
2022-08-23	No data	325 WINDSOR HIGHWAY, NEW WINDSOR	Not Critical Violation	Food Service Establishment Inspections	New York State Department of Health	12E - Handwashing facilities inaccessible, improperly located, dirty, in disrepair, improper fixtures, soap, and single service towels or hand drying devices missing
2022-04-08	No data	475 17M ROUTE, Monroe	Not Critical Violation	Food Service Establishment Inspections	New York State Department of Health	8A - Food not protected during storage, preparation, display, transportation and service, from potential sources of contamination (e.g., food uncovered, mislabeled, stored on floor, missing or inadequate sneeze guards, food containers double stacked)
2022-01-31	No data	325 WINDSOR HIGHWAY, NEW WINDSOR	Not Critical Violation	Food Service Establishment Inspections	New York State Department of Health	8A - Food not protected during storage, preparation, display, transportation and service, from potential sources of contamination (e.g., food uncovered, mislabeled, stored on floor, missing or inadequate sneeze guards, food containers double stacked)
2021-10-25	No data	475 17M ROUTE, Monroe	Not Critical Violation	Food Service Establishment Inspections	New York State Department of Health	8E - Accurate thermometers not available or used to evaluate refrigerated or heated storage temperatures
2021-10-01	No data	325 WINDSOR HIGHWAY, NEW WINDSOR	Not Critical Violation	Food Service Establishment Inspections	New York State Department of Health	11D - Non food contact surfaces of equipment not clean
2021-06-09	No data	475 17M ROUTE, Monroe	Not Critical Violation	Food Service Establishment Inspections	New York State Department of Health	No data
2021-05-18	No data	475 17M ROUTE, Monroe	Not Critical Violation	Food Service Establishment Inspections	New York State Department of Health	8A - Food not protected during storage, preparation, display, transportation and service, from potential sources of contamination (e.g., food uncovered, mislabeled, stored on floor, missing or inadequate sneeze guards, food containers double stacked)
2021-04-28	No data	475 17M ROUTE, Monroe	Not Critical Violation	Food Service Establishment Inspections	New York State Department of Health	10B - Non-food contact surfaces and equipment are improperly designed, constructed, installed, maintained (equipment not readily accessible for cleaning, surface not smooth finish)
2020-09-17	No data	475 17M ROUTE, Monroe	Not Critical Violation	Food Service Establishment Inspections	New York State Department of Health	No data

Paycheck Protection Program

Loan Number

Loan Funded Date

SBA Origination Office Code

Loan Delivery Method

Borrower Street Address

2725877200

2020-04-16

0202

PPP

25 Creamery Drive, NEW WINDSOR, NY, 12553

Loan Status Date	2021-07-22
Loan Status	Paid in Full
Loan Maturity in Months	24
SBA Guaranty Percentage	100
Loan Approval Amount (at origination)	48050
Loan Approval Amount (current)	48050
Undisbursed Amount	0
Franchise Name	-
Lender Location ID	48270
Servicing Lender Name	JPMorgan Chase Bank, National Association
Servicing Lender Address	1111 Polaris Pkwy, COLUMBUS, OH, 43240-2031
Rural or Urban Indicator	U
Hubzone	N
LMI	N
Business Age Description	Existing or more than 2 years old
Project Address	NEW WINDSOR, ORANGE, NY, 12553-0001
Project Congressional District	NY-18
Number of Employees	22
NAICS code	722515
Borrower Race	Unanswered
Borrower Ethnicity	Hispanic or Latino
Business Type	Limited Liability Company(LLC)
Originating Lender ID	194093
Originating Lender Name	JPMorgan Chase Bank, National Association
Originating Lender Address	CHICAGO, IL
Gender	Male Owned
Veteran	Non-Veteran
Forgiveness Amount	48594.14
Forgiveness Paid Date	2021-06-08

Motor Carrier Census

USDOT Number

Carrier Operation

MCS-150 Form Date

MCS-150 Mileage

MCS-150 Year

Power Units

Drivers

Operation Classification

3434383

Intrastate Non-Hazmat

2021-02-22

62550

2014

1

5

Private(Property)

Legal Name	BLEND SMOOTHIE BAR LLC
DBA Name	BLEND SMOOTHIE AND SALAD BAR
Physical Address	325 WINDSOR HWY, NEW WINDSOR, NY, 12553-6909, US
Mailing Address	25 CREAMERY DR, NEW WINDSOR, NY, 12553-8011, US
Phone	(347) 603-2124
Fax	-
E-mail	BLENDSMOOTHIEBAR@GMAIL.COM

Safety Measurement System - All Transportation

Total Number of Inspections for the measurement period (24 months)	0
Driver Fitness BASIC Serious Violation Indicator	No
Vehicle Maintenance BASIC Acute/Critical Indicator	No
Unsafe Driving BASIC Acute/Critical Indicator	No
Driver Fitness BASIC Roadside Performance measure value	0
Hours-of-Service (HOS) Compliance BASIC Roadside Performance measure value	0
Total Number of Driver Inspections for the measurment period	0
Vehicle Maintenance BASIC Roadside Performance measure value	0
Total Number of Vehicle Inspections for the measurement period	0
Controlled Substances and Alcohol BASIC Roadside Performance measure value	0
Unsafe Driving BASIC Roadside Performance Measure Value	0
Number of inspections with at least one Driver Fitness BASIC violation	0
Number of inspections with at least one Hours-of-Service BASIC violation	0
Total Number of Driver Inspections containing at least one Driver Out-of-Service Violation	0
Number of inspections with at least one Vehicle Maintenance BASIC violation	0
Total Number of Vehicle Inspections containing at least one Vehicle Out-of-Service violation	0
Number of inspections with at least one Controlled Substances and Alcohol BASIC violation	0
Number of inspections with at least one Unsafe Driving BASIC violation	0

Name:	BLEND SMOOTHIE BAR LLC
Jurisdiction:	New York
Legal type:	DOMESTIC LIMITED LIABILITY COMPANY
Status:	Active
Date of registration:	05 May 2014 (11 years ago)
Entity Number:	4571989
ZIP code:	12553
County:	Orange
Place of Formation:	New York
Address:	325 WINDSOR HIGHWAY, NEW WINDSOR, NY, United States, 12553

Company Details