EVERGREEN HEALTH SERVICES WRAP PLAN
|
2022
|
161202971
|
2023-07-20
|
EHS, INC.
|
419
|
|
File |
View Page
|
Three-digit plan number (PN) |
506
|
Effective date of plan |
2019-01-01
|
Business code |
621498
|
Sponsor’s telephone number |
7168470212
|
Plan
sponsor’s DBA name |
EVERGREEN HEALTH SERVICES
|
Plan sponsor’s mailing address |
206 S ELMWOOD AVE, BUFFALO, NY, 142012398
|
Plan sponsor’s
address |
206 S ELMWOOD AVE, BUFFALO, NY, 142012398
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2023-07-20 |
Name of individual signing |
JESSE GASBARRO |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
EVERGREEN HEALTH SERVICES WRAP PLAN
|
2021
|
161202971
|
2022-07-21
|
EHS, INC.
|
406
|
|
File |
View Page
|
Three-digit plan number (PN) |
506
|
Effective date of plan |
2019-01-01
|
Business code |
621498
|
Sponsor’s telephone number |
7168470212
|
Plan
sponsor’s DBA name |
EVERGREEN HEALTH SERVICES
|
Plan sponsor’s mailing address |
206 S ELMWOOD AVE, BUFFALO, NY, 142012398
|
Plan sponsor’s
address |
206 S ELMWOOD AVE, BUFFALO, NY, 142012398
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2022-07-21 |
Name of individual signing |
JESSE GASBARRO |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
EVERGREEN HEALTH SERVICES WRAP PLAN
|
2020
|
161202971
|
2021-06-09
|
EHS, INC.
|
412
|
|
File |
View Page
|
Three-digit plan number (PN) |
506
|
Effective date of plan |
2019-01-01
|
Business code |
621498
|
Sponsor’s telephone number |
7168470212
|
Plan
sponsor’s DBA name |
EVERGREEN HEALTH SERVICES
|
Plan sponsor’s mailing address |
206 S ELMWOOD AVE, BUFFALO, NY, 142012398
|
Plan sponsor’s
address |
206 S ELMWOOD AVE, BUFFALO, NY, 142012398
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2021-06-09 |
Name of individual signing |
JESSE GASBARRO |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
EMPLOYEE BENEFIT PLAN OF AIDS COMMUNITY SERVICES OF WESTERN NEW YORK, INC.
|
2019
|
161202971
|
2020-01-28
|
EHS, INC.
|
11
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
2002-12-01
|
Business code |
624100
|
Sponsor’s telephone number |
7168470212
|
Plan sponsor’s
address |
206 S. ELMWOOD AVENUE, BUFFALO, NY, 14201
|
Signature of
Role |
Plan administrator |
Date |
2020-01-28 |
Name of individual signing |
JESSE GASBARRO |
|
|
EMPLOYEE BENEFIT PLAN OF AIDS COMMUNITY SERVICES OF WESTERN NEW YORK, INC.
|
2018
|
161202971
|
2019-07-02
|
EHS, INC.
|
14
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
2002-12-01
|
Business code |
624100
|
Sponsor’s telephone number |
7168470212
|
Plan sponsor’s
address |
206 S. ELMWOOD AVENUE, BUFFALO, NY, 14201
|
Signature of
Role |
Plan administrator |
Date |
2019-07-02 |
Name of individual signing |
JESSE GASBARRO |
|
Role |
Employer/plan sponsor |
Date |
2019-07-02 |
Name of individual signing |
JESSE GASBARRO |
|
|
EMPLOYEE BENEFIT PLAN OF AIDS COMMUNITY SERVICES OF WESTERN NEW YORK, INC.
|
2017
|
161202971
|
2019-07-02
|
EHS, INC.
|
14
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
2002-12-01
|
Business code |
624100
|
Sponsor’s telephone number |
7168470212
|
Plan sponsor’s
address |
206 S. ELMWOOD AVENUE, BUFFALO, NY, 14201
|
Signature of
Role |
Plan administrator |
Date |
2019-07-02 |
Name of individual signing |
JESSE GASBARRO |
|
Role |
Employer/plan sponsor |
Date |
2019-07-02 |
Name of individual signing |
JESSE GASBARRO |
|
|
EMPLOYEE BENEFIT PLAN OF AIDS COMMUNITY SERVICES OF WESTERN NEW YORK, INC.
|
2016
|
161202971
|
2019-07-02
|
EHS, INC.
|
14
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
2002-12-01
|
Business code |
624100
|
Sponsor’s telephone number |
7168470212
|
Plan sponsor’s
address |
206 S. ELMWOOD AVENUE, BUFFALO, NY, 14201
|
Signature of
Role |
Plan administrator |
Date |
2019-07-02 |
Name of individual signing |
JESSE GASBARRO |
|
Role |
Employer/plan sponsor |
Date |
2019-07-02 |
Name of individual signing |
JESSE GASBARRO |
|
|
EMPLOYEE BENEFIT PLAN OF AIDS COMMUNITY SERVICES OF WESTERN NEW YORK, INC.
|
2015
|
161202971
|
2019-07-02
|
EHS, INC.
|
14
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
2002-12-01
|
Business code |
624100
|
Sponsor’s telephone number |
7168470212
|
Plan sponsor’s
address |
206 S. ELMWOOD AVENUE, BUFFALO, NY, 14201
|
Signature of
Role |
Plan administrator |
Date |
2019-07-02 |
Name of individual signing |
JESSE GASBARRO |
|
Role |
Employer/plan sponsor |
Date |
2019-07-02 |
Name of individual signing |
JESSE GASBARRO |
|
|
EHS, INC. STD PLAN
|
2013
|
161202971
|
2014-05-22
|
EHS INC.
|
119
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2013-01-01
|
Business code |
624100
|
Sponsor’s telephone number |
7168470212
|
Plan sponsor’s mailing address |
206 SOUTH ELMWOOD AVENUE, BUFFALO, NY, 14201
|
Plan sponsor’s
address |
206 SOUTH ELMWOOD AVENUE, BUFFALO, NY, 14201
|
Number of participants as of the end of the plan year
Active participants |
141 |
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 |
2014-05-21 |
Name of individual signing |
MICHAEL HAMANN |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2014-05-21 |
Name of individual signing |
RONALD SILVERIO |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
EHS, INC 403(B) PLAN
|
2012
|
161202971
|
2013-06-13
|
EHS INC
|
119
|
|
File |
View Page
|
Three-digit plan number (PN) |
003
|
Effective date of plan |
1998-09-05
|
Business code |
624100
|
Sponsor’s telephone number |
7168470212
|
Plan sponsor’s
address |
206 SOUTH ELMWOOD AVENUE, BUFFALO, NY, 14201
|
Signature of
Role |
Plan administrator |
Date |
2013-06-10 |
Name of individual signing |
MICHAEL HAMANN |
|
|